Laserfiche WebLink
-- G, .ii:hC,.. ., P,N, .:,,SUffL, tai(AIJUUNMIi ! INbL'LC.11UN <br /> (:>ifADED AREA & DE FILLED IN FOR THIS rliw TANK ONLY) <br /> ` r - <br /> G OWNER NAME <br /> E OWNER PHONE q <br /> N < CONTRACTOR <br /> E CON. PHONEq <br /> R SJLHD PERMIT qEPA I FIRE PERMIT q <br /> L : <br /> INSPECTOR DATE ?� 9j TANK q 39 <br /> R RINSED ( /N) METH0 ti RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S A a. ) >< Lone./446 <br /> E MANIFEST q -OR- 0TH <br /> V VAPORS PURGED Y N) METHODCAMOUNT USED <br /> A C / 2 <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL ( STE - , FIBERGLASS, 0`1HER) TANK SIZE`> <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, HOLE ) <br /> P N <br /> I S PIPE MATERIAL STEE , FIBERGLASS, OTHER) q FEET, / <br /> P T v� <br /> I PIPING CONDITION (GOOD, P00 , HOLES) <br /> N F771 771 nP.PTtI enxT, /Tvf.+n nRSR,RVATTON n p SAMPLE U <br /> 71 8/ /2� G'ICuA . ._ 11 ._l <br /> der- 0✓ CC(S(°oC -LZ— �� <br /> I N (/ <br /> E K <br /> L <br /> D 3- _EXCAVATION SIZE: X X YDS OF SOIL : <br /> — <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE I <br /> S P I ilJ <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 C.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 q OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> LABORATORY SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />