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5. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES[] <br />b. Identify contractor performing decontamination: <br />Name <br />Address <br />c. Describe method to be used for decontamination: <br />3ECEIVED <br />SEP 2 6 2016 <br />NO [ ] <br />Phone ( )ENVIRONMENTAL HEALTH <br />Ljt:PARTMENT <br />City Zip <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone ( ) <br />Address City <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 <br />Address <br />Hauler Registration # (if hauled as hazardous) <br />c. Piping Disposal Site: <br />Name <br />Address <br />EPA ID# (if transported to a permitted TSD facility) <br />7. Is the sampling firm an independent third party from the contractor? <br />a. Identify sampling firm: <br />Name <br />b. Identify laboratory performing analysis: <br />Name <br />Hauler Reg# <br />Zip <br />Phone ( )_ <br />City <br />Phone ( )_ <br />City <br />YES [ ] <br />Phone( ) <br />City <br />Phone ( ) <br />Zip <br />M <br />NO[] <br />Address City Zip <br />8. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br />9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name Hauler Registration # <br />Address City <br />b. If soil is not to be hauled, describe what will be done with it: <br />In <br />Phone ( ) <br />Zip <br />