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a. (a) Is a .EHD ractor's questionnaire on Ale or enclosee <br />YES NO j <br />(b) h dw.current certificate of Workee5 COMPORWOM insursaft on flk? <br />YES 140 <br />(c) Does tt costracow possess a ONA=rftm Seftmon Ramoval G i YES ."� NO [ j <br />(d) Ho.eveyorA on site, including cranalbockhoe opentar, bm ceM isd <br />to work on b site in accordance whh CCR 'lith V <br />YES K r4o � ) <br />7- Has m & 56ftq Plas-)'or this job aitt been submitted? <br />YES? NOT J <br />3, Has applicant pedenning removal in: the City of Tracy obtained x " <br />. <br />MA YES}€ Pica I i if it a <br />4.Has the centreeter obtaiaed approval from else local tins department to performs tank cutting? N Yui i Not f <br />5. Is or evidewce of Isakage from s) xwVor piping? <br />(If yes, pkwe explain) YES (f NOK <br />�. Ir balk. resiftal exists. identify trznWorcWgbAvlm : <br />7 �,� vA•• <br />2 cuv r. <br />7.1 ` 3 <br />A <br />a. Will k(s) and pipift be d4co3statahmed prior to oval? <br />NZ <br />YES Yk NO ( 1 <br />.r <br />♦. <br />. 4111111111111i ... r <br />;,�r f <br />Disposal <br />r <br />AA$ <br />r. -- .,4L&,m <br />f &.10 <br />rcratii _ Disposal_ <br />91123 0" { <br />