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SANJ e U1 I Environmental Health Department <br /> 0lJ NIT 'I. <br /> c. Describe method to be used for decontamination : <br /> - a <br /> d . Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rlnsate Hauler and permttted Treatment, Storage & Disposal Facility: <br /> Hauler Name A140% 5 4trv� L6S Phone (�Q, SZS 4u30 Hauler Reg# <br /> oeeeMEN <br /> Address W at 1M1M. 9264 CRY _ Zip s <br /> Permitted posak ' Ite <br /> 6. a. Describe the method that will be utilized to purge and/or inert the piping: <br /> b. Piping Hauler: <br /> Name VS CC* * big 3fQ4kSparA�t�•. Soltt 0009 Phone laiSZ 1 $� <br /> Address _ City Zip <br /> Hauler Registration # (if hauled as hazardous) It 1k 5043 7113 d 3a <br /> c. Piping Disposal Site : <br /> Name . V 7 Phone 77 SS 3 UO3 <br /> Address T i—,-4 95 _ City w Zip $�lua3 <br /> EPA ID# ( if transported to a permitted TSD facility)_/V`7 33oa /0000 <br /> 7. Is the sampling firm an Independent third party from the contractor? YES NO [ ] <br /> a. Identify sampling firm : <br /> Name PTI Yn _ . Phone(�j <br /> Address 1200 & i d city B4 an fWAit. Mpilow <br /> b. Identify laboratory performing analysis: <br /> Name cXo� A 45 t4 (Ct Phone (� <br /> Address l,S 12, t. aw► tli,44 ` City iLk _ zip d <br /> Be Describe . In detail , how the soil and/or water sample(s) beneath 'tile piping or dispenser will be obtained : <br /> 9. a. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br /> Name c ad SInk"v% NC"{C',� Hauler Registration # 1 POO U6 3 Phone (4 <br /> Address _ l2. lt�A.. 4 � City +a zip y '1565 <br /> b. If soil Is not to be hauled , describe what will be done with it: <br /> 7> 1 "M its - <br /> NO* 10940 AW 11 k\ tf <br /> b6b , qoq 4451 4of6 <br />