COMPLIANCE INFO_1986-2008 - Laserfiche WebLink

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1. (a) Is there a PRS-EKD contractor's and subcontractor's questionnaire on Elle or enclosed? YES NO[) (b) Is the current certificate of worker's compensation Insurance on file? YES NO[) (c) Does the contractor possess a"Hazardous Substance Removal Certification"? YES NO[j (d) Has everyone on site,including cranelbackhoe operator,been certified to work on hazardous waste site in accordance with CCR Title 8? YES X NO[] 2. Has a"Site Health&Safety Plan"for this job site been submitted? YES)( NO(j 3. Has a plicant performing removal in the City of Tracy obtained a"Grading and Excavation Permit"? NIA YES[] NO(I If YES, Permit d 4. Has the contractor obtained approval from the local fire department to perform tank cutting?NA[]YES[]Nt)[ 5. Is there knowledge or evidence of leakage from the tank(s)and/or piping? (If yes,please explain)YES NO[] 5 3 Adffincea in GreST S i i V Vo ILEE T -AS G .SIT is R�l A i nJ To Aur J o C, IaH L c� 6. If tank residual exists,identify transporting hazardous waste hauler: Vol? Name U Q a c a L Qd r^Hauler Registration# �y10� Address P, 0. City QE N p, ZIP 3/ b927Phoned(�,�?�1 (2b:7 12692- 7. . Decontamination Procedures: ` ' a. Will s)and piping be decontaminated prior to removal? YE�.[� NO(j b. Identify contractor performing decontamination: ��/ 111 Name dURNU 0 Geo LIN,aanaFn►ZA C. Address yoo5 N. W )Son 'WA'f city S�'ocK-ron zip q 520 S Phone No.( 24� a �h 7 — / o O �Q _- c. Describe method to be used for decontamination: �RESSvRi+ QinS@. iniac ®-� TANKS p an 6- 1 5 d. Describe how rinsate material will be stored onsite,prior to manifesting offsite: R.;0582i, tuill b� Av�,noT C� °M� Mobi)� I/Atvvnr. TfrcK A/oR cAtl a�J /) e. Rinsate Hauler and permitted Treatment,Storage&Disposal Facility: Hauler Name N a.t - r l Hauler Registration d Address T. ® . ® City D-E ;X 21995,S/ 6 Mone No.CZQ � — 2, Permitted Disposal Site S SQ 'c Co . GAO 99 / 255) EH 23 046 (Revised 10119198) Page 4