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a. Will piping be decontaminated prior to removal? YES NO <br />b. Identify contractor performing decontamination: <br />Name Phone <br />Address city Zip <br />01 # * , V a 5 19 9 . 0 A <br />rill & =.,I I I I •I I I I I I I I I! I I I I I I I, I MM <br />I � III I I �� I <br />11ITOMMM r -M -Tin, rill M., <br />z;. Rinsate Hauler and permitt�d�Treatment, Storage & Disposal Facility: <br />Hauler Name P Phone ( Hauler ReQ# <br />2M -1 -IM �*—� <br />6. a. Describe the method that will be utilized to purge and/or inert the piping: 0 IVEL', <br />b. Piping Hauler: f I JAN 0 5 2015 <br />Name - }j V1— Phone L--j----EWR0NMENTA1. <br />Address city Zip- UF:V-W-- <br />Hauler Registration # (if hauled as hazardous <br />312M�.� <br />Name Phone ( <br />IM=4— <br />city <br />Zip <br />EPA lD# (if transported to a permitted TSD facility <br />7. Is the sampling firm an independent third party from the contractor? YES[] NO[] <br />a. Identify sampling firm: <br />Name ha Phone(_). <br />Address Cilft <br />1. identify laboratory performing analysis: <br />,"I <br />1341 =1 <br />Phone I <br />city Zip <br />2. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br />A. <br />S. a, Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name Hauler Registration 0 Phone <br />Address CitA <br />M <br />