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law <br /> SJLHD — UND�OUND 'TANK CLOSUkX/Al(AND*NT INSPLU'!'luN J %r <br /> (SHADED AR TO DE FILLED IN FOR TUE FIRST TANK ONLY) <br /> 2icYJittytiittt 7 f <br /> I i i en,\Jlo� c c c:sit t 3z t c ` l �t t t <br /> o u E nn C S OWNER NAME —j �hi i R <br /> OWNER PHONE I � 33 7 <br /> yydd 7i0 �— $ZJS <br /> EI, CONTRACTOR Tev o� hi5 p` p CON. PHONE# <br /> bA <br /> R SJLHD PERMIT # EFIRE PERMIT q / 0 <br /> Ay . . . . . . . . . . . : � . . . . . . . . y. <br /> INSPECTO DATE 5 D TANK # 39 <br /> R RINSED (Y N METHOD RINSE AMOUNT <br /> I n <br /> 3 RINSATE DISPOSAL SITE V_ W060t( <br /> E MANIFEST # —OR— OTHER <br /> V VAPORS PURGED (�/N) METHOD D2 ZG2 <br /> .A vvi AMOUNT USED <br /> P L.E.L. READING AT REMOVAL (MUST BE ( 20%) <br /> 0 <br /> T R COMMENTS <br /> A L d�L <br /> N TANK MATERIAL T FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION GOO , POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) E <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPT SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F A <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: TL X X YDS OF SOIL: <br /> S; <br /> I A DEPTH SOIL TYPE OBSERVATION SAM LE # <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 -- <br /> 0 H DEPTH TO C.N. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> H70 <br /> OTHER SAMPLE: p-f_A41C gPpPS <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE 1 =MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />