Laserfiche WebLink
PHS—EHD — UNDF"''" FOUND TANK OLOSUREIABANDQC ' - IT INSPECTION <br /> {SHADED AREP BE FILLED IN FOR THE FI'"„j” TANK ONLY} <br /> E OWNER NAME OWNER PHONE # f <br /> E r. <br /> N CONTRACTOR CON. PHONE# <br /> E <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # <br /> A ' , f r. <br /> L f� r <br /> INSPECTOR , / DATE f� TANK # 3(3 <br /> R RINSED { N) METHOD RINSE AMOUNT <br /> I <br /> SN RINSATE DISPOSAL SITE <br /> tfrCp'� - c x, <br /> E MANIFEST # —OR— OTHER <br /> V VAPORS PURGED ON) METHOD <br /> A AMOUNT USED <br /> G7 S <br /> Em LA READING AT REMOVAL {MUST BE { `Ox} <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL {STEE , FIBERGLASS, OTHER} TANK SIZE <br /> K C <br /> ! 0 TANK CONDITION {GOOD, POOR, HOLES} <br /> N Fc—fP' , 1 c7 �rdG s <br /> S PIPE MATERIAL_ { TEEL FIBERGLASS, OTHER} # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F A <br /> I N , <br /> E K <br /> L <br /> D S EXCAVATION SIZE. X X YDS OF SOIL: <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S P I <br /> " L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X <br /> I YDS OF SOIL <br /> 0 H DEPTH TO Gs Wo : FT <br /> N SAMPLING METHOD <br /> ;� <br /> G # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 0304 ( 10/89) <br /> DRAW SITE MAP ON REVERSE <br />