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• f'. `yIT <br /> b. Rinsate Hauler <br /> Name LLIC 720Z-e!4( I <br /> Address <br /> City State 6,4 _T Zip 2 <br /> Phone No. S 6 5 Od Hauler Registration # l S <br /> C. Tank/Piping Hauler <br /> Name 7,,?qcK/N6 <br /> Address S f <br /> city State _.�_ Zip 1?53Sf <br /> Phone No. ( ) O.S Hauler Registration #_ CAS �e 7r'S q/ <br /> d. Tank/Piping Disposal,Site a 7v3 <br /> Name L� <br /> Address d fh T <br /> City 2JL6 A? State—jf4----- Zip ql30/ <br /> Phone No. ( /$ } (o r © EPA ID # :jV <br /> e. Contaminated Soil Hazardous''/Waste Hauler <br /> Name <br /> Address ft Cf <br /> City 1970,0 A*G State Ot Zip S <br /> Phone No. ( ) 5 Hauler Registration # _C.9!) <br /> 99753 <br /> 9. Describe the method for purging and/or inerting of the tank(s). <br /> E GD 4,c x a— &42ng,r�/ SEG GEES/mac 61-1 <br /> XIOAL-o 1x <br /> 10. Has the applicant provided the detection imits that will be utilized in the suggested analysis? YES ] NO [►� <br /> �ti��� <br /> 11. Describe in detail how the soil and/or water samples beneath the tank's invert and 2&ing will be obtiined. <br /> �y sulk myb ���i9���O/��'� �z�ly��5 i3�av 7' E<<��,���oc�r�✓s5 7cl`i~ii Za <br /> 12. Describe how the excavation will be backfilled with suitable material (earth, sand, etc.) upon removal. <br />� _��_�kC�.v�YT�c�N G✓i c��� j�{-CF�c-c.�-� W%Ifi` GG��ti ��t'/L'r!¢ � �.4 — <br /> v�L <br /> --_.T�� �9U�F-rt-L IJIGL !i//3�'Cai+�.O•9CT�_ �U/ice <f- G�Z/J/[ L/L �o/�'J�/fG7�.�', <br /> Page 5 <br />