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S�_ Q �ti3y <br /> 5. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES[] NO[] N/A <br /> b. Identify contractor performing decontamination: <br /> Name Phone (_) <br /> Address City ip <br /> c. Describe method to be used for decontamination: <br /> VED <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: OCT U 6 2017 <br /> EN IRONMENTAL HEALTH <br /> e. Rinsate Hauler and permitted Treatment, Storage& Disposal Facility: DEPARTMENT <br /> Hauler Name Phone(_) Hauler Reg# <br /> Address City Z <br /> Permitted Disposal Site <br /> 6. a. Describe the method that will be utilized to purge and/or inert the piping: <br /> b. Piping Hauler: <br /> Name Phone (_) <br /> Address City ip <br /> Hauler Registration # (if hauled as hazardous) <br /> c. Piping Disposal Site: <br /> Name Phone O <br /> Address City ip <br /> EPA ID#(if transported to a permitted TSD facility) <br /> 7. Is the sampling firm an independent third party from the contractor? YES 110 [] <br /> a. Identify sampling firm: <br /> Name Phone(_) <br /> Address Cityqwill <br /> ip <br /> b. Identify laboratory performing analysis: <br /> Name Phone ( <br /> Address Cityp <br /> 8. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispetained: <br /> 9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br /> Name Hauler Registration# Phone(_) <br /> Address City Zip <br /> b. If soil is not to be hauled, describe what will be done with it: <br /> EH230038(revised 7-26-2016) 4 <br />