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(a) Is there a PHS•EHD contractors and subcontractors questionnaire on file or enclosed? YES NO ( ] <br />(b) Is the current certificate of worker's compensation Insurance on tile? YES No ( ] <br />(c) Does the Contractor possess a "Hazardous Substance Removal Certification"? YES NO [ ) <br />(d) Has everyone on site, including cranelbackhoe operator, been certified <br />to work on hazardous waste site in accordance wltb CCR Title 8? YES I No I 1 <br />Z. Has a "Site Health & Safety Pian" for this Job site been submitted? YRS f NO ( ] <br />3. Has applicant performing removal In the City of Tracy obtained a "Grading and Excavation Permit"? <br />NIA a YES[ ) NO [I If YES, Permit # <br />4. Has the contractor obtalned approval from the local fire department to perform tank cutting? NA( ] YES[ I NOR <br />S. Is there knowledge or evidence of leakage from the twNs) and/or piping? (If yes, please explain) YES (] NO (� <br />6. If tank residual exists, Identify transporting hazardous waste hauler. <br />Name N/A — No Residual — Tanks Empty Hauler Registration #. <br />Address city 7Ap <br />Phone # <br />Decontamination Procedures_ <br />a. Will tank(s) and piping be decontaminated prior to removal? YES a NO [ ] <br />b. identity contractor performing decontamination: <br />Name Ramcon Engineering & Environmental contracting Tn <br />Address 3751 Commerce Drive City W. Sacramento Zip 95691 <br />PhoneNo4 916 1 372-7535 <br />C. Describe method to be used for deeantaminatioa <br />Triple Rinse with High Pressure Hotsv Nozzle Using Ripper II Solution <br />d. Describe how dusate material will be stared unite prior to manifesting affairs: <br />Rinseate will not be stored on site <br />Rinseate will be removed and hauled awa with Vac Truck <br />e. Rinsate Hauler and permitted Trestmem, Storage & Disposal Facility: <br />0518 <br />HauierName Ramos Environmental Himierilegistration# CAD 04400355 <br />Address 1515 South River Road Olay W. Sacramento Zip 95691 <br />Phone Na( 916 ) 371-5747 <br />Permitted Disposal Site 1515 South River Road, West Sacramento, CA 95691 <br />21128046 (Revised 0812199) Page 4 <br />