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11_ GENERAL INFORMATION: <br /> 1. Obtain an EPA Site Number from the Department of Toxic Substances Control (SM) 61-TO)UC for temporary <br /> hazardous waste removal activities associated with underground storage tank(USI) removals. <br /> 2. Disposal information: Public Health Services Underground Storage Tank Disposition Tracking Record(USI' <br /> Tracking Record, page 10) shall accompany each tank removed from site. Tank(s)will be issued an identification <br /> number which PIIS-EHD's representative will nate on the UST Tracking Record. Contractor will affix same <br /> identification number onto tank end using fluorescent spray Paine Conremirm tanks and/or piping are to be <br /> transported under Hazardous Waste Manifest by a state registered hazardous waste hauler. <br /> 3. Contractor to Provide: Combustible/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 extinguj.-her(s), barriers to secure the area as necessary to minimize ti;atfic and pedestrian im=ference, and <br /> fluorescent spray paint to affix tank identification numbers. It shall be die Project manager's responsibility for <br /> compliance with all health & safety regulations and requirements, which shall be strictly adhered to at all times <br /> during the course of the closure activities. <br /> 4 The PHS-EHD permit shall be on site dazing rank excavation and removal. <br /> 5_ Any Chi m this document shall be approved by PHS-E-11) prior w initiating work. <br /> 6. Closare-ia-Place: If Closure-in-Place is the suggested method of abandonment. complete form <br /> E.`i 33 039 and submit written approval from the local Fire DeParmtepr. <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 ;oral Fire Department <br /> - <br /> S. The following documentation shall be submitted within 30 days of the tank removal date: <br /> a) Analytical —suits, mailed directly from taboratory to PHS-EKD, including a chain of cushy 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 (OTSC form 1249). <br /> d) Hazardous Waste Manifests for piping, unsafe, residual fuel, or waste o8 receipt. <br /> C) Submit the backfill excavation certificate as regaired'oy San Joaquin County and the incorporated Cln' <br /> 3udding Departments, This report will be referred w the appropriate agency for their review. <br /> A site which has had UST(s) removed, shall not be considered for final closure tmtfl the above items are <br /> submitted for review. <br /> M. SITE MTTIGATION: <br /> 1. In the event contamination is observed, ermPirmed or suspected as a result of a lealang UST system it is the <br /> responsibility of the owner or operator to submit a workplan to PHS-EHD Site Muiptioa Unit prior m initiating <br /> any assessment or ranediation activities. To mSmimize dr—says, a Cormtrve Action Plan may be snbmitrcd <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 farther assistance contact the Site Mitigation Unit at(209)468-3450. <br /> EH 23 046 (Revi3edl0/19/98) Page 2 <br />