Laserfiche WebLink
._........... .._.._..__ ........ mac..., <br /> PHS-EHD UNDERGROL TANK�. CLOSURE/ABANDONMENTISPECTION,: <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK .ONLY) <br /> � �� ✓� _ o a s�, �-� ��a �� fir <br /> h <br /> E ,� ow AIV V e��y OWNER PHONE # G <br /> N CONTRACTOR CON. PHONE# ,7p X61 ��� <br /> E r <br /> ' 4 <br /> R % SJLHD PERMIT # P Z <br /> n FIRE PERMIT <br /> J J <br /> 4 <br /> IN S © DATE 6��6�9Z TAN}{ # 9 — <br /> h <br /> ! R RINSED (Y N METHOD L NSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S � <br /> E MANIFEST # --OR- OTHER <br /> V VAPORS :PURGED METHOAMOUNT USED 3 <br /> A <br /> F L..E. L. '',,READING AT REMOVAL (MUST BE <br /> T R COMMENTS <br /> I A ' <br /> N € TANK :MATCR I AL STEEL F I}3E RC,LASS, OTHER) TANK SIZE <br /> / 0 TANK ;CONDITION G.0 POOR, HOLES) <br /> N <br /> S WIPE 3MAFERIALTEE , FIBERGLASS, OTHER) # FEE'r <br /> P T <br /> I PIPING CONDITION (GOOD <br /> , F,DOR, HOLES) <br /> N <br /> DEPTH SOIL TYPE OBSERVATION <br /> T Cr ~- /CS /i�/ .fitcq g �j�G9t�Fn SAMPLE � <br /> F AS- <br /> I N <br /> E a <br /> L <br /> K <br /> D EXCAVATION SIZE: <br /> S X X YDS OF SOIL: JIDa <br /> I A DEPTH SOIL TYPE OBSERVATION N M P SAMPLE # <br /> S P I <br /> C N <br /> T G TRENCH DIMENSION <br /> i X X YDS OF SOIL <br /> O H DEPTH TO G. w. : <br /> N '-� FT SAMPLING METHOD <br /> t; # '•OF HOURS SINCE DEWATERING- <br /> 0 OTHER SAMPLE: <br /> _ ELAE�DRATORY: <br /> SAMPLERS NAME: <br /> CLOSURE IN ,'PLACE MIXTURE: �`7 <br /> VOLUME: <br /> i; <br /> 22043 j{ 10/89). DRAW SITE .MAP ON REVERSE <br />