Laserfiche WebLink
SJLHD – UNDCV%"eUUND 'TANK CL OSURE/AILANDON 1149PECTIUN <br /> (SHADED AREA TO DE FILLED IN FOR THE FIRST TANK ONLY) <br /> G OWNER NAME k8�5 I g2 OWNER PHONE u 3. 3 ; <br /> E <br /> N CONTRACTOR — CON. PHONEW 7' <br /> E 1 A l I HORDE O 11. �- y-Se) <br /> R SJLHD PERMIT V EPA # 0 FIRE PERMIT b <br /> INSPECTOR, , DATE �51"Lt' TANK d 39 – Z3–IS – 0/ <br /> FSR <br /> RINSED (Y/N) METHOD RINSE AMOUNT <br /> RINSATE DISPOSAL SITE <br /> MANIFEST I –OR– OTHER <br /> V VAPORS PURGED Y/ ) METHOD <br /> A T:� AMOUNT USED -� C) ILLS <br /> P L.E.L. READING AT REMOVAL (MUST BE C 20% ) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL TEEL FIBERGLASS, UTHER) TANK SIZE Z QUO <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, HOLES ) <br /> P N <br /> I S PIPE MATERIAL EEL, FIBERGLASS, OTHER) I FEET 46tht 'Inikl <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES ) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE Y <br /> T <br /> F A 10 a' f ems— <br /> I N & 5 <br /> E K <br /> L <br /> D EXCAVATION SIZE: (� XI�tX �5 ," 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 G TRENCH DIMENSION X _ X YDS OF SOIL <br /> I <br /> O H DEPTH TO C.H. : FT SAMPLING METHOD <br /> N 2 <br /> 0 Y OF HOURS SINCE DEWATERING: <br /> H70OTHER SAMPLE: <br /> LABORATORY: Ca,)JOI)I E SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE Mn ^ R��p„n.`.t•, -- __ <br />