Laserfiche WebLink
SA g (1 � O � {� N Environmental Health Department <br /> Cil O U rJ T Y - <br /> c. Describe method to be used for decontamination : tt <br /> ( �S ( 5 'cr '�a ►. K par < WA Af'pra `ici ; baS fz inerT'j <br /> ce, <br /> r <br /> d . Describe how rinsate material will be stored onsite prior to manifesting offsite : <br /> No riaSalse V.Sed <br /> e . Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone �_) Hauler Reg# <br /> Address City Zip <br /> Permitted Disposal Site <br /> Ism <br /> 1.4 <br /> 6 . a . Describe the method that will be utilized to purge and/or inert the piping : <br /> Alaa.? bac, `fuel !r� �o abs yo I &Ir-; e i � Hi 6z� g �r v inert 11 �-• <br /> ?3' T <br /> sun fa dty r- <br /> cs � d ► � P" rosed pY¢� 'I ti E� jCoo J <br /> b . Piping Hauler: <br /> Name Phone C.) <br /> Address City Zip <br /> Hauler Registration # ( if hauled as hazardous) <br /> c. Piping Disposal Site: <br /> Name Phone (__) <br /> Address City Zip <br /> EPA IM (if transported to a permitted TSD facility) <br /> 7 . Is the sampling firm an independent third party from the contractor? YES [ ] NO [ ] <br /> a . Identify sampling firm : tj ' t <br /> Name Phone (.) <br /> Address City Zip <br /> b . Identify laboratory performing analysis : <br /> Name Phone �) <br /> Address City Zip <br /> 8 . Describe , in detail , how the soil and/or water sample (s ) beneath the piping or dispenser will be obtained : <br /> 9 . a . Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler) : <br /> Name Hauler Registration # i – ` — {', e . rnm Pk� <br /> Address City ?� . �:• � ? _ P i <br /> i 4 <br /> b . If soil is not to be hauled , describe what will be done with it: <br /> ENVIRONMENTAL HEALTH <br /> 4 of 6 DEPARTMENT <br />