REMOVAL_1998 - Laserfiche WebLink

Home Browse Search

r 1. (a) Is there a PHS-EHD contractor's questionnaire on file or enclosed? YES [4 NO [ J (b) Is the current certificate of worker's compensation insurance on file? YES [ NO [ J (c) Does the contractor possess a '91=rdoas Substance Removal Certification"? YES [ NO [ J (d) Has everyone on site, including crane/backhoe operator, been certified to work on hazardous waste site in accordance with CCR Title 8? YES NO [ J 2. Has a "Site Health & Safety Plan" for this job site been submitted? YES It NO [ [ 3. Has ap,yplicant performing removal in the City of Tracy obtained a "Grading and Excavation Permit"? N/A K YES [ [ NO [ J If YES, Permit # 4. Has the contractor obtained approval from the local fire department to perform tank cutting? NA[A YES[ J NO[ J 5. Is there knowledge or evidence of leakage from the tank(s) and/or piping? (If yes, please explain) YES [ J NO X 6. 7 If tank residual exists, identify transporting hazardous waste hauler: Name Allied Petroleum Hauler Registration it 1158 Address Po Box 193 City Modesto Zip 95352 Phone #( 209 ) 576-8500 Decontamination Procedures: a. Will tank(s) and piping be decontaminated prior to removal? YES bd NO [ [ b. Identify contractor performing decontamination: Name SL'MCO Address 1217 S. 7th St. City Modesto Zip 95351 Phone Na( 209 ) 524-9653 C. Describe method to be used for decontamination: The tanks & piping will be triple rinsed at 1800 using a low vola pressure washer. The first rinse will include the use of a bio dei d. Describe how rinsate material will be stored onsite prior to manifesting offsite: The rinsate material will be stored on site in DOT 55 gallon drums with appropriate labels. e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: Hauler Name Allied Petroleum Hauler Registration # 1158 Address PO Box 193 City Modesto Zip 95352 Phone No.( 209 ) 576-8500 Permitted Disposal Site Americlean - Si Iver _ rin= NV EH 23 046 (Revised 7/10/96) Page 4