Laserfiche WebLink
J. <br /> PHS-EHD - UNDEf-ROUND TANK CLOSURE/ABANDq'i INSPECTION <br /> (SHADED AR0 BE FILLED IN FOR THE :FI,. <br /> p�yTANK QNLY) <br /> E �ci��cc .fP, �Iirr,Y, OWNER PHONE. # <br /> N CONTRACTOR �Uq �5ra �'SyaD <br /> E 15p %C7 �ti✓/ran w�P. I <br /> / CON.' ��WONdE# �� /jg <br /> �c-%Ga /GNS <br /> R SJLHD PERMIT # EPA #c�b9E�i y�t�j,y <br /> A FIRE PERMIT # f 3agj , ,i <br /> L ' <br /> . INSPECTOR � <br /> C'. ��liN PATE / 9C� a TANK ,# 39 - 07 <br /> R RINSED (9N) METHOD <br /> I �G�. �l�su RINSE AMOUNT <br /> N R I NSATE DISPOSAL SITE PP !?�yci�tr Gf - <br /> E MANIFEST # -OR- OTHER <br /> AV VAPORS PURGED (Y N): METHOD AMOUNT USED <br /> Ic . 07/65 <br /> P L. E. L. READING AT REMOVAL (MUST BE. < .26%) <br /> 0 <br /> T R COMMENTS C�(,L '.no TllrA <br /> N TANK MATERIAL ( TEE FIBERGLASS, OTHER.) TANK SIZE <br /> K C L p <br /> / 0 TANK CONDI-TION , (GOOD, POOR, HOLES) <br /> N R'7r -rra r!itl�s obsP/a^P <br /> .' 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 /> F A <br /> 3, vpj P LjS� T-Z <br /> N - <br /> K <br /> L ✓ r a � STZ.' <br /> D EXCAVATION SIZE, 115, X Lao' X. YDS :OF SOIL: <br /> S Soo qd f= <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P . SAMPLE # <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 /> LON <br /> i <br /> DEPTH TO G. W. T FT AMPI, I NG ' METHOD <br /> # OF HOURSSINCE DEWATERING: <br /> 4 <br /> OTHER SAMPLE:ABORATORY: ( ERS NAME: 1 c;:. 4s•�3 -RE IN PL7 <br /> ACE MIXTURE: VOLUME: <br /> EH 03043 ( 10/89) DRAW SITE MAP ON REVERSE <br />