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Environmental Health Department <br /> SAK)JONQUIN • <br /> —COUNTY— <br /> c. Describe method to 7 b used for decontami <br /> nation: <br /> d. Describe how rinsate m@terial will be stored onsite prior to manifesting offsite: <br /> -e- Rinsate Hauler and pe miffed Treatment, Storage&Disposal Facility: <br /> Hauler Name Phone U Hauler Reg# <br /> Address <br /> City Zip <br /> Permitted Disposal Site <br /> 6. a. Describe the method int III be utilized to purge and/or inert the piping: <br /> Ila- <br /> b. Piping Mauler: <br /> Name <br /> Phone <br /> Address city Zip <br /> Hauler Registration#(if hauled as hazardo6s) <br /> c. Piping Disposal Site: <br /> Name 1A Phone <br /> Address <br /> City Zip <br /> EPA ID#(if transported to a permitted TSD facility) <br /> 7. Isthe sampling firm an independent third party from the contractor? YES NO[] <br /> a. Identify sampling firm* <br /> Name Phone( <br /> Address City Zip <br /> b. Identify laboratory performing analysis: <br /> Name Phone <br /> Address CRY Zip <br /> 8. Describe,in detail, o soil andlor water sain ple(s)beneath the piping or dispenser will be obtained: <br /> 9. a. Handling of kxqa ed soil(Contaminated Soil Hazardous Waste Hauler): <br /> i <br /> Name Hauler!Registration# Phone <br /> Address <br /> City Zip <br /> b. If soil is not to be hauled,describe what will be done with it: IVED <br /> RECF <br /> SEF 0 201:/ <br /> Ji If 6 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br />