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FROM TAIT & ASSOCIATES - Sacr ito FAX NO. : 9166352606 Jan. 04 2002 06:49AM P2 <br />1. (a) Is there a PHS -Elio contractor's and subeontraetoes questlonnatre on flle or enclosed? Yak Nor j <br />(b) Is the Current certificate of worker's compensation W=agee on Hae? YES r j NQ [ ) <br />(c) Does the contractor possess a "Hazardous Sabstance Removal Cestiffeation"? US'W NO <br />(d) Has everyone on site, including cranelbackhoe operator, been certified <br />to work on hazardous waste site in accordance With CCI; Title 8? YBsg NO r 1 <br />Z. Has a "late Health & Safety Plan" for this job site been submitted? <br />YES)( No [; <br />3- Has plicant pertortsdug removal in the City of Tracy obtained a "Grading and 1=vation permit"? <br />NIA pQ YES [ j xo [ ) Ir YES, Persalt 0 <br />4. Has the contractor obtained approval from the local fire department to perform tank cutting? NA /M I NO( y <br />S. Is there knowledge or evidence of leakage from the tanks) andfor piping? (if yes, please explain) YES [ ) No U <br />G. It tank residual exists, identity/transporting hazardous waste hauler. <br />NamedrA—�( nIT190,41 CS Hauler RegWratjw <br />Address '2�'5 t���L Il1J Clty / zip `9 lc1 r/ <br />phone #c ,/D-3 9.2 <br />7. DecontamtRada ProeedapM <br />a. WM tar]O) and piping be decontaminated prior to removai? YES No [ 1 <br />b. Identify contractor performing decontamination: <br />Name -111\1y C <br />Address City 57t Zip 5 <br />Pboae xo.c <br />C. Describe method to be ed for decontamination: <br />1 t 1-ta2()�\ t o J'- 1 t 1W1--V'-,-Y7 -rr-, 0, , <br />d. Describe hoW rlitsate aerial will be stored onsite prior to maniiest3ng offsite: <br />A A <br />e. Rlnsate Hauler and permitted Treatment. Storage & Disposal Facility. <br />Hauler Name C C \ <br />Hanler Reotradon �J 3 <br />AddreSSZ5 rJ P I�S Ra L �i City L 7.1p CJ <br />Phone No.( <br />Permltted Disposal Site {tdk� <br />EB ?.3 046 (Remised 0811 &99) Page 4 <br />