Laserfiche WebLink
S-- -H N J O HQ II N Environmental Health Department <br /> -- COUNTY <br /> REFER TO 1991 DOCUMENTS AT SJ EHD FOR REMOVAL & DISPOSAL DETAILS <br /> 1 . (a) Is the current certificate of worker's compensation insurance on file? Ground Zero YES K ] NO [ ] <br /> (b) Does the contractor possess a " Hazardous Substance Removal Certification " ? N/A YES [ ] NO [ ] <br /> (c) Has everyone on site , including crane/backhoe operator, been certified to work on YES .K NO [ ] <br /> hazardous waste sites in accordance with CCR Title 8? <br /> 2 . Has a "Site Health & Safety Plan " for this job site been submitted ? YES M NO [ ] <br /> 3 . Has applicant performing removal in the City of Tracy obtained a "Grading and Excavation Permit"? <br /> N/A N YES [ ] NO [ ] If YES , Permit # <br /> 4 . Has the contractor obtained approval from the local fire department to perform tank cutting? NAQK ] YES [ ] NO [ ] <br /> 5 . Is there knowledge or evidence of leakage from the tank(s) and/or piping ? (If yes , please explain) YES [ ] NO [ ] <br /> Tank was removed June 1991 , no excavation will be done for this project. Refer to SJC EHD files for this site to obtain <br /> additional information of tank removal <br /> 6 . If tank residual exists , identify transporting hazardous waste hauler: NOT APPLICABLE <br /> Name Hauler Registration # <br /> Address City Zip <br /> Phone # ( ) <br /> 7 . Decontamination Procedures : Tank was removed in June 1991 , this is not applicable <br /> a . Will tank(s) and piping be decontaminated prior to removal ? YES [ ] NO [ ] <br /> b . Identify contractor performing decontamination : <br /> Name <br /> Address City Zip <br /> Phone No . ( ) <br /> C, Describe method to be used for decontamination : <br /> d . Describe how rinsate material will be stored onsite prior to manifesting offsite : <br /> e . Rinsate Hauler and permitted Treatment , Storage & Disposal Facility: <br /> Hauler Name Hauler Registration # <br /> Address City Zip <br /> Phone No . ( ) <br /> Permitted Disposal Site <br /> 8 . a . Describe the method that will be utilized to purge and/or inert the tank(s) : Tank was removed in June 1991 , this is not applicable <br /> b . Tank/Piping Hauler: See SJ EHD Files <br /> Name <br /> Address City Zip <br /> Phone No. ( ) <br /> Hauler Registration # (if hauled as hazardous) <br /> 4of10 <br />