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SJLHD - UNDf^0UWD TANK CLOSUFtk:/A4ANDO�;NT INSPECT!UN <br /> ((SHADED AR& PO BE FILLED IN FOR THE Flt TANK ONLY) <br /> i <br /> � � '. IT <br /> R c- TAti <br /> G OWNER NAME � OWNER PHONE # <br /> E <br /> N r CONTRACTOR ` Q,r CON. PHONE <br /> E ►7ui,L SrE.� <br /> R s SJLHD PERMIT I EPA I FIRE PERMIT I <br /> A <br /> ' t <br /> INSPECTORL DATE ;J 9 #� TANK 0 39 - 4LJ -- —�f-- <br /> R RINSED (Y/ METHOD RINSE AMOUNT �- <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST I -OR- OTHER <br /> V VAPORS PURGED 6>1 ) METHOD�1>1_oj d =AMOUNT USED <br /> .A <br /> . P G.E.L. READING AT REMOVAL (MUST BE < 20%) �- <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K c <br /> / 0 TANK CONDITION (GOOD, POOR, HOLE <br /> P N <br /> I S PIPE MATERIALEEL, FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, <br /> col- <br /> DEPTH <br /> N SOIL TYPE OBSERVATION SAMPLE 4 <br /> TI~ C{- i, e' <br /> N i <br /> F A <br /> I <br /> 1 ti <br /> E K <br /> L <br /> D EXCAVATION SIZE: X � 'X �� YDS Is <br /> '7 <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 i <br /> . I <br /> 0 H DEPTH TO G.W. : ma FT SAMPLING METHOD <br /> N 2 <br /> 0 I OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> Fo <br /> LABORATORY: � <br /> SAMPLERS NAME: �- <br /> _T_ <br /> CLOSURE IN PLACE MIXTURE: VOLUME:L : <br /> DRAW SITE MAP ON REVERSE <br /> Ell 2:3 0,13(7/88) <br />