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C. Tank/Piping Disposal Site: <br /> Name West Coast Equipment <br /> Address 1221 S. Tegner City Turlock Zip 95380 <br /> Phone No.( 209 ) 668-9378 <br /> Dillard Environmental <br /> EPA ID#(if transported to a permitted TSD facility) CACO2653845 CAD982523433 <br /> 9. Is the sampling firm an independent third party from the contractor (REQUIRED)? YES P] NO[] <br /> 9a. Describe, in detail,how the soil and/or water sample(s)beneath the tank and piping will be obtained: <br /> Samples will be taken at least two feet under the former tank location with the backhoe, <br /> soil sample will be taken from the teeth area of he hucket <br /> 10. Describe how the excavation will be backfilled with suitable material upon removal: <br /> Backfill with pea gravel <br /> 11. Handling of excavated soil: <br /> a)What material will be used to line the tank pit and cover the stockpile? <br /> 6 mil black plastic <br /> b)What will be the final destination of the excavated stockpile? <br /> If the stockpile is contaminated a decision based upon the contamination levels will decide <br /> where it will be disposed of. <br /> c)Contaminated Soil Hazardous Waste Hauler: <br /> CAD982523433 <br /> Name Dillard Environmental Hauler Registration# 01715 ICC#218541 <br /> Address P.O. Box 579 City Byron Zip 94514 <br /> Phone Number( 925 ) 634-685Q FAX 925-634-0874 <br /> 12. What is the depth to groundwater? 40' to 50' (City of Lodi) <br /> Describe the source of information: <br /> 13. Are there any water wells on this parcel o ad]acen roperties? YES [$ NO[] <br /> TYPE OF WELLS DISTANCE TO TANKS(S) <br /> Public Well <br /> Private Well <br /> Irrigation Well <br /> Monitorino Well 145 ft. <br /> Other - ft• <br /> 14. Will the tank(s)pending closure be replaced with an aboveground or underground storage tank(s)? YES[] NOPJ <br /> 15. Indicate the responsible party to be billed for additional EHD staff time expended beyond 3 hour minimum <br /> permit payment per tank. If the party designated below is different than the permit applicant, e.g. property <br /> owner,the party must acknowledge this responsibility for the billing by signature and date below. <br /> Name City of Lodi <br /> Mailing AddresS 221 W Pine Street P.O. Box 3006 Lodi CA 95241-1910 <br /> Da Phone Nurpber 20 ) 333-6740 <br /> Compliance Engineer 3 �I L11 <br /> ignatu Title Date <br /> EH 23 046 (Revised 07/22/10) 5 <br />