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PHS-EHD - UNDER—OUND TANK CLOSURE/ABANDONMENT" INSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> OWNER NAME <br /> E OWNER PHONE # Y _ YGG S37/ <br /> E , , CONTRACTOR J CON. PHONE# <br /> 209 YL� - Yrd <br /> R SJLHD GERM # c <br /> EPA # FIRE PERMIT # <br /> - J <br /> INSPECTOR _ Uz DATE S iS'i TANK # 39 <br /> R RINSEDMETHOD <br /> I RINSE AMOUNT <br /> �ii� >a <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD l>Y i�c AMOUNT USED <br /> A x/63 <br /> P L. E. L. READING qT REMOVAL (MUST BE ( 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL -(STEEL, IBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, )HOLES) <br /> N <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P T -O <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F A 5cr <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: <br /> S -� X 1�2 X -JL' YDS OF SOIL: 3 > 3 <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE <br /> S P I / <br /> P L G <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION <br /> I X --- X YDS OF SOIL <br /> 0 FH7 DEPTH 'f0 G. w. FT SAMPLING METHOD /'_ <br /> N - ---- -- <br /> l� # OF HOURS SINCE DEWA-fERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: //+ rw SAMPLERS NAME: <br /> CiGroiB <br /> CLOSURE IN F'LACE MIXTURE: <br /> VOLUME: <br /> EH 3043 ( lo/639) DRAW SITE MAP 0N REVERSE <br />