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PHS-EHD - UNDERGRO ` % TANK CLOSURE/ABANDONMENTSPECTION <br /> (SHADED AREA TO ILLED IN FOR THE FIRST TIO ONLY) <br /> •! /�Y�j •�/l/,Y/•/�� . /f • .. / li /. •l�J(!/.,ly(//��y/ �r�1 . . r. •.•/. ,l�/ • • ' <br /> i 1.4ITI e I /QrIUJ!/�YH �UJLl1!/!J/fAJ/! H17iJ/ Lv 1S IUDlA7G %G1V!!!fU <br /> -p H Y <br /> OWNER NAME -ret <br /> `f I OWNER PHONE #.Ze?-y _ aO <br /> E <br /> N FCCONTRACTOR CON. .PHONE# Qlb 3 <br />} E . <br /> R SJLHD PERMIT # NN EPA # NAr FIRE PERMIT # NA <br /> rt• G r <br /> L + i �-► c t <br /> INSPECTOR G.- �uN - DATE 92, '�Ri�kFf• 39 - - <br /> R RINSED (Y/N) METHOD oRI E AMOUN <br /> I � <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # z -OR- OT <br /> r <br /> V VAPORS PURGED (Y/N) D AMOUNT USED <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE C 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZE <br /> KERAMCON <br /> C <br /> L <br /> f P Engineering&Environmental Contracting <br /> EI Michael S. (Mick) Ramos <br /> N �� �;�, William Damon <br /> E P.O.Box 1024 :71 _Sr ICL V f Staff Techolclan <br /> 1401 Halyard Drive,Suite 130 Western Environmental' <br /> West Sacramento,CA 95691 Science&Technology <br /> F 1046 olive Drive,Suite 3 <br /> I Phone (916) 372-7535 Davis,CA 95616 <br /> E Fax(916) 372-4209 umn�NU.5,00a4 916 753-9500 <br /> L <br /> D S LEXCAVATION SIZE: X X YDS OF SOIL: '? <br /> I A DEPTH SOIL TYPE OBSERVATION 'SAMPLE # <br /> N M P <br /> S P I Z,6 No or, a ke., as , CH- <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL h1,4 <br /> z <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N <br /> 0 # OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: C -7.500. <br /> 4 <br /> LABORATORY; PS'/" c)I SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br />:H 23043 (10/89) DRAW SITE- MAP ON REVERSE <br />