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I� (SHADED AREA TO BF--FqI L�L;EDx'gIN�FOR THE�FIURSaT yTr <br /> k ONLY) <br /> ,�/y� � v <br /> •� a i •"�'_.�•'r���'r�ilr�Jr�1r�`���.�r�",1�1r�1�'�'f�f�v�, f�, '. j '��r.�ir11r1G�'rr1���.'IL+� '�'vr r v��r1Ei,� �i'� <br /> E OWNER• NA ' Cp,� A7v )S4_ OWNER PHONE #J`��D-2�� -�S <br /> i <br /> N ': CONTRACT 'R peRS CON. PHONE�i y <br /> '� ddab Z •f <br /> R .F S,1LHD PERMIT # A # FIRE PERMIT #� �j�8 Q S� I <br /> INSPEC DATE / a TANK # 39 <br /> f R RINSER (Y N) METHOCI RINSE AMOUNT. <br /> N R I NSATE DISPOSAL S I'C'E f <br /> S <br /> E MANIFEST # --OR- OTHER <br /> V VAPORS PURGED METHOD/)k AMOUNT USED S' <br /> P <br /> L.-E. L. READING AT REMOVAL (MUST BE <br /> oxy 45'e- <br /> T { R COMMENTS <br /> A <br /> N TANK MA'.'ERIAL TEEL FIBERGLASS, pTHER) TANK <br /> K C SIZE 0 L /� ^ <br /> O TANK CONDITION GOOD, POOR, HOLES) <br /> N <br /> l S PIPE MATERIALSTEEL, FIBERGLASS, OTHER) 4F FEET <br /> P T <br /> I PIPING CONDITION CGOOD, POOR HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F � A <br /> I N . <br /> i K <br /> D EXCAVATION I ZE: X �cn/ <br /> S X YDS OF SOIL: <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M <br /> S P <br /> � , <br /> P L <br /> E I <br /> C N <br /> T G TRENCH DIM NSI N X <br /> I �-.» YDS OF SOIL <br /> 0 H DEPTH TO G. W. : <br /> N FT SAMPLING METHOD I <br /> G # bF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> LABORATORY: <br /> SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: <br /> i . <br /> VOLUME: <br /> EH 23043 ( 10!89) DRAW SITE MAP ON REVERSE <br /> . �....-_......__ . .t ... _ _......._ ..�_._.._._.... "-. ....... _.. ..- ... - .. - .-..... <br />