HomeMy WebLinkAbout2201 taft hwy_ust removal _6-6UNMED PROGRAM CONS011DATED FOWL
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IM CMTMCATION
On exambmfi(m of the twk I certify the tank is vLqmHy fi-ae fium pwduct, sludM scale (thin, -flaky residual of tank COMMI rye and debris. I fiv%er certify that
the mfonmunn pmwied hmem is trw and =wwa to the best of my knowledgr-
SIGMA OF UEWFIRER.
STATUS OR AFFUIATION OF CERTff;-yWG pEMN
C,--Affier is awpUb-4-:1--da-fiveof fte, CJN�A, ainhwized agency, orLIA--
Yes El No
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Nanev G. CarrawaV
Mm of CUPA, m9honzed a&enqy,, or LTA--
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TME OF (ARJUIER 755
Certified Industrial Hygienist
If cerdflex is 01ha &M CUPA I LIA check aW ophit ft box bdow.
Q a. Cwl fled Ind � ]- yg enist(CM)
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ADDRESS
991 East California Boulevard
0 bL Certffied Safety ftWbsdomj (CSP)
0 c. Certified Mmine Ch=ist (a1Q
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Pasadena, California 91106
0 d. Rpgi.� Em&owm-nW Health Sp=Wist (REDS)
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PHONE
62.66767681
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DATE - 759
CERM CATION 1"fla
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TA1#-M HOMY MULD FLAWIM"LE OR COMBUSTIBLE MATERLALS E'5 CL (fL C L,
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gr-M the tokimaiwammsphi-radabe A &J, -1 a c=busfible gn h3&c=rpfior toymik being owdusded an the tm?l--) 0 N16
Uifff- - S TRIM AIAMAGEAMMINSTRUMOM FOP, SCRAP DEALER, DISPOSAL FACILITY, EM.
764
INERT TANK EXTERIOR BEFORE TORCH CUTTING OR USING SPARKING TOOLS ON OR NE 4R TAj%jL TANK IS NOT SUIT-ABLE
FOR FOOD OR POTABLE WATER STORAGE. FOR PERSoNTNEL ENTRY, OR FOR HOT WORK. TANK IS SUITABLE FOR COLD
NVORK.
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