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*A,/ <br /> IL GENERAL INFORMATION: <br /> 1. Obtain an EPA Site Number from the Department of Toxic Substances Control (800) 61-TOXIC for <br /> temporary hazardous waste removal activities associated with underground storage tank(UST) removals. <br /> 2. Disposal Information: Public Health Services Underground Storage Tank Disposition Tracking Record <br /> (UST Tracking Record, page 10) shall accompany each tank removed from site. Timk(s) will be issued <br /> an identification number which PHS-EHD's representative will nae on the UST Tracking Record. <br /> COnua"Or will affix same identification number onto tank end using fluorescent spray paint. Contaminated <br /> tanks and/or piping are to be transported under Hazardous Waste Manifest by a state registered hazardous <br /> waste hauler. <br /> 3. Contractor to Provide: Combustible/Flartunable gas detector(to verify the Lower Explosive Limit(LEL) <br /> atmosphere and oxygen level of tank prior to lifting from excavation), adequate number(s)and appropriate <br /> type(s) of fire extinguisher(s), barriers to secure the area as necessary to minimize traffic and pedestrian <br /> interference, and fluorescent spray paint to affix tank identification numbers. It shall be the project <br /> manager's respousibility for compliance with all health&safety regulations and requirements, which shall <br /> be strictly adhered to at all titins during the course of the closure activities. <br /> 4 The PHS-EHD permit shall be on site during tank excavation and removal. <br /> 5. Any changes in this document shall be approved by PHS-EHD prior to initiating work. <br /> 6. Closure-in-Place If Closure-in-Place is the suggested method of abandonment, complete form <br /> EH 23 039 and submit written approval from the local Fire Department. <br /> 7. Temporary Closure If Temporary Closure is the suggested method of abandonment, complete <br /> and submit this form and a written approval from the local Fire Department. <br /> 8. The following documentation shall be submitted within 30 days of the tank removal <br /> [late: <br /> a) Analytical results, mailed directly from laboratory to PHS-EHD, including a chain of custody and <br /> quality assurance and quality control(QA &QC). <br /> b) UST Tracking Record Sheet(s) and/or Tank Hazardous Waste Manifest(s). <br /> c) Hazardous Waste Manifests for piping, rinsate, residual Net, or wane oil receipt. <br /> d) Submit the backfill excavation certificate as required by San Joaquin County and the incorporated <br /> City Building Departments. This report will be referred to the appropriate agency for their <br /> review. <br /> A site which has had UST(s) removed, shall not be considered for final closure until the above iteral <br /> are submitted for review, <br /> HI. SITE MITIGATION: <br /> 1. In the event contamination is obscrvcd, confirmed or suspected as a result of a leaking UST system it is <br /> the responsibility of the owner or operator to submit a workplan to PHS-EHD Site Mitigation Unit prior <br /> to initiating any assessment or rcmediation activities. To minimize delays. a Corrective Action Plan may <br /> be submitted concurrent with tank closure or installation plans. Address one copy of the Corrective Action <br /> Plan to the Site Mitigation Unit for review For further assistance contact the Site Mitigation Unit at(209) <br /> 468-3450. <br /> EH Z3 046 (Revised 10/24/97) Page 2 <br />