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I <br />(a) Is there a PIIS-EIID contractor's questionnaire on rile or enclosed? <br />(b) Is the current certificate of worker's compensation insurance on rile? <br />(c) Does the contractor possess a 'Hazardous Substance Removal Certification`! <br />Has a 'Site Health & Safety Plan' for this job site been submitted? <br />YES [)j <br />NO[] <br />YES [X] <br />NO I I <br />YES IkI <br />NO [ ] <br />YES DO <br />NO [ ] <br />Has applicant performing removal in the City of Tracy obtained a 'Grading and Excavation Permit'? <br />N/A [X] YES [ ] NO [ ] If YFS, Permit # <br />Has the contractor obtained approval from the local fire department to perform tank cutting? NAr] YES[ ] NO[ I <br />Is there knowledge or evidence of leakage from the tank(s) and/or piping? (If yes, please explain) YES [ ] NO ICY, <br />6. If tank residual exists, identify transporting hazardous waste hauler. <br />PRC Patterson Inc. <br />Name dba Refineries Services Hauler Registration # 2591 <br />Address 13331 N.Hwy 33 Cit. Patterson Zip 95363 <br />Phone # ( 800 ) 874-4444 <br />7. Decontamination Procedures: <br />a. Will tank(s) and piping be decontaminated prior to removal? YES [ I NO [ <br />b. Identify contractor performing decontamination: <br />Name /(1 <br />Address City Zip <br />Phone <br />C. Describe method to be used for decontamination: <br />'flA <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />e. Rinsate Hauler_and permitted-Treatment,.Storage <br />" & Disposal Facility: <br />Hauler Name /y /T Hauler Registration # <br />Phone No. <br />Permitted Disposal <br />Page 4 <br />City <br />Zip <br />