Laserfiche WebLink
SJLHD - UNDER'-;ROUND 'TANK CLOSURE/A4AND0N^11iNT INSPECTION <br /> (SHADED ARov <br /> TO BE FILLED IN FOR THE F T TANK ONLY) <br /> tee. A,2,1 <br /> G OWNER NAME <br /> E OWNER PHONE tl <br /> N CONTRACTOR LeoNQtq <br /> E Ctts CON. PHONE# <br /> R SJLHD PERMIT tl 2o9_ <br /> LtA tl FIRE PERMIT tl <br /> INSPECTOR <br /> C f{ttL,-f- DATE z/22 5 TANK tl 39 <br /> Q� \� R RINSED (Y/N) METHOD -�— <br /> I RINSE AMOUNT <br /> r N RINSATE DISPOSAL SIT <br /> S <br /> �u E MANIFEST tl <br /> -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD <br /> A AMOUNT USED <br /> p L.E.L. READING AT REMOVAL <br /> O UST BE < 20$) <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL, FIBER LASS <br /> K C , OTHER) TANK SIZE <br /> / 0 TANK CONDITION (GOOD, <br /> P N POOR, H LES) <br /> I S PIPE MATERIAL (STEEL, FIBERGLASS OTHER) tl FEET <br /> p T <br /> I PIPING CONDITION (GOOD, <br /> N POOR, HOLE.6) <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE tl <br /> F A 1 <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: X X <br /> S . YDS OF SOIL : <br /> I A DEPTH SOIL TYPE OBSERVATION N M SAMPLE <br /> I ON tl <br /> S P '� • +aw � <br /> m , <br /> P L p o., co or iati a�c'� Gd1 <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION —z„ X <br /> 1z X �O <br /> I YDS OF SOILS <br /> 0 H DEPTH TO G.W. : <br /> N 2 FT SAMPLING METHOD — <br /> O tl OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: — <br /> LABORATORY: F(,t- SAMPLERS NAME: Mar{ <br /> CLOSURE IN PLACEro, <br /> MIXTURE: <br /> VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> lilt 2'P ^9'!(7/88) <br />