Laserfiche WebLink
SJLIiD — UNVE:F,-ItUUND 'TANK CLOS URP;/AILANDON� . ;NT INS1'1+rCTlUN <br /> (SHADED ARi; r BE !TILLED IN FOR 7, Fa T TANK ONLY) <br /> G OWNER NAME OWNER PHONE # T <br /> E Ib <br /> N CONTRACTOR CON. PHONEIli�' - <br /> E <br /> R + SJLHD PERMIT I! EPA I FI�fRE PERMIT I <br /> A . . . . . . . . . . . . M.5 <br /> I NSPECTOR Q j, DATE 12/9/8$ TANK 1 39 — ,jD2S __ — .62, <br /> -- <br /> R RINSED (Y/O METHODS"" RINSE AMOUNT— <br /> J_. <br /> N RINSATE DISPOSAL SITE ;M <br /> S � <br /> E MANIFEST I '—"" —OR—' OTHER <br /> V VAPORS PURGED /N) METHOD / j.C�' ;p AMOUNT USED �OD Jfu <br /> A � <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20$x) r <br /> 0 aM <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL STEEL FIBERGLASS, OTHER) TANK SIZE • <br /> K C 7 i0�111C OF cae�cmo? � <br /> / 0 TANK CONDITION OOD, POOR, HOLES). ,� xo oc.� n!o"r' <br /> P N _ <br /> I S PIPE MATERIAL STEL 41' FIBERGLASS, OTHER)' FEET MAC" <br /> P T M <br /> I PIPING CONDITION (GOOD, POOR, HOLES) �...��. <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION0 SAMPLE I <br /> . T � <br /> F A <br /> I N it 2. O� <br /> E K II c 4 Of <br /> I: L �} <br /> D EXCAVATION SIZE: X X .3 1 .11YDS OF SOIL: .�— <br /> S: � <br /> I A DEPTH SOIL TYPE OBSERVATION'`i SAMPLE I <br /> N M P �p <br /> S P I <br /> � II <br /> PIXd} <br /> P L P <br /> !M <br /> E I E <br /> II <br /> C N <br /> T G TRENCH DIMENSION X X IYDS OF SOIL11 <br /> INO 171N!'J"dLLf <br /> O H DEPTH TO G..W. : "hI FT SAMPLING METHOD <br /> N 2 II ivolw /woos <br /> 0 A OF HOURS SINCE DEWATERING: �! <br /> ❑OR SAMPLE: <br /> OTHEC <br /> I� <br /> LABORATORY: !t_ �lSAMPLERS NAME: <br /> i <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> Jul 2:1 04:1(7/88) �� <br />