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SJLHD - UNDE[N )UND 'TANK CLOSURLIA161NDON. 1'1' <br /> (SIIADED <br /> ARE ;0 DE FILLED N FON THE FIRST TANK ONLY) ; 2 a l' <br /> .. J� �c��c�c-.c�c . . ti f:. . . . s7=fit .' <br /> 22 <br /> G OWNER NA <br /> E ME to .2U OWNER PHONE I <br /> N CONTRACTOR r ' <br /> E t� C LD/VS�' CON- PHONE# ' �, <br /> R SJLHD PERMIT # EPA # <br /> A ` `f FIRE PERMIT # iLL S7AV/i7 ,_ <br /> J U�� <br /> n <br /> INSPECTO DATE <br /> R RINSED N) METHOD <br /> I / RINSE AMOUNT / <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIF9ST Y -OR- OTHER <br /> V VAPORS PURGED Y N) METHOD AMOUNT USED <br /> A <br /> • P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEELl) FIBERGLASS, OTHER) TANK SIZE::_ �� i <br /> / 0 TANK CONDITION (GOOD POOR, HOLES) <br /> P N <br /> ` I S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) Y FEET <br /> J P T <br /> I PIPING CONDITION (G00P,,� POOR, HOLES) SPS flt <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F A i '_ 317. <br /> I -2-/Ll <br /> E K � - <br /> L <br /> D 3; EXCAVATION SIZE: �, X X / ° YDS OF SOIL: <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 X X <br /> I YDS OF SOIL <br /> O H DEPTH TO C.W. : FT <br /> N 2 SAMPLING METHOD <br /> 0 M OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />