Laserfiche WebLink
PHS-EHD - UNDERL . OND TANK CLOSURE/ABANDONA'"hwW INSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> j� " OWNER NAME /f�//(1r/.,r�1� /LL�1r! �/ OWNER PHONE # Z2T dZZ <br /> / -r ..'Ys <br /> E <br /> N CONTRACTOR � CON. PHONE# <br /> E :v <br /> R SJLHD PERMIT # EPA # FIRE PERMIT F <br /> INSPECTOR gg_ 4- DATES �q j TANK # 39 - 6 Z - <br /> R RINSED <br /> RINSE AMOUNT 7-Al" <br /> / ) METHOD ('��•�t�l�� <br /> N R I NSATE DISPOSAL SITE 2 ','Wl C PS a <br /> S <br /> E MANIFEST # ��0 13K -OR <br /> V VAPORS PURGED ON) METHOD AMOUNT USED r,200/bs <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE < 20%) <br /> O ' <br /> T R COMMENTS <br /> A <br /> N TANK MATERIA � FIBERGLASS, OTHER) TANK SIZE <br /> (STEEL, <br /> K C <br /> / O TANK CONDITION (GOOD, 'PO0 HOLES) <br /> N - <br /> S P I °E MATERIAL STEE , BER GLASS,� OTHER) # FEET <br /> P T <br /> I PIPING CONDITION GOOD POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> Tf' <br /> F A (c " .k) 4- H o <br /> I N <br /> C �..-� a E s <br /> E K <br /> L <br /> D EXCAVATION SIZE: X � X ' !/� YDS OF SOIL: e pute <br /> S SAMPLE # <br /> I A DEPTH SOIL TYPE OBSERVATION Ma Nos <br /> N M - <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> 7 G TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> O H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N <br /> v # OF HOURS SINCE DEWATERING: <br /> Fo_I <br /> OTHER SAMPLE: <br /> _T <br /> LABORATORY: ./* �n� GY�t ' SAMPLERS NAME:, /\ <br /> CLOSURE IN F'LACE MIXTURE: VOLUME: <br /> EH 23043 ( lo/89) DRAW SITE MAP ON REVERSE <br />