Laserfiche WebLink
8co e.a f Gl�T <br /> PUBLIo ,.EALTH SERVICES-ENVIRONMEN.-C, HEALTH DIVISION UU <br /> SITE NAME Tri Srur He + cs ADDRESS 1325 Cv,-�c�l }ollo a CITY <br /> OWNER NAME TOWNER PHONE <br /> CONTRACTOR MCYI CONT. PHONE <br /> FIRE PERMIT <br /> REMOVAL X CLOSURE IN PLACE TEMPORARY CLOSURE <br /> INSPECTOR Ypshi6kc� DATE (o/Z/Q-4 TANK ig 39 (32S CMZ <br /> R RINSED YjN) METHOD RINSE AMOUNT <br /> I G1 <br /> N RINSATE DISPOSAL SITE N6,7- Cod <br /> S <br /> E MANIFEST OR OTHER <br /> V VAPORS PURGED METHOD �_ C AMOUNT USED <br /> A <br /> P READING AT REMOVAL L.E.L. : 02: Q <br /> 0 <br /> R COMMENTS <br /> C TANK MATERIAL STE FIBERGLASS, OTHER) <br /> 0 <br /> N TANK CONDITION (GOOD, O HOLES) l <br /> S Ko <br /> T PIPE MATERIAL STE FIBERGLASS, OTHER) rz FEET <br /> PIPE CONDITION (GOOD P00 , HOLES) <br /> DEPTH SOIL TYPE OBSERVATION SAMPLE ,24 <br /> A NC Z <br /> N I <br /> K I cxtm t4 - <br /> S EXCAVATION SIZE _ X X YDS OF SOIL <br /> A <br /> M DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> P P <br /> L I Al A <br /> I P <br /> N E <br /> G <br /> TRENCH DIMENSION X X YDS OF SOIL <br /> DEPTH TO G.W. : FT. SAMPLING METHOD <br /> I H <br /> 2 HOURS SINCE DEWATERING: <br /> 0 <br /> OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> EH 23-0043 (REV 2/23/94) PROVIDE SITE MAP <br />