Laserfiche WebLink
0 0 <br /> 1 (a) Is the current uertifioateofworkers NO <br /> (b) Does the contractor possess o"Hazardous Substance Removal Certification"? Y�o <br /> NO <br /> (c) Has everyone onade,including crane/backhoe ' ratu� been certified towork on <br /> hazardous waste sites inaccordance with CCR Title 8' YESX [] <br /> NO <br /> 2. Has o"Site Health&Safety Plan"for this job site been submitted? Y�nu�' NO[] <br /> - <br /> @. Has applicant perfbnningnamowa|/n\hCity of Tracy obtained a"Grading and Excavation Permit"? <br /> YES[] NO[] If YES, Pwnnit# <br /> 4. Has the contractor obtained approval from the local fire department to perform tank cutting?N~^<EG[] NO[] <br /> ~ ` <br /> 5. Iothere knowledge urevidence ofleakage from the tanh(s)and/or piping? (if yes,please explain)YES[] WW4 <br /> 6. If tank residualmxistu identify transporting <br /> Name Hauler Registration` <br /> 35 <br /> Phone#LRVQ) J. 302- 9,716- <br /> 7. Decontamination Procedures: <br /> a. Will hmnk(o)and piping bedecontaminated prior&oremoval? YE��� NO <br /> b. |denb�con�a�orpedbnminAdems�amina�on: ` <br /> Name me,. <br /> Phone No.( <br /> C. Describe <br /> d. Describ how nns_ate material will be stored onsite prior to manifesting offsite: <br /> ~ - � <br /> e. RinsateH ke d pennift d T Storage&Disposal Facility:rea �e7n <br /> Hauler Name Hauler Registration <br /> Address-2L city Zi <br /> Permitted Disposal Site46�J���/ <br /> O. a. Describe <br /> b. Tank/PipingHeu(ac <br /> Name <br /> Address city zip <br /> Hauler Reg|mtoation#(if hauled mshezan±uue <br /> A4 Vile 57Z <br /> E823046 (Bbevivad8/l/11) 4 ' <br />