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SJLHD — UNDEf 7UNO 'TANK CLOSURE/AIJANDUb_ �'1' IN;;1'Ll:'1'1UN 600o <br /> . (SHADED AREA r0 BE FILLED I N FO�R�,THE FIRST TANK ONL Y <br /> �� �C������c�- �� i =�. ?=�. . . ;. ' ,• <br /> G � <br /> OWNER NA ktcoo?e 1 W <br /> E OWNER PHONE JI • �- c <br /> NCONTRACTOR r< <br /> CON. P H ONE M <br /> R SJLHD PERMIT I EPA CJ <br /> FIRE PERMIT U <br /> Ile <br /> l ft5 Uft <br /> 7 r, <br /> INSPECTq / DATE — <br /> •-�, �j_L���3 TANK II 39 - ���'v 5� 3 <br /> R RINSED (YIN) METHOD' <br /> I RINSE AMOUNT/ <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST I -OR- OTHER <br /> V VAPORS PURGED �Y�/N) METHOD )�('� :77 AMOUNT USED <br /> .A y. <br /> ' P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEE , FIBERGLASS, OTHER) TANK SIZE <br /> K c l�G <� - I <br /> / 0 TANK CONDITION ' COOD, POOR, HOLES) <br /> P N _ <br /> ` I S PIPE MATERIAL (STEED BERCLASS, OTHER) 11 FEET / i <br /> J P T -� <br /> I LPIPING CONDITION' (GOOD POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE Jt <br /> F A <br /> I N - c� <br /> E K <br /> L <br /> D EXCAVATION SIZE: _�X 2 X // <br /> g: 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 rz Z- 11 <br /> C N <br /> T C TRENCH DIMENSION __ X X <br /> I YDS OF SOIL <br /> 0 H DEPTH TO C.N. : FT SAMPLING METHOD <br /> N 2 <br /> U 1 OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> i LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />