Laserfiche WebLink
SJLHU - UNUk;l(u 14U fAL4A k.LUt)UItjljALWU1Uu/U• +•.����• • �• ✓ 6v/ <br /> (SHADED AREA PU DE FILLED IN FOR THE FIRST' TANK ONLY) <br /> 2 1570 <br /> G t OWNER NAME I)f\A / ✓1 OWNER PHONE tl(qj�l qc� <br /> N t CONTRACTOR ��� N11 TF IZ CON. PH0NEI - (b ( <br /> R SJLHD PERMIT 1 EPA M ) i Vie. FIRE PERMIT u a � 3 <br /> � �s <br /> INSPECTOR // DATE 3/Z3 g/ TANK Y 39 - � - :7— <br /> R RINSED Y/ ) METHOD RINSE AMOUNT � �U � <br /> I 2 y�Rvice <br /> N RINSATE DISPOSAL SITE RETIA ` � <br /> S <br /> E MANIFEST I -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD I�� AMOUNT USED /�� ) <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD), POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) I FEET /vj— <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) �� – PV)2/fn aUel- eXcku'4710 , <br /> N <br /> G NEXCAVATION <br /> SOIL TYPE OBSERVATION SAMPLE @ <br /> T <br /> I NKL <br /> D F SIZE: X 3D X YDS OF SOIL: <br /> 3: <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE I <br /> N M P XLLv <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 /> O H DEPTH TO G.W. : �_ FT SAMPLING METHOD v w <br /> N 2 <br /> 0 M OF HOURS SINCE DEWATERING: <br /> aOTHER �AMPL <br /> LABORATORY: AME: -�7 G AjCi- <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />