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I <br /> II. GENERAL INFORMATION: I. <br /> 1. Obtain an EPA Site Number from the Department of Toxic Substances Control (800) 61-TOXIC for temporary <br /> hazardous waste removal activities associated with underground storage tank (UST) removals. <br /> 2. Disposal Information: Public Health Services Underground Storage Tanis Disposition Tracking Record (UST <br /> Tracking Record, page 10) shall accompany each tank removed from site. Tank(s) will be issued an identification <br /> number which PHS-EHD's representative will note on the UST.Tracking Record. Contractor will affix same <br /> identification number onto tank end using fluorescent spray paint. Contaminated tanks and/or piping are to be <br /> transported under Hazardous Waste Manifest by a state registered hazardous waste hauler. <br /> i <br /> 3. Contractor to Provide: Combustibie/Flammable gas detector (to verify the Lower Explosive Limit (LEL) <br /> atmosphere and oxygen level of tank prior to lifting from excavation),;adequate number(s) and appropriate type(s) <br /> of fire extinguisher(s), barriers to secure the area as necessary"to minizniae traffic and pedestrian interference, and <br /> fluorescent spray paint to affix, tank identification numbers. It shall be' the project manager's responsibility for <br /> compliance with all health & safety regulations and requirements, which shall be strictly adhered to at all tithes <br /> F during the course of the closure activities. <br /> f 4 The PHS-EHD permit shall be on site during tank excavation}d removal. <br /> Ib <br /> Any changes in this document shall be approved by PHS-EHD;prior to initiating work. <br /> 6. Closure-in-Place: If Closure-in-Place is the suggested method,of abandonment, complete form <br /> EH 23 039 and submit written approval from the local Fire Department. <br /> la <br /> 7. Temporary Closure: If Temporary Closure is the suggested method of abandonment, complete <br /> and submit this form and a written approval from the local Fire Department. <br /> The following documentation shall be submitted within'30 days of the tank removal date: <br /> �l <br /> a) Analytical results, mailed directly from laboratory to PHS-EHD, including a chain of custody and quality <br /> assurance and quality control (QA & QC). <br /> b) UST Tracking Record Sheet(s) and/or Tank Hazardous Waste Manifest(s). <br /> C) Tank Closure Certification Form(DTSC form 1249),I,i <br /> d) Hazardous Waste Manifests for piping, rinsate, residual fuel, or waste oil receipt. <br /> I� <br /> C) Submit the backfill excavation certificate as required by San Joaquin County and the incorporated City <br /> Building Departments. This report will be referred to the appropriate agency for their review. <br /> k <br /> A site which has had UST(s) removed, shall not be considered for final closure until the above items are <br /> submitted for review. <br /> a' <br /> III. SITE MITIGATION: <br /> j1 <br /> i <br /> 1. In the event contamination is observed, confirmed or suspected as,a result of a leaking UST system it is the <br /> responsibility of the owner or operator to submit a workplan to PHS-EHD Site Mitigation Unit prior to initiating <br /> any assessment or remediation activities. To minimize delays'!a Corrective Action Plan may be submitted <br /> concurrent with tank closure or installation plans. Address one copy of the Corrective Action Plan to the Site <br /> Mitigation Unit for review. For further assistance contact the Site Mitigation Unit at (209)468-3450. <br /> li <br /> EH 23 046 (Revised l0/19198) Page 2 <br />