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10/22/2008 WED 8: 30 FAX 2094683433 SJC BED »+- Elite Iv 006/006 <br /> ZZ 0� <br /> RUST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 2 sets of plans&applications as originals will be retained by EHD) <br /> I- Site map enclosed YES[I NO f) <br /> 2 manubclurers spec sheets attached br all equipment to be installed YES[) NO[t <br /> - Descxtptlon of work to be compbefed(!f a ftng piping.UDC's,or other UST I r tank t <br /> Ur USTWon Appication pages 4-8 as necessary for a equiprrrenl;or rfpsmf opupgrade <br /> � ctllP�n4. <br /> rrt to be used draw- neoe-nary). <br /> 5. AN equipment is State celled or appiovr d. YES f) Nb f j <br /> 6. DecoriMminattion Procedures` <br /> a. Will piping be decontaininated prior to removal? YES f] No[) <br /> b_tden67y contractor performing decontamination: <br /> Name <br /> Address Phone(___) <br /> Cdy Zsp <br /> c. Describe mefhnd to be used for decontamination: <br /> ------------- <br /> d Desaibe how Msate mMerial wilt be stored onsde prior to manifesfaig offsite: <br /> e. Ftilnsate Hauler and Permid ed Treaft�Storage&Disposal Faa'iity, <br /> Acid�Hauter�'e One(—J Hauler <br /> P'trrniiftexi Disposal She Coy— -- <br /> 7. a- Desch the method that Qt be udifized to purge andlor best tine ptijr <br /> b. riptng Hauler. <br /> Narde <br /> Phone{^ ) <br /> Hat& lte9istratgaar d(dt�ded as harardous 1 —_ rrP <br /> C. Piping Disposal Site: <br /> Name <br /> Address Phone( ) <br /> EPA MW(if to a Permitted TSV faclfi Coh Zgr <br /> S. is the camping firm an independerit(bird party fmm Me contractor?YES[) Nt?[f <br /> 9. Desonbe,in detail.tow the soR andlor waler sample(s)berrea6i gre piping or dispenser wi l be obtained. <br /> 10. !rKWng of excawled$GO(Contaminated-Soft Fhm2u lous Waste timer): <br /> Name <br /> Address HauW Registration g Phone(� <br /> Zip- <br /> b)If$oil is not to be houled,desenbe what will be stone wkh W <br /> 2 <br />