Laserfiche WebLink
PHS-EHD - UNDEIND TANK CLOSURE/ABANDON, .* INSPECTION <br /> (SHADED AREA T BE FILLED IN FOR THE FIRST TANK ONLY) <br /> ,/ OWNER NAME OWNER PHDNE # <br /> E „ <br /> N C /- -7( j <br /> , ONTRACTOR CGN. PHONE# <br /> R ' s PERMIT fly <br /> # , <br /> A E 'A #CF�aW�7SbcD FIRE PERMIT # <br /> INSPECTOR <br /> R RINSED (Y/N) METHOD / <br /> I v �k� jr� RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE f <br /> E MANIFEST # -OR- OTHER f <br /> V VAPORS PURGED CY/N) METHOD <br /> A oL i ,r AMOUNT USED _, <br /> PL. E. L. <br /> 0 L. E. L. READING AT REMOVAL (MUST BE' ( 20%) <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL 'STEEL,�FIBERGLASS <br /> K C , OTHER) TANK SIZE <br /> / 0 - �. i✓fid � , ,� < % <br /> N TANK CONDITION (GOOD,' F�O� p�OLES) <br /> S PI,P€-MA-TER-I-AL---(-STEEL-�--F-ISERGLASSi OTHER) # FEE-r <br /> tir1 <br /> P T <br /> I PI-P-1-NG-EONDITTON -tGOGD- -POOR, --HOLES)_-_ <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F A r/' <br /> N <br /> E K 773 .N <br /> L <br /> D -D EXCAVATION SIZE: ' <br /> S X Z XYDS OF SOIL: <br /> I A DEPTH " TYPE OBSERVATION <br /> N M _w✓� <br /> P L io SAMPLE # <br /> S P <br /> c,� R <br /> C N <br /> T G TRENCH DIMENSION X X <br /> I YDS OF SOIL <br /> 0 H DEPTH TO G. W. : <br /> N - FT SAMPLING METHOD <br /> U # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: <br /> SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: <br /> H 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />