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lzrl�rlaa� 14::e4 4b40138 ENVIRONMENTAL HEALTH PAGE 03 <br />Hauler Registration <br />i <br />Permitted Disposal 6 te <br />a. Describe the method that will be utilized to purge and/or in• i <br />Name <br />Address Cly Zip <br />• <br />-i..as hazardous) <br />C. Piping Disposal Site: <br />Name Phone <br />Address Zi <br />EPA 10 (if transported to a permitted TSD facility) <br />Is the sampling firm an independent third party from the contractor? YES (j NO [ <br />9. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser V <br />be obtained: <br />1 Handling of excavated soil: <br />a) Contaminated Soil Hazardous Waste Hauler. <br />Name Hauler Registration <br />Address <br />Glty Z'p <br />hauled,b) If soil is not to be descdbe be done <br />with it: <br />0 <br />