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PH8—EHD — UNDE IGUND TANK CLOSURE/ABANDONtlENT INSPECTION <br /> (SHADED AREA 10 BE FILLED IN FOR THE FIRST TANK ONLY) <br /> VA <br /> OWNER NAME .. OWNER PHONE # e <br /> E , <br /> N CONTRACTOR P ,� CON. PHONE# <br /> E <br /> R SJLHD PERMIT # EPA # FIRE PERMIT it ) 3t4O rl <br /> A <br /> L <br /> INSPECTOR DATE /, / TANK # 39 <br /> R RINSED (Y/N) METHOD ,��Q�N($� RINSE AMOUNT <br /> I �.�./ <br /> N RINSATE DISPOSAL SITE (.V�''<fTX ✓FIQOV/yF/1T—� L� <br /> S <br /> E MANIFEST # —OR— OTHER <br /> V VAPORS PURGED ON) METHOD (Ay IC E7 AMOUNT USED 7cpIts <br /> R <br /> P L. E. L. READING AT REMOVAL (MUST RE ( 20%) = O =7 <br /> D <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL , FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION ,O POOR, HOLES) <br /> N <br /> S PIPE MATERIALEE FIBERGLASS, OTHER) # FEET �D <br /> P T <br /> I PIPING CONDITION (GOOD, (SH HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE it <br /> T <br /> F A T <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: X YL- X 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 XX YDS Uf= SOIL <br /> I -- — <br /> 0 H DEPTH TO G. w. FT SAMPLING METHOD <br /> N -- <br /> U # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />