Laserfiche WebLink
PHS-EHD - UNDERG&UND TANK CLOSURE/ABANDONMbKT INSPECTIONP t' <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> ,u "" �" "y�3"�"�,"y" """; "3 �"6�"� "5 <br /> OWNER N ME OWNER PHONE # y- ?' Y� <br /> E g. [ 4�bN 2 _y�6 � <br /> N CONTRACTOR ll . ��NS� CON. PHONE# <br /> ((`` <br /> R SJLHD PERMIT # EF'R # �sy�/� FIRE PERMIT ' # fes/-0�9 <br /> L - <br /> IN S'PECG 0� DATE�� � TANK # 39 - /3G 2_— _ 62 <br /> R RINSED QY N) METHOD u RINSE AMOUNT �J <br /> I <br /> N RINSATE DISPOSAL SITE rqqyjs& yp,e�eS <br /> S /`� <br /> E MANIFEST # _ -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD AMOUNT USED j S � <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE ( 20%) <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 pL / <br /> S PIPE MATERIAL (STEE FIBERGLASS, OTHER) # FEET N <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) _ <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> I <br /> N tD^^.- p u Z s <br /> E K <br /> L <br /> D EXCAVATION SIZE: ' X -'� X 7- <br /> — YDS OF SOIL: <br /> S <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T GTRENCH DIMENSION X X YDS OF SOIL <br /> I -- -- <br /> 0 H I DEPTH TO G. W. FT SAMPLING METHOD <br /> 0 LLWF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: G �Do�lie �_ / SAMPLERS NAME : /J Ph r�� <br /> CLOSURE IN PLACE MIXTURE: VOLUME: fG <br /> EH 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />