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[]
[{"$nulls":18},"5/90"]
[{"$nulls":23},{"v":7,"d":"7."},null,"Specific Site Characteristics (Hazardous Waste) :"]
["LOUISIANA DEPARTMENT OF TRANSPORTATION AND DEVELOPMENT"]
[{"$nulls":25},"a.",null,"Suspected source of hazardous waste:"]
["UNDERGROUND STORAGE TANK (UST) / HAZARDOUS-WASTE SITE"]
["INFORMATION FORM",{"$nulls":26},"Waste pit",null,null,"Industrial facility",{"$nulls":3},"Dipping vat"]
[{"$nulls":27},"Drum storage area",{"$nulls":4},"Other"]
[]
[{"$nulls":25},"b.",null,"Is there evidence of combination?",{"$nulls":6},"Yes",null,"No"]
[null,{"v":1,"d":"1."},null,"Project Name",{"$nulls":12},"Route"]
[{"$nulls":25},"c.",null,"Containment: Drums",{"$nulls":4},"Cans",null,"Open spill",null,null,"other"]
[null,{"v":2,"d":"2."},null,"Assigned State Project Numbers:"]
[{"$nulls":25},"d.",null,"If contained, number and size of containers:"]
[{"$nulls":3},"a.",null,"SP NO.",{"$nulls":9},"( Preliminary Engineering)"]
[{"$nulls":25},"e.",null,"If open spill, size of affected area:"]
[{"$nulls":3},"b.",null,"SP NO.",{"$nulls":9},"( Right-of-way)"]
[{"$nulls":25},"f.",null,"Characteristic color/odor:"]
[{"$nulls":3},"c.",null,"SP NO.",{"$nulls":9},"(Construction)"]
[{"$nulls":25},"g.",null,"Type of contamination:",{"$nulls":4},"Soil",null,"Water",null,"Air"]
[null,{"v":3,"d":"3."},null,"Parcel number",{"$nulls":7},"Property acquired?",null,null,"Yes",null,"No"]
[{"$nulls":25},"h.",null,"Depth or extent of contamination:",{"$nulls":8},"Surface"]
[{"$nulls":3},"(NOTE: If additional parcels contain UST or hazardous-waste",{"$nulls":32},"Ft. below surface"]
[{"$nulls":3},"sites, separate forms must be completed and submitted.)"]
[{"$nulls":25},"I.",null,"Physical state of waste:",{"$nulls":4},"Solid",null,"Semi-solid"]
[null,{"v":4,"d":"4."},null,"Site Location (UST/Hazardous Waste) and Status:",{"$nulls":28},"Liquid",null,"Gaseous"]
[]
[{"$nulls":3},"a.",null,"Street address",{"$nulls":17},{"v":8,"d":"8."},null,"Other Requirements:"]
[]
[{"$nulls":3},"b.",null,"Station number",{"$nulls":8},"or log mile",{"$nulls":10},"Provide copies of applicable portions of right-of-way maps, plans, field rolls,  etc , showing suspected"]
[{"$nulls":25},"UST or hazardous waste site(s); denote with  highlight marker all suspected site locations.  Sketch "]
[{"$nulls":3},"c.",null,"Distance right or left of centerline",{"$nulls":19},"site showing orientation of UST or hazardous waste parameters."]
[]
[{"$nulls":3},"d.",null,"Business in operation?",{"$nulls":5},"Yes",null,"No"]
[{"$nulls":25},"Attachment checklist:"]
[{"$nulls":3},"e.",null,"Approximate date of business closure",{"$nulls":26},"Right-of-Way Maps"]
[{"$nulls":32},"Construction Plans"]
[null,{"v":5,"d":"5."},null,"Property Ownership (prior to DOTD acquisition) :",{"$nulls":28},"Field Roll Sheets"]
[{"$nulls":32},"Aerial Photograph"]
[{"$nulls":3},"a.",null,"Owner's name",{"$nulls":26},"Site Sketch"]
[{"$nulls":32},"Other"]
[{"$nulls":3},"b.",null,"Telephone number",null,null,"(",null,")"]
[{"$nulls":23},"*******************************************************************************************************************"]
[null,{"v":6,"d":"6."},null,null,"Specific Site Characteristics (UST) :"]
[{"$nulls":23},"INSTRUCTIONS: Complete in detail the appropriate"]
[{"$nulls":3},"a.",null,"Number of tanks",{"$nulls":6},"Size of tanks (gal)",{"$nulls":10},"sections of this form and submit to:"]
[]
[{"$nulls":3},"b.",null,"Contents of tank (gas, oil, diesel, etc.",{"$nulls":17},"Gary Doyle, P.E."]
[{"$nulls":23},"DOTD Materials Engineer Administrator"]
[{"$nulls":3},"c.",null,"Surface cover (concrete, asphalt, soit, etc.)"]
[{"$nulls":23},"*******************************************************************************************************************"]
[{"$nulls":3},"d.",null,"Approximate age of tanks"]
[{"$nulls":23},"Submitted by:"]
[{"$nulls":28},"(Name)",{"$nulls":5},"(Section)",null,null,"(Date)"]
[]
[{"$nulls":20},"Pg. 1",{"$nulls":18},"Pg. 2"]