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i <br /> PHS—EHD — UNDERGRf,uJNU TANK CLOSURE/ABANDONMEN— . 3PECTION <br /> (SHADED AREA TSE FILLED IN FOR THE FIRST�aNK ONLY) y/ <br /> i�!1�X ,�r}X,r%rte 4 /Ya/%; ,.�� / ./�, r/�/Y�rj i�Tr1.� .r 1 . / ,, . ./.r,i/'/,, ,;� i;'lr.Yi/ !•�/ r i;�i%' <br /> . �r1varCur�H�4if�riururrrruiuruiururanrurrurrrurviuuriucvraw.ram H�r�r ��raiaiaiararaurarurlaluiuiu �.r�r.�;rr�iuur!!/iailrcr uiuiuiu�� <br /> OWNER NAME OWNER PHONE # <br /> E <br /> N CONTRACTOR CON. PHONE# <br /> E <br /> R 'sSJLHD PERMIT # EPA # FIRE PERMIT # <br /> L ' <br /> INSPECTOR �, SUN — DATEb/� TANK # 39 — /6FS7 — .3 J1 <br /> _ <br /> R R I NSED (D) METHOD prMSU12t. GY RINSE AMOUNT,/a <br /> I <br /> N RINSATE DISPOSAL SITE � ' <br /> S Rp7/,4� �n�. ?s ,v.� ,4 <br /> E MANIFEST # —OR— OTHER <br /> �V VAPORS PURGED Y/ ) METHOD C AMOUNT USED _ <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE < 20:x) <br /> 0 0 <br /> T R COMMENTS <br /> A zecf <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZE 004 _ <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, �ES) <br /> N <br /> S PIPE MATERIAL (S E FIBERGLASS, OTHER) T—# FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> TT <br /> F A !z C/ - o r, sc <br /> I N I, / N� � < R> <br /> E K <br /> L <br /> D EXCAVATION SIZE: X X YDS OF SOIL: �� ��� �� <br /> S <br /> y <br /> I ALE <br /> DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M <br /> S P <br /> P L <br /> E IC N <br /> T GTRENCH DIMENSION X X --FYDS OF SOIL <br /> I <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 <br /> Cs # OF HOURS SINCE DEWATERING: <br /> 01 OTHER SAMPLE: <br /> LABORATORY: L SAMPLERS NAME : Bch <br /> CLOSURE IN PLACE MIXTURE: I VOLUME: <br /> 2304-3 ( 10/89) DRAW SITE• MAP ON REVERSE <br />