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SJLHU - UNULRUR UUNU TANK CLOSURE/A1IANUONMWNT INLPEC-1'1014 <br /> (SHADED ARE/. 0 BE FILLED IN FOR THE FL P TANK ONLY) <br /> Y T <br /> G < OWNER NAME �4 ni« OWNER PHONE I! <br /> E <br /> i <br /> N < CONTRACTOR SL�AAcO CON . PHONEI ? <br /> E <br /> R < SJLHD PERM444 IT @ EPA 1 FIREPERMIT 1 <br /> L4 � 110111. . <br /> INSPECTOR DATE ; > . , TANK 1 39 - - � <br /> R RINSED (Y/NMETHOD "T � RINSE AMOUNT,-- <br /> I <br /> MOUNT,-I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST 1 -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD ; AMOUNT USED <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 201) n I r:l <br /> 0 <br /> T R COMMENTS (jpkleQ <br /> A <br /> N TANK MATERIAL , STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD,( POOR, OLES ) <br /> P N <br /> I S PIPE MATERIALSTEEL, FIBERGLASS, OTHER) 1 FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE 1 <br /> T <br /> F A ISCO ora 'on <br /> �! <br /> I N � <br /> E K <br /> L <br /> D EXCAVATION SIZE: X X YDS OF SOIL : <br /> 3- <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE 1 <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> O H DEPTH TO C.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 1 OF HOURS SINCE DEWATERING: <br /> ❑O OTHER SAMPLE: <br /> LABORATORY: (Q/ y o L Ad S SAMPLERS NAME: <br /> CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> Ell 2:1 043(7/88) <br />