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s � k <br /> Is there a P1lS-$1lb contractor's queslictnnaire nn file or euclosed7 <br /> YES 1XI No i I <br /> (h) is lite current certificate of worker's compensation insurance on file? YES 114 NO I I <br /> No I <br /> 1 (c) Does the contraclor possess a hazardous Substance Removal Cttltlscafion?" YES I1 <br /> 2. !las It "Site health & Safely Plan" for Ibis job site been subntilled7 Y133S IN No I I <br /> 3. !las applicant performing removal in file City of"Tracy ol+fained a "Grading and Excavation Permit"? <br /> NIA (X r YUs I i NO i r if YUS, Permit# <br /> 4. Itas contractor obtained approval from the local fire deparlmenl to perform tank culling? NA IXJ YRS I I NO I I <br /> I$ <br /> 3. Is there knowledge or evidence of leakage front lite lank(s) andltir pipin976(if yes, please explain) YRS i NO <br /> t <br /> 6. if lank residual exists, identify tratrsporlittg hazardous waste hauler: <br /> F <br /> Name: Nor-Cal Waste Oil haulers flauler Registration#: CAD 981417255 <br /> Address: P.O. Box 645 City: 1knair, CA Zip: 95316 <br /> Phone: (209)332$710 <br /> 7. DecontaatiIla Iion Procedures: it <br /> a. Will (ank0s) and piping be deconlamilraled pricer to removal? YRS iXI NO I I <br /> t <br /> h. identify contractor perforating demilaminalion: <br /> Name: Jirrt 'hIMM Oil Co., floc. <br /> Address: 351. N. Beckman Roars I r.O. Box 357 City: Lodl 'CA Zip: 95241-0357 <br /> Phone No. (209) 462,-4581 nr 209 368-6175 <br /> c. Describe method to he used for decrntfaminatinn: <br /> I <br /> Tanks and pilling will be lrlple rinsed wiflr hal wafer and iblodegradahle soap solution. <br /> ,r <br /> 3k <br /> It <br /> d. I)escribe how rinsate material will he stored on-sire prior to ata I'd fesling off-sift: <br /> ii if <br /> 'ihe rinsate will he removed by.fhn Thorne 011, inc., personnel anis be placed In drums, The <br /> drums will be lahled acrd stored on site awAifing pick up for disposal at a proper disposal <br /> facility.. <br /> ii <br /> C. Kinsale llauler and permitted Treatment, Storage&Disposal facility: <br /> llauler Name: Sarre as No. 6 i Haider Regislralion#: <br /> Address: City: Zip: <br /> I <br /> Phone No. <br /> Permitted Disposal Site: Refineries SeryIces,Pafterson, CA, or other approved facilil,. <br /> .t <br /> Pege 4 <br />