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SA N J O H Q U I N Environmental Health Department <br /> COUNTY <br /> c. Describe method to be used for decontamination: <br /> NIA <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> L 14 <br /> e. Rinsate Hauler and permitted Treatment, Storage& Disposal Facility: J(lq <br /> Hauler Name Phone Hauler Reg# <br /> Address City Zip <br /> Permitted Disposal Site <br /> 6. a. Describe the method that will be utilized to purge and/or inert the piping: <br /> f7 <br /> b. Piping Hauler: <br /> Name A Phone ( � <br /> Address City Zip <br /> Hauler Registration#(if hauled as hazardous) <br /> c. Piping Disposal Site: /�� <br /> Name 7� Phone(�) <br /> Address City Zip <br /> EPA ID#(if transported to a permitted TSD facility) <br /> 7. Is the sampling firm an independent third party from the contractor? YES [} NO [} <br /> a. Identify sampling firm; 1 r ^ <br /> Name /7�1 Phone( <br /> Address City Zip <br /> b. identify laboratory performing analysis: <br /> Name fy t Phone {� <br /> Address City Zip <br /> 8. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br /> 9. a. Handling of excavated Nil (Contaminated Soil Hazardous Waste Hauler): <br /> Name /�`( I"r Hauler Registration# Phone (_ ) <br /> Address City Zip <br /> b. If soil is not to be hauled, describe what will be done with it: <br /> V L D <br /> 4of5 j A1 91 2 M8 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br />