Laserfiche WebLink
SJLHO - UNDENr'--VUND TANK CLOSURE/A4ANDONM- 'T INSPECTION <br /> (SHADED AREA �J BE FILLED IN FOR THE FZR� TANK ONLY) <br /> . . . . . . . . . . . . . . . . . . <br /> G OWNER NAME <br /> E OWNER PHONE # 20q <br /> N CONTRACTOR <br /> E �R-/JOy CON. PHONE# Zc +ioZ_5p8z <br /> R < SJLHD PERMIT # EPA 166c. Doo 1 1 : FIRE PERMIT # k) w <br /> A <br /> L <br /> INSPECTOR DATE G/3/�? _ TANK # 39 <br /> R RINSED ft)N) METHOD-T,g1p� �inSE RINSE AMOUNT /gyp C <br /> I c <br /> N RINSATE DISPOSAL SITE TMPopi�� , H 5 yAe� <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED Y N) METHOD 'n AMOUNT / - <br /> A J�Cy lCE USED <br /> l bS, <br /> P L.E.L. READING AT REMOVAL (MUST BE C 208) none USec� <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL ( EEL FIBERGLASS, OTHER) TANK SIZE <br /> K C c�000 C rA�o <br /> / O TANK CONDITION (GOOD, POOR HOLES) Rus-r (fV1D&&'J o,u TAvUK >o �c cmc <br /> P N o <br /> I S PIPE MATERIAL EEL, FIBERGLASS, OTHER) # FEET /O F7e�T <br /> P T hia c s k <br /> I PIPING CONDITION (GOOD, OOR HOLES) S iGl r CPP-Rts,o J <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A - <br /> �) -c <br /> I N , <br /> E K c- / z LDgnl , . <br /> D EXCAVATION SIZE: 1�4/XX 9 YDS OF SOIL: AkleT•v 'in,"{ � <br /> S <br /> I A DEPTH OIL TYPE OBS NATION 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 yds3 <br /> I — <br /> 0 H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> �O OTHER SAHPLE: <br /> LABORATORY: L'P-AJC AJC SAMPLERS NAME: — <br /> CLOSURE IN PLACE I MIXTURE: N)✓4- VOLUME: � jy+ <br /> DRAW SITE NAP ON REVERSE <br />