Stanislaus County Striving to be the Best STANISLAUS COUNTY HAZARDOUS by armedman2

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									        Stanislaus


                                                                           STANISLAUS COUNTY
                                                                  HAZARDOUS MATERIALS DIVISION
                         County                                            EXCAVATION REPORT
          Striving to be the Best




Facility Name_________________________ Site Location________________________________

Owner of Facility_________________________ Phone___________________________________

Approximately____________ cubic yards of contaminated soil was removed from the location above.

TYPE OF CONTAMINATION

____ Gasoline                   ____ Oil     ____Diesel    ____Other (contamination____________________)

FATE OF CONTAMINATED SOIL

Stored onsite for future treatment                        _____

Aerated onsite under permit from APCD                     _____

Aerated offsite under permit from APCD                    _____

       Location of aeration ________________________________________________________

Bioremediation under permit from APCD                     _____

Disposal at Class III landfill (attach tare slip)         _____

Manifested as Hazardous Waste and disposed
of at a Class I landfill (attach tare slip) _____

Used as fill onsite after treatment                       _____

Other __________________________________________________________________________

________________________________________________________________________________
                                           PLEASE ATTACH MAP OF AREA EXCAVATED


Contractor signature _____________________________________ Date ___________________

Contractor License Number/Type_____________________________________________________

Property owners signature__________________________________ Date ___________________

                                                                                                revised 9.04

								
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