Laserfiche WebLink
/,..tr14E., \ '-'�'- •��••�. �i+rrvrt7 sif7f7vNi:r4Ti/v��rNrt✓�ra.riri�irrwr .rr «." •� <br /> KJ C l i c SO i1 r 1 k H15 btt <br /> --�- wNER NAME OWNER PHONE # <br /> N CONTRACTOR CON. PHCNE* c <br /> S,FLHD PERMIT # I EPA #(-„#COOfr/770/ FIRE PERMIT <br /> ,.l�GrG rGcy y � '” ��L�yy`G.s J G .G''rG rrG�✓rGrGrG rr '''r6rGG GiG� <br /> M=. V" t_.._ S'um= Ll r r+l.= mr l.L.uz3Qm= <br /> INSPECTOR I DATE _ TANK # ,39 <br /> R RINSED O/N) ! METH003 � RINSE AMCUNT � <br /> I !'gin �ifs1 �5 <br /> N RINSATE DISPOSAL SITE <br /> E MANIFEST # 0�20 565y9d -OR- OTHER '• <br /> V VAPORS PURGED (9N) I METHOD / ( AMCUNT USED J <br /> P { L. E. L. READING AT REMOVAL (MUST RE < 20::) <br /> 0 / <br /> i T R COMMENTS <br /> A l <br /> N i TANK MATERIAL ±E=o, FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> coo >cSe <br /> / 0 i TANK CONDITION (GOOD, POOR, GLE ) j <br /> ~. S i PIPE MATERIAL ((!TE= , FIBERGLASS, OTHER) # FEET jQ <br /> P , 1 <br /> I { i PIPING CONDITION (GOOD CO HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION I SAMPLE <br /> ( # ! <br /> IT I ; <br /> F I I A <br /> I N <br /> C <br /> E( <br /> L i I <br /> D j ( EXCAVATION SIZE: X X 7 YDS OF SOIL: jr <br /> I S I <br /> I i A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N ,M P I I <br /> S I P I I <br /> P L P <br /> r E i I E <br /> C I N <br /> I � <br /> G I TRENCH DIMENSION X X YDS OF SOIL �- JxO <br /> 0 i H t DEPTH TO G. W. : FT I SAMPLING METHOD <br /> N j 1 2 <br /> I 0 # OF HOURS SINCE DEWATERING: ' <br /> i f <br /> 0 i OTHER SAMPLE: f <br /> LABORATORY: 1--6 ZSAMPLERS NAME: M <br /> LLOSURE IN PLACE ( MIXTURE: VOLUME: <br />:H 2_04 (I4/8S) DRAW SITE MAP ON REVERSE <br />