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(b) Is the current certificate of w.,rker's compensation insurance on file? YES,W NO[] <br /> (c) Does the contractor possess a"Hazardous Substance Removal Certification"? YES p]' NO[] <br /> (d) Has everyone on site,including crane/backhoe operator,been certified to work on <br /> (e) hazardous waste site in accordance with CCR Title 8? YES$�- NO(] <br /> 2. Hasa"Site Health&Safety Plan"for this job site been submitted? Al-kuw YESN- NO[] <br /> 3. Has applicant performing removal in the City of Tracy obtained a"Grading and Excavation Permit"? fo <br /> N/A [] YES [] NO[] If YES, Permit# f�bnv �/.Y►'N1 i Scb►- <br /> 4. Has the contractor obtained approval from the local fire department to perform tank cutting?N []NO[] <br /> /Ue �-4 k r- ew h" <br /> 5. Is there knowledge or evidence of leakage from the tank(s)and/or piping? (If yes,please explain)YES[] NO[] <br /> NKnJ WW <br /> 6. If tank residual exists,identify transporting hazardous waste hauler: <br /> _ _ chD <br /> Name L C L Hauler Registration# fyze3ei73 <br /> Address Z65- P4w'r t5lV',d City Rt,Grl w+o'+�d Zip <br /> Phone#( 5L0 ) x-35- 133 <br /> 7. Decontamination Procedures: <br /> a. Will tank(s)and piping be decontaminated prior to removal? YES, - NO[] <br /> b. Identify contractor performing decontamination: <br /> Name k^C-L <br /> Address ��� A4 e - 43l v d City Zip f YV-0 <br /> Phone No.( s[o) 23!!�'- 1313, <br /> C. Describe methd to be used f?r decontamination: <br /> �rlp(C r Jh 3L <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> U4C, 7C eve-LL <br /> e. Rinsate Hauler and permitted Treatment,Storage&Disposal Facility: e �� <br /> Hauler Name &::G-�— Hauler Registration# If <br /> Address �'�s PC: w r 6�� City Al Ni0�0� Zip 1 <br /> Phone No.( 1 D ) <br /> Permitted Disposal Site 110 m 1 L 7 <br /> EH 23 046 (Revised 10/16/03) Page 4 <br />