Laserfiche WebLink
PHS-EHD - UNDE ROUND TANK CLOSURE/ABANDO NT INSPECTION <br /> (SHADED AREAS BE FILLED IN FOR THE FIRST TANK ONLY) <br /> yj <br /> S E ►peen � err ��fY���'� --�� � ���/ , S <br /> � r <br /> / OWNER NAME OWNER PHONE # l <br /> E •��01�' .v S,Irer- CrTNn �- %8 - Boz i' <br /> N % CONTRACTOR �� CON. PHONE# <br /> E l �.vc 16- <br /> R . SJLHD PERMIT # <br /> A EPA #('q- ooroZ�O33 FIRE PERMIT # <br /> �j � <br /> L <br /> J <br /> INSPECTOR �- N� DATE 5-/311p TANK # 39 - 106T-- <br /> R RINSED (Y ) METHODRINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S P sf L ^,N e pf-f -Zell; S�' �crcTv 0995 Z <br /> E MANIFEST # -OR- OTHER <br /> AV VAPORS PURGED (Y N) METHOD �� AMOUNT USED <br /> 22' So lis <br /> P L. E. L. READING AT REMOVAL (MUST BE <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIALTEEL FIBERGLASS, OTHER) TANK SIZE <br /> K C Sl pod <br /> / 0 TANK CONDITION (GOOD, POOR LES) <br /> N <br /> S PIFSE MATERI (STEEL FIBERGLASS, OTHER) # FEET,, �O <br /> P T <br /> I PIPING CONDITION (GOOD POOR, OLES) <br /> N <br /> G T DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> 1 <br /> F A „ t C o s r 6 o,^ /d <br /> I N <br /> E K Ilk <br /> L <br /> D S EXCAVATION SIZE: X 1 3 X � r YDS OF SOIL: v Ols <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I �" e <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X Z2 X 3r YDS OF SOIL <br /> � <br /> I � �S <br /> —7 <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 <br /> C► # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY : yo <br /> �f ' � <br /> � SAMPLERS NAME <br /> -7 CLOSURE IN PLACE MIXTURE: VOLUME : <br /> EH 23043 (10/89) DRAW 7ITE MAP ON REVERSE <br />