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I. (a) Is there a PHS-END contractor's and subcontractor's questionnaire on file or enclosed? YES 14 NO t j (b) Is the current certificate of worker's compensation insurance on file? YES[t NO[X (c) Does the contractor possess a"Hazardous Substance Removal Certification"? YES[4 NO[] (d) Has everyone on site,including cranelbackhoe operator,been certified to work on hazardous waste site in accordance with CCR Title 8? YES[ NO]) 2. Has a"Site Health&Safety Pian"for this fob site been submitted? YES[ NO[ 3. Has applicant performing removal in the City of Tracy obtained a"Grading and Excavation Permit"? NIA YES[] NO[j If YES, Permit# 4. Has the contractor obtained approval from the local fire department to perform tank cutting?NAkkYES(j NO[] 5. Is there knowledge or evidence of leakage from the tank(s)andlar piping? (If yes,please explain)YES[] NO 6. if tank residual exists,Identify transporting hazardous waste hauler. Name NorCal Waste Oil Haulers Hauler Registration#CAD 982417255 AddressP.O. Box 643 City Denair,CA Zip 95316 Phone#( 800 332-87.10 7. Decontamination Procedures: a. Will tanks)and piping be decontaminated prior to removal? YES W NO[] b. Identify contractor performing decontamination: Name Jim Thorpe Oil, Inc. Address P. O. Box 357 City Lodi CA ?dp 95240 Phone No.{ 209 ] 368-6175 C. Describe method to be used for decontamination: Tank(s) and piping will be tri le son solution and hot Water, d. Describe haw rinsate material will be stored onsite prior to manifesting offsite: The rinsave being- delivCred to the opposite end of the tank- e. Rinsate Hauler and permitted Treatment,Storage&Disposal Facility- Hauler Name Same as #6 Hauler Registration# Address City Zip Phone No.{ Permitted Disposal Site Americlean Inc. , 2670 Almond Dr. , Silver Springs, NV or of er approved facility. EH 23 046 (Revised 10119198) Page 4