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CARRIER. NAME ANC ACDRES - nQ'l f0+'� -- <br /> TANK CLEANING <br /> AND INSPECTION REPORT <br /> P.a.roO. Z � Zc.79 Jr Z <br /> TRAILER NO. LOAD NO. EQUIPMENT CONTROL <br /> 17 r- `^ DATE: DESCRIPTION OUT IN DESCRIPTION OUT IN <br /> Ole <br /> NAME DRIVER NO. NUMBER OF T HOSES TANK CLEANLINESS RATING <br /> 1. NUMBER OF T HOSES ' 3 X 2 PRODUCER <br /> V 4' <br /> 2 NUMBER 8 TYPE SPECIAL HOSES GASKETS TEFLON OTHER <br /> 3_ FUSIBLE CAPS CHRISTMAS TREE <br /> q_ <br /> NOTIFY DISPATCH OF ANY DISCREPANCIES <br /> NAME OF TANK WASH REMARKS: f O7yE' <br /> I <br /> I <br /> I <br /> I <br /> COMP. LAST PRODUCT SEL <br /> 1. N(a �lar...��t ( CLEANING AND INSPECTION <br /> 2. ALL OF THE FOLLOWING ITEMS MUST BE CLEANED <br /> 3. TANK INTERIOR CHRISTMAS TREE DISCHARGE VAUES <br /> DOME LIDS CAPS GASKETS UNLOADING LINES <br /> 4. SPILL DAM HOSE TUBES <br /> $, CLEANED CHECKED TIME <br /> TRAILER DAMAGE CONTROL _ BY ------ BY <br /> DATE-__ <br /> TYPE OF CLEAN- COST PER COST PER CAST PER , COST PER <br /> 11. 14. 13. t2. E ING OR PROCESS ! COUP.1 COMP.2 COUPS COMP4 <br /> 48 HOOKAlNHOOK <br /> 1. N2 7, 9. 49 E DRAIN. <br /> 3. 4. <br /> a- to. 51 f CAUSTIC <br /> 52 I DETERGENT <br /> 53 PRESO4VE <br /> FR NT 1 RIGHT SIDE -� 54 SCRAPE' _ -� <br /> -- <br /> 23. 25. 55 'STEAM I <br /> 16. 17_ 24. 26. - <br /> 20. 56 HOT WATER FLJ H i <br /> 76. 19. <br /> 57 COLD WATER _ <br /> 171 FLUSH <br /> 421. 58 DRY <br /> 22. <br /> REAR 27. LEFT SIDE X29' 59 DISPOSAL FEE <br /> 64 PUMP CLEANING <br /> .i 31. 33. <br /> 65 HOSE S FITTING <br /> 32_ 34. - I <br /> T7. ,EXTEIOR WASH <br /> :TRAILER <br /> 28. <br /> TOP 30. SD TOTAL TANK <br /> WASH CHARGES 3 <br /> Lim all damages using numbers in diagram to identity location. Give brief List all damages using nnmoers in C,agam to identity location.Gwe brief de icrlptlon of <br /> description of all image usingthe code on the back of this farm. all damage using the code an the back of this to"- 1 <br /> DRIVER:. { -_ TANK WASH: Lie t0- 10 <br /> I <br /> DATE <br /> ._. I <br /> SIGNATURE DATE SiGNAT'JRE <br />