Laserfiche WebLink
NO <br /> 1 (a) is there a PHS•EHD cantridor's and subeomraetOr' gnestiaanalro on t11e Or enclosed? YES M N0(] <br /> (b) Is the current certificate Of worker's eompensatfan insurance an tile, <br /> (a) does the coatraetor possess a-Hazarttuus YES ND substance Removal Cartifloathm"? [1 <br /> (d) Bas a7et7one an sire,including rrane'baekhce operate,-,been certlffed YES N011 <br /> to work 07,hazardous roasts site In accordance with r TILle S? <br /> 2, Has a 'Site Heslth 4 31trety Pian" for this Job site been subtalxed? YES NO[] <br /> ?_ Has appli-ant perfarming retrieval In the tlty of Tracy obtained a"Grading and ECa7atl0ri Permlt"? <br /> NlAI; YES I1 *1oL it YES, Permit# ^ <br /> y Has rhe contractor obtatrtid appro7al front the local Are department to perform tank catling?NA[J YES[]N0[] <br /> 5. Is there imowledge or evidence of leakage batt.the tauls(s)amd:or piping? (It yes,please explain)YES([ NO[] <br /> 3. If tank rw ti lei sis.aL 1dC� naBo�rtlt4gy ous Waste battler. C I�L cr <br /> Name Waste Oil Haulers `HaulerRegistrations <br /> Address P.O. Box $'iG 751/0 plry Denair , CA 21p 9531,- <br /> Phone#L_890 j 322-8710 <br /> 7 Decrntaramatfon Procedures: <br /> a. Wilt tauk(s)and piping be decontaminated prior to removal? YHS( NO!] <br /> b. Identil]contractor performing decoummina'San: <br /> Name Jim Thorpe Oil , Inc . <br /> a,da"ass <br /> P.O. Box 357 City Lodi , CA ZIP 95241-0357 <br /> Phone No' 2{_09 368-6175 <br /> c. Describe method to be rued for deaontatn1na13om <br /> P <br /> manner . <br /> 1 desc ibe.haw rinsate tratertal WlH be stored onsite prior to manifesting offsite: <br /> Rinseate will either be removed from the tank( s) and lines as <br /> they are bei ri d by the ,-w-aste1 r <br /> ectly int his <br /> truck, or be stored in sealed drums until it can be disposed of . <br /> P_ Rm&ue Hauler and permittad Treatment.Storage k Dlspasal FaeAity: <br /> Rattier Name Same as #6 HaslerHegistretlon <br /> Address Clh.? zp <br /> Phone No.f I <br /> PermtttedGtsposalSite Americlean , Inc . 2570 Almond Dr . , Silver Springs, <br /> NV. or other approved facility . <br /> Page d <br /> E3 Gt8 (Revised ft H 2 <br />