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SANJOAQUIN Environmental Health Department <br /> — COUNTY <br /> c. Tank/Piping Disposal Site : <br /> Name Wet oast E ^ � �_� t <br /> Address P . O . Box 2368 city Turlock, CA zip 95381 <br /> Phone No . ( 800 ) 441 - 8544 <br /> EPA ID# (if transported to a permitted TSD facility) N/A Tank will be transported as Non - Haz <br /> 9 . Is the sampling firm an independent third party from the contractor (REQUIRED)? YES [x] NO [ ] <br /> 9a . Describe , in detail , how the soil and/or water sample(s) beneath the tank and piping will be obtained : <br /> Soil samples will be collected from the backhoe bucket using a metric sampler and clean <br /> stainless steel of each sleeme. will be coyered with teflon sheets , capped and sealed with tape . <br /> 10 . De c i e how the excavati will ackfilled wit suit a material upo removal : „ <br /> 19 1 com actin , c` can Til materica� wit e im orted to re lace the volume of the UST . Soil excavated <br /> cluring removal will Be placea Dackinto the excavation , voly sneeting soil from ac ill if soil appears <br /> impacted. <br /> 11 . Handling of excavated soil : <br /> a ) What material will be used to line tree tank pit and cover the stockpile? <br /> 4 - mil plastic sheeting, it necessary. <br /> b ) Whatwill be the final esti on of th a ca ted s k ' I ? <br /> xc - . -sotI wt` d for� acic�l . �� impacted, soil may be stockpiled onsite and disposed of <br /> folloictio <br /> ler:aNagc) ContamHazardous aste <br /> Name L & B Environmental Inc . Hauler Registration # 3946 <br /> Address 4460 South Highway 99 cityStockton , CA zip <br /> _L515 <br /> Phone Number ( 209 ) 932 - 0606 <br /> 12 . What is the depth to groundwater? 45 feet below surface grade <br /> Describe the source of information : <br /> 13 . Are there any water wells on this parcel or adjacent properties? YES (x] NO [ ] <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> 7 <br /> Public Well 2500 ft. <br /> Private Well ft. <br /> Irrigation Well ft. <br /> Monitoring Well 500 ft. <br /> Other ft. <br /> 14 . Will the tank(s) pending closure be replaced with an aboveground or underground storage tank(s)? YES[ ] NO[X] <br /> 15 . Indicate the responsible party to be billed for additional EHD staff time expended beyond 3 hour minimum p <br /> permit payment per tank. If the party designated below is different than the permit applicant, e .g . property n /��j ,p� <br /> owner, the party must acknowledge this responsibility for the billing by signature and date below. S� ] �G( L' C C <br /> Name DBL Rentals - John Bubica e Walt <br /> Mailing Address 701 South Ham Lane - Suite C, Lodi, CA, 95242 <br /> �aq-F`Fi�one Number ( 209 ) 625 - 5261 <br /> 5of10 <br />