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:1 <br /> RHS—EHD — UNDEF` SOUND TANK CLOSURE/ABANDON JT INSPECTION <br /> N (SHADED AREA Tyr BE�jFILLED <br /> IN FOR THE; FIRST TANK ONLY) / <br /> E <br /> OWNERNAME OWNER PHONE # <br /> N CONTRACTOR ;l <br /> E �jQ �� CON. PHONE# <br /> R SJLHD RMIT # <br /> A , EPA # 11FIREi PERMIT # / <br /> L 3 <br /> 1 ' <br /> INSPECTOR DATE <br /> TANK i�# 39 7 i — Z <br /> R RINSED N} <br /> I METHOD RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # —OR-- OTHER <br />{; <br /> V VAPORS PURGED /N) METHOD <br /> A /�P AMOUNT USED X130,1k_�� <br /> P L..E. L. READING AT REMOVAL (MUST BE < a6%) 7 <br /> 0 <br /> T R COMMENTS <br /> i N TANK MATERIAL (STE , FIBERGLAS <br /> K C S, OTHER) 'TANK SIZE <br /> R <br /> / 0 �oc�u <br /> TANK CONDITION (GOOD, POOR HALES) <br /> I N ,. <br /> 1 S PIPE MATERIAL CSTEEL FIBERGLASS, DTHER;) # FEET G <br /> P T x <br /> I PIPING CONDITION (GO <br /> i N OD, POOR, HOLES) <br /> G DEPTH SOIL TYPE OBSERVATION } <br /> T SAMPLE # <br /> F A f •lu a c�rr� � � , <br /> I N <br /> E .� rcrn fro. /Gc7 <br /> it Y� <br /> L <br /> D EXCAVATION SIZE; Or <br /> S �-- X 30L X }YDS :OF SOIL: S2.Q C'/U <br /> I A TH SOIL TYPE OBSERVATION <br /> N M P j SAMPLE # <br /> S P I <br /> P L P i3 <br /> E I E Gi <br /> C N <br /> T G <br /> I <br /> TRE DIMENSION X X YDS <br /> It OF SOIL <br /> 0 H DEPTH TO G. W. ; — FT lee I <br /> N i SAMPLING METHOD S � des <br /> 0 # OF HOURS SINCE DEWATERING: �G <br /> ,1 <br /> 0 OTHER SAMPLE: 3, <br /> LABORATORY: Qf SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: syti <br /> Id VOLUME: <br /> EH 2:,043 (10/89) DRAW SITE MAP ON REVERSE <br />