Laserfiche WebLink
d : - <br /> SJLHD a UNDER P,OTJND TANK CLOSURE/ ABANDONMENT INSPECTION <br /> ( SHADED AREA BE FILLED IN FOR THE FIl( ` 'AHK ONLY ) <br /> G OWNER 'NAME OWNER PHONE # <br /> E S <br /> N CONTRACTORCON . PHONE # <br /> E P � k � <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # Uv Scehl� <br /> A <br /> L <br /> INSPECTORK • FOLEy DATE TANK # 39 Ol <br /> R RINSED ( Y N METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE — <br /> S <br /> E MANIFEST # - OR - OTHER <br /> V VAPORS PURGED ( Y N ) METHOD �jz� ZC� AMOUNT USED <br /> A <br /> P L . E . L . READING AT REMOVAL ( MUST BE < 20 $ ) .— <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL ( STEEL FIBERGLASS , OTHER ) TANK SIZEICCC �G � ` <br /> K C of <br /> / 0 TANK CONDITION ( GOODIEOR , HOLECd }�- <br /> S ) (�n� Cc%r:'z% ,a-i� <br /> P N <br /> I S PIPE MATERIAL ( STEEL , FIBERGLASS , OTHER ) # FEET <br /> P T <br /> I PIPING CONDITION ( GOOD , POOR , HOLES ) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T ref C <br /> F A <br /> I N <br /> E K (219 <br /> y IFZ <br /> D EXCAVATION SIZE : X /amIIm' X YDS OF SOLL : 9fzjA 30465 <br /> S <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> I �(IR e �COJ <br /> 0 H DEPTH TO G . W . : r1 N SAMPLING METHOD <br /> N 2 � <br /> 0 # OF HOURS SINCE DEWATERING : <br /> OTHER SAMPLE : <br /> LABORATORY : SAMPLERS NAME : — <br /> n <br /> CLOSURE IN PLACE MIXTURE : VOLUME : — <br /> DRAW SITE MAP ON REVERSE <br /> _ � i <br />