Laserfiche WebLink
"J,tiv - UNDERGRUUND TANK CLOSURE/A$ANDONMENT INSPECTION <br /> (SHADED TO BE FILLED IN FOR THE RST TANK ONLY) <br /> s/ ES« io,. <br /> G OWNER NAME <br /> E OWNER PHONE # Su T <br /> W k n e � btsr" _�6 <br /> N < CONTRACTOR Lary CON. PHONE# <br /> E ser" �*cr . /n c. to - 8333 <br /> R SJLH PERMIT # EPA # eAc-000�p- FIRE PERMIT # <br /> L _ � , . a Aas <br /> INSPECTOR etzral O, DATE say_p9 TANK # 39 - cR39a- - UL <br /> R RINSED (Y,0 METHOD <br /> I RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE uncrPSsa�� c(at fy <br /> S G �rnF 6�inf iPuso Gs' <br /> a <br /> E MANIFEST //} -OR- OTHER <br /> V VAPORS PURGED Y N) METHOD /bry ice AMOUNT USED <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 208) <br /> 0 <br /> T R COMMENTS by <br /> A <br /> N (s TE EL� <br /> / 0 TANK CONDITION (GOO , POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL STEEL, FIBERGLASS, OTHER) # FEET i <br /> P T <br /> I PIPING CONDITION GOOD POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F A s G o <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: <br /> S- _2_ X �r X 'J yDS OF SOIL: b7 <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S P I <br /> P L P - - - <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION <br /> I X X YDS OF SOIL <br /> 0 H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> Fol OTHER SAMPLE: <br /> LABORATORY: /�� I ^ 6 SAMPLERS NAME: '-TeAC <br /> CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> ]31[ 23 043(7/88) DRAW SITE MAP ON REVERSE <br />