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GENERAL INFORMATION: <br /> 1 Obtain an EPA Site Number from the Department of Toxic Substances Control(800iemo OXIC for temporary <br /> bazardous waste removal activities associated with underground storage tank(UST) <br /> 2 Disposal Information: SIC EHD's Underground Storage Tank Disposition Tracking Record(UST Tracking Record, <br /> page 10)shall accompany each tank removed from site. Tank(s)will be issued an identification number which EHD's <br /> representative will note on the UST Tracking Record. Contractor will affix same identification nil er onto tank end <br /> using fluorescent spray paint. Contaminated tanks and/or piping are to be transported under Hazardous Waste <br /> Manifest by a state registered bazardous waste hauler. <br /> 3. Contractor to Provide: Combustible/Flammable gas detector(to verify the Lower Explosive Limit(LEL)atmosphere <br /> and oxygen level of tank prior to lifting from excavation),Rdngm'e tr ffic rasa and <br /> dePman inSerfereIICe Of <br /> fluorescent <br /> extinguisher(s),barriers to secure the area as necessary to fire <br /> re onsibili for compliance with all <br /> spray paint to affix tank identification numbers. It shall be the prcj ect manager'ssp tY <br /> health&safety regulations and requirements,which shall be strictly adhered to at all times during the course of the <br /> closure activities. <br /> 4 The EHD permit shall be on site during tank excavation and removal. <br /> 5 Any changes in this document shall be approved by 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 and Temporary <br /> this form and a written approval from the local Fire abandonment,complete <br /> Fire Department <br /> 8. The following documentation shall be submitted within 30 days of the tank removal date: <br /> a) Analytical results,mailed directly from laboratory to EHD,including a chain of custody and quality assurance <br /> and quality control(QA&QC). <br /> b) UST Tracking Record Sheet(s)and/or Tank Hazardous Waste Manifest(s). <br /> C) Tank Closure Certification Form(DTSC form 1249). <br /> d) Hazardous Waste Manifests for piping,riusate,residual fuel,or waste oil receipt. <br /> e) Submit the backfill excavation certificate as required by San Joaquin County and the incorporated City <br /> Building Departments. This report will be referred to the appropriate agency for their review. <br /> A site which has had UST(s)removed,shall not be considered for final closure until the above iterns are <br /> submitted for review. <br /> III. SITE MITIGATION: <br /> 1. In the event contamination is observed,confirmed or suspected as a result of a leaking UST system it is the <br /> responsibility of the owner or operator to submit a work plan to EHD Site Mitigation Unit and have it approved prior <br /> to initiating any assessment or remediation activities. To minimize delays,the work plan maybe submitted concurrent <br /> with tank closure or installation plans. Address one copy of the work plan to the Site Mitigation Unit for review. If the <br /> site is not currently in the Local Oversight Program,a billing form and a$24678 minimum fee must be submitted with the <br /> work plan. For further assistance contact the Site Mitigation Unit at(209) 3 <br /> 450. <br /> EH 23 046 (Revised 3/15/02) Page 2 <br />