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S (3) is there a PS4EHD caotnctor's and saboontreetoe questionnaire on file or enclosed? YES;q No 11 <br /> 1b) Is the current certtflcate of worker's compensation lasaranca on tile? YES No 11 <br /> (c) Does the contractor possess a•Harat dam Substance Removal Cartlneatlan"? Y88 NU[i <br /> (d) Has svet7oaa an site,t7cludint eraneibacWlce operue:,been certfled <br /> to work on hazardous waste site in accordance wltk CCH Tlde st MSM No <br /> 2 Has a 'Site Health S Safaty Plan" farthis job site been submftzed? YES NO 11 <br /> Has appheanr Performing remaeal in the tlty it Tracy sbtained a'Grading and sxc00011 Permit"? <br /> N!A[1 us 11 No(; if YES, Permits~ <br /> 1 Has the Contractor obtalned approval trom the local fire department to perform tank Catdt V NA[1 YES(I No(1 <br /> n. Is there imowledga or evidence of leakagt frost:the ta0S)a=d.'ar 1141111? (it yes,please explain)YE911 N0[) <br /> S. 11 tank residual eAsta,Sdendt3 transporting hazardous waste hauler. <br /> Waste Oil Haulers Hauler Registration CAD 982417255 <br /> Name NORCAL <br /> Addrm P.O. Box 645 City Denair , CA ap 95316 <br /> Phones( 800 i 322-8710 <br /> DeccntazalnatIoU PMOednres: <br /> a. Will tanks)and piplttg be W-econuminated price to removal? YES(X 110i <br /> b. Sdentlfyeontraetarperlaemingdecontamina:on: <br /> Name Jim Thorpe Oil , Inc. <br /> 8.daress <br /> P.O. Box 357 glty Lodi , CA Zip 95241-0357 <br /> Phone Na' 2� ) 368-6175 <br /> e. Describe method to he usad for decontamination: <br /> m i ( c) ixill ha tri rain ncarl ith <br /> manner. <br /> d Desebe haw rinsate matetielwill be stored onsite prior to manifesting offsite: <br /> Rinseate will either be removed from t t nk s nd lines as <br /> �,.,1,1or dire j into his <br /> thev are beans r sed by the wast Y—� <br /> truck, or be stored in sealedsed dprums until it can be disposed of . <br /> e Hlnsare Hauler and pemaittad Treatment.StoragTr <br /> Hauler Name Same as #6 Hauler Registration t <br /> ,address Circ �p <br /> Phone No.l I <br /> Per==dDispasalsite Americlean, Inc. 2570 Almond Dr. , Silver Springs , <br /> NV. or other approved facility. <br /> EH 22 G18 (Ravlsed 001 131 'age� <br />