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SJLHD - UND�" {1UND TANK CLOSURE/Al�AND0''- T INSPECTION <br /> (SHADED AA91yTO BE FILLED IN FOR THE F TANK ONLY) <br /> illuu�s117b aw; ; <br /> G OWNER NAME Ld' 0,IQ e5 OWNER PHONE # nz <br /> E <br /> N CONTRACTOR '-! CON. PHONE# ' <br /> E .. W 1 f oNs - O,N <br /> R < SJLHD PERMIT # EPA #CgGO00- FIRE PERMIT 047 V7 #:/�. <br /> INSPECTOR Nu�'7 DATE 6/2i jM TANK 1 39 - 3Y/ <br /> R. RINSE (Y/ ) METHODS amen RINSE AMOUN .� <br /> r - <br /> N: RINSATE DISPOSAL ;'SITE <br /> EMANIFEST # -OR- OTHER [c_Xrre`� •% �v�kd <br /> _ V VAPORS PURGE (Y/ ) METHOD a� ZG.e AMOUNT USED. <br /> !. A. <br /> P - L.E.L. READING AT REMOVAL (MUST BE C 20%) <br /> s 0 <br /> ' T R COMMENTS <br /> A <br /> N TANK MATERIAL {STEEL, FIBERGLASS, OTHER) TANK SIZE DOQ <br /> K C <br /> / O TANK CONDITION (GOOD, POOR, HOLES) <br /> P N <br /> IJT PIPE.,MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> 3I PIPING CONDITION'�' (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL ' TYPE OBSERVATION SAMPLE # <br /> 1, A �^- <br /> E K <br /> L <br /> D EXCAVATION SIZE: 37 X t3 X 7 YDS OF SOIL: <br /> I ' A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> p L P. <br /> E' I - E <br /> :. C N <br /> T G TRENCH DIMENSION X X. YDS OF SOIL <br /> 0 H DEPTH TO G.W'. : - FT SAMPLING METHOD . <br /> N 2' <br /> 0 I OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> LABORATORY: �' �dN�,e SAMPLERS NAME: <br /> _ i <br /> CLOSURE IN PLACE MIXTURE: VOLUME: '. <br /> DRAW SITE MAP ON REVERSE <br /> :° _ <br /> AF.:-23- €)4:3(7/88). =: ' <br />