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DocuSign Envelope ID:2F173BE3-D39C-47D3-A993-65B9F76377E9 <br /> SAN J O A Q u <br /> I N <br /> Environmental Health Department <br /> COUNTY <br /> be method to be used for decontamination: <br /> dD Describe <br /> how rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate uler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone ( ) Hauler Reg# <br /> Address City Zip <br /> Permitted Disposaite <br /> 6. a. Describe the method tha will be utilized to purge and/or inert the piping: <br /> b. Piping Hauler: <br /> Name Phone ( ) <br /> Address City Zip <br /> Hauler Registration # (if hauled as haz rdous) <br /> c. Piping Disposal Site: <br /> Name Phone ( ) <br /> Address City Zip <br /> EPA ID# (if transported to a permitted TSD facility) <br /> 7. Is the sampling firm an independent third party from the con ctor? YES [] NO [] <br /> a. Identify sampling firm: <br /> Name Phone( ) <br /> Address ity Zip <br /> b. Identify laboratory performing analysis: <br /> Name Phon ( ) <br /> Address City Zip <br /> 8. Describe, in detail, how the soil and/or water sample(s) beneath the piping or dis enser will be obtained: <br /> 9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br /> Name Hauler Registration# Phone <br /> Address City Zip <br /> b. If soil is not to be hauled, describe what will be done with it: <br /> 4 of 6 <br />