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SAN JOAQUIN <br />--COUNTY <br />c. Tank/Piping Disposal Site: <br />Name WEST COAST EQUIPMENT <br />Address P.O. BOX 2368 <br />Phone No.( 800 <br />441-8544 <br />Environmental Health Department <br />City TURLOCK Zip 95381 <br />EPA ID# (if transported to a permitted TSD facty) N/A -TANK WILL BE TRANSPORTED AS NON -HAZARDOUS <br />9. Is the sampling firm an independent third party from the contractor (REQUIRED)? <br />YES pC] NO [ ] <br />9a. Describe, in detail, how the soil and/or water samples) beneath the tank and piping will be obtained: <br />Soil samples will be collected from backhoe bucket using a metric soil sampler and loaded with clean steel sleeves. <br />Ends of each sample sleeve will be covered with teflon sheets, plastic caps and sealed with duct tape. <br />10. Describe how the excavation will be backfilled with suitable material u on removal: <br />Self -compacting pea -gravel will be imported to replace the volume ofpthe UST. <br />11. Handling of excavated soil: <br />a) What material will be used to line the tank pit and cover the stockpile? <br />4 -mil plastic sheeting <br />12 <br />13 <br />14. <br />b) What will be the final destination of the excavated stockppile? <br />Excavated soil will be used for backfill. If excavated soil significantly impacted, soil will be stockpiled on-site pendng <br />characterization for proper disposal. <br />c) Contaminated Soil Hazardous Waste Hauler: <br />ame <br />RB ENVIRONMENTAL, INC, Hauler Registration # 3946 <br />N <br />Address 4460 SOUTH HIGHWAY 99 FRONTAGE ROAD City STOCKTON Zip 95215 <br />Phone Number( 209 932-0606 <br />What is the depth to groundwater? Approx. 25' - 30' .Based on information from nearby monitoring wells (Geotracker) <br />Describe the source of information: <br />Are there any water wells on this parcel or adjacent properties? <br />YES[ <br />] NO [x] <br />Will the tanks) 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 <br />permit payment per tank. If the party designated below is different than the permit applicant, e.g. property <br />owner, the party must acknowledge this responsibility for the billing by signature and date below. <br />Name RB ENVIRONMENTAL, INC. <br />Mailing Address 4460 SOUTH HIGHWAY 99 FRONTAGE ROAD, STOCKTON, CA 95215 <br />Day Phone Number ( 209 ) 932-0606 <br />5of10 <br />TYPE OF WELLS <br />DISTANCE TO TANKS(S) <br />Public Well <br />11050 ft NE <br />Private Well <br />ft. <br />Irrigation Well <br />ft. <br />Monitoring Well <br />850 ft. S <br />Other <br />ft. <br />Will the tanks) 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 <br />permit payment per tank. If the party designated below is different than the permit applicant, e.g. property <br />owner, the party must acknowledge this responsibility for the billing by signature and date below. <br />Name RB ENVIRONMENTAL, INC. <br />Mailing Address 4460 SOUTH HIGHWAY 99 FRONTAGE ROAD, STOCKTON, CA 95215 <br />Day Phone Number ( 209 ) 932-0606 <br />5of10 <br />