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SJLHD - UNDI 'ROUND 'TANK CLOSURE/A11ANDO -NT INS;VECTIUN <br /> (SHADED AR0r TO DE FILLED IN FCw THE F1'?fST TANK ONLY) <br /> �C �hLf/V-✓-cam 6 J .S .--) TOG/�T4y1 <br /> G < OWNER NAME �� �� . ✓ OWNER PHONE q <br /> E y� g y8- 7 ( 6' <br /> _ <br /> N CONTRACTORI ACES �� ✓� CON. PHONEN <br /> E ! /G <br /> R < SJLHD PERMIT tl EPA Y FIRE PERMIT p '2- <br /> A FI SZ <br /> L ; HIM, IRMIN <br /> INSPECTOR T DATE "� / &lg / TANK Y 39 4Z2 <br /> R RINSED e(N) METHO RINSE AMOUNT �v <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST @ -OR- OTHER <br /> V VAPORS PURGED (�YN) METHOD �` (,j AMOUNT USE 6 <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE ( 20�) <br /> 0 <br /> T R COMMENTS <br /> N TANK MATERIAL (STEEL FIBERGLASS, OTHER) TANK SIZE <br /> Sda� <br /> x c <br /> r / 0 TANK CONDITION 0 POOR, HOLES) f I L ,. n _ <br /> P N I� <br /> I S PIPE MATERIALSTEEL FIBERGLASS, OTHER) Y FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES ) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION wl SAMPLE Y <br /> T <br /> F A <br /> I N h tvz.at2cGlivv / <br /> E K <br /> el �� buJ <br /> L <br /> D EXCAVATION SIZE: XX / YDS OF SOIL: <br /> S- <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE q <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 G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 tl OF HOURS SINCE DEWATERING: <br /> ur_o� OTHER SAMPLE: G O <br /> LABORATORY: � � SAMPLERS NAME: Qlel _27;0M A <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> EH 2:1 04:1(7/88) <br />