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i, (a) is there a PES-EHD contractor's and sub contractor's questionnaire on file or enclosed? YES VNO{] <br /> (b) Is the current certificate of worker's compensation insurance on file? YES U''NO[] <br /> (c) Does the contractor possess a"Hazardous Substance Removal Certincation"? YES U,-NO[1 <br /> (d) Has everyone on site,including cranefbackhae operator,been certified <br /> to worts on hazardous waste site In accordance with CCR Title 8? YES <br /> 2_ Has a "Site Health&Safety Plan" for this job site been submitted? YES LSO[] <br /> 3, Has appli ant performing removal in the City of Tracy obtained a "Grading and Excavation Permit"? <br /> N/A YES[] NO[] if YES, Permit# <br /> 4. Has the contractor obtained approval from the local fire department to perform tank cutting?N ]]NO[] <br /> 5. Is there knowledge or evidence of leakage from the tank(s)andlor piping? (If yes,please explain)YES[] NOX <br /> 6. If tames residual exists,identify transporting hazardous waste hauler. <br /> Name Hauler Registration# )�7 <br /> Address. Z-155 UL—YA-rv-O City ie-}#NwP4P zlp Q4'ga <br /> #t � � Z ,S - <br /> Phone 0 t <br /> 7, Decontamination Procedures: <br /> a. Will tanks)and piping be decontaminated prior to removal? YESX NO [] <br /> b. Identify contractor performing decontamination <br /> NameG] <br /> Address 25.5- SPL 50U La4A7Q-CD city R L ivLo�,j o zip 9 4 g© <br /> Phone No.( ll z3s— r9 <br /> c. Describe method to be used for decontamination <br /> AC U "t p L)(!,v-_ RC-Mo VA-L-©r QE5 i QU 4L- UF—L, N oT .47C-9-PPU <br /> 'y��' UUh1 TR-uC.K <br /> d. Describe how rinsate material will be stored onsite prior to ma.nifestlug offsite: ticl � G <br /> Sia REQ o j YAC-UU* TRV C-K S poizj i, I4 YA-c <br /> e, Rinsate Hauler and permitted Treatment,Storage &Disposal FaciUrT. <br /> Hauler Name ®C 5 0 5,4L-�ZaM�C ty+'1 Cra L Co IIier Beg9stration# © ] f� <br /> Address city E T PAi-6 AVM <br /> Phone No.( 60 F5V <br /> Permitted Disposal Site �S Old e 4 -30 WCST 1(orN 5T` <br />