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I <br /> i <br /> GENERAL INFORMATION: <br /> 1. Gbtnin an EPA She Number from tine Department of Fleatth Services (916) 324-1781 for lemporary <br /> hn7ardoue waste removal activities assodnted with underground storage lank (UST) removals. <br /> 2. Disposal Information: Public Ifeallh Services Tracking Sheet shall accompany each lank removed <br /> I <br /> from site. 'Tnok(s) will be issued all Identification number which PIIS-WID's reptesentallvewill note <br /> on tile, 'lank 'Trncking Sheel. Contractor will Affix slime Identification number onto tnnk end using <br /> Ilnorescenl spray paint. Coutandnated ranks and/or piping are to be transported under Hazardous <br /> Whsle Manifest by a slate rcglsletcd Ina7ardous waste hauler. <br /> 1. Connncotr to Provide: Combustible/FlaIII nable gas detector (if) verify the tower Explosive IAMB <br /> (I.F.I,)nlmosphcre And oxygen level of lank prlor Io 1101,19 front excavntion),Adequate number(s)and <br /> npq,roprlate type(i)of fire exlinguisher(s),barriers to secure tine area as necessary to minimize traffic <br /> and pedestrian interference, and fimorescent spray pnint to affix lank identification numbers. It shall <br /> be Ilse project manager's responsiblllly for complinuce with all health & safely regulations and <br /> lequlrennents,which shall be sitictiy Adhered to At all times doting the course of tine closure activities. <br /> 4 'I he PI IS-Fit ID pernnit simll be on site during tank excavnllon and tettroval. <br /> 5. Any changes in tlds document shall be Approved by PHS-EIID prior to Initiating work. <br /> 6. Closure-III-I'Ince: If Closure-ht-Pince is the suggested method of abandonment, complete form <br /> Fit 23 039 still submit written approval from the local Fire Department. <br /> 1. Tempnrnoy Closure: If,lcnnporary Closule is the suggested method of abandonment, complete <br /> form El 123 046 And submit written approval horn line local Fire Depatunent. <br /> 8. 'I he following documenlalion shall be subnnitted within 30 days of the tank removal <br /> I <br /> dale: <br /> A) Annlytiusl results,ill-'lied directly hon, laboralony to PI IS-EIID,Including a chain of custody. <br /> i <br /> b) Tank Tracking Record Sheel(s) and/or 'lank Ilazaidoms Waste Manife-M(s). <br /> c) I1a7,rodous Waste Manifests for piping, rhrsale, csidual fuel, or waste oil receipt. <br /> d) Submit the backfill excavation certificate Its required by San Joaquin County and the <br /> Incorporated City 0uiiding Departments. Hans report will be referred to the appropriate <br /> Agency for their review. <br /> A slle which Ins had IIST(s) removed, shall not Ire considered for Final closure milli file nlwve Iletns <br /> nae submilled ror review. <br /> I <br /> I <br /> EI1 23 U40 (Revised 7-IU-92) Page 2 <br />