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RHS-EHD - UNDERGROU*6 TANK CLOSURE/ABANDONMENT"'" <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> i�ii�!/�" /, . .rr .�/ , iyPd�iY,l/�/�'��'%�/r�'�,y���✓I�(/ r120,00111 <br /> '. , ,�' <br /> 1� t�tV i1�t rur ruruiaruiaiuurruruuriuivaiiuwurruuri rur�r1 � iuiuiuiuiuuriuuiJaiuiuiuiui' �i ui0vrririri <br /> d ,�d 2 J Cen Ae r sc,� <br /> OWNER NAME jP T OWNER PHONE # <br /> E 214 �f) - Jas 9 <br /> ECONTRACTOR-r LC :y Ct `�JYl/c+tn\ CON, PHONE# <br /> A SJLHD PERMIT # nllA ERA #CAStODo� FIRE PERMIT # <br /> L <br /> INSPECTOR DATE j5 lq) TANK # 39 <br /> R RINSED &A) METHOD Ori.pj.e ri nom, RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE -Th e- K i eseI <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y/ ) METHOD 'L)y le- AMOUNT USED ZqU rb5 <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE ( 0%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> NTANK MATERIAL (STEEL, i I BERGLASS OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, HOLES) 9a h e�s, (L3 <br /> N <br /> S PIPE MATERIAL (STEEL,) FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G SOIL TYPE OBSERVATION SAMPLE # <br /> T �y , / 1- <br /> F A C (. �j I�v Ori O G�o r <br /> I N <br /> T� <br /> E �{ Tz <br /> L <br /> D EXCAVATION SIZE: LJIZ X /Z"X IZ YDS OF SOIL: <br /> S <br /> I A DE�TH SOIL TYPE . RSE VATIO J SAM 'LE # <br /> N M P t ��,n-� _ Y' Gi tS CdI DYQf 161 <br /> S P I 2 i D J11 {j <br /> P L P <br /> � S p A Cd <br /> t I E 3 Od0 r �4 <br /> C N 15�D10�a �Y O <br /> T G TRENCH DIMENSION JDA X X YDS OF SOIL r <br /> I L I — - <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: l <br /> EllOTHER SAMPLE: 1 <br /> LABORATORY: (� j, EnViruofric-l-tx� 446 s SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME <br /> 1.304„ ( 10/89) DRAW SITE MAP ON REVERSE <br />