Laserfiche WebLink
PHS--EHD -- UNDE*UND TANK CLOSURE/ABANDON144T INSPECTION <br /> (SHADED AREA 'CO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> faIF� � <br /> OWNER• NAME OWNER PHONE <br /> N CONTRACT <br /> E OR CON. PHONE# `r <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # <br /> A <br /> L _� <br /> INSPECTOR � DATE I}51�}O TANK # <br /> ENNRINSED (Y N) METHOD RINSE AMOUN-f -- <br /> RINSATE DISPOSAL SITEMANIFEST # -OR-- OTHER <br /> V VAPORS PURGED Y N) METHOD <br /> A (ce AMOUNT USED <br /> P L.E.L. READING AT REMOVAL (MUST BE ( 0%) <br /> O <br /> T R I COMMENTS <br /> A <br /> N TANK MA-rERIAL STEE , FIBERGLASS, OTHER) TANK SITD <br /> K C <br /> / O TANK CONDITION (GOOD, P'GOR LES) 14U� f Ki t <br /> N <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHI # FEET �r <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G <br /> T DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> F A < J e l -E=7 EE AfJ 4 <br /> I N t Nr) 4 { 7 S <br /> E K <br /> L <br /> D EXCAVATION SIZE, " <br /> S , �X [ X 't YDS ❑F SOILv <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I 4 - <br /> P L P <br /> E i E <br /> C N <br /> T G TRENCH DIMENSION X X _ YDS OF SOIL <br /> O �[H <br /> DEPTH TO G. W. : FT SAMPLING METHOD <br /> N <br /> # OF HOURS SINCE DEWATERING: ] <br /> ❑ O "��Infr1 SAMPLERS NAME: <br /> John Jones <br /> CLOSURE IN PLACE MIXTURE:Lf VOLURIE: ! <br /> EH 21"3043 ( 10/89) DRAW SITE MAP ON REVERSE <br />