Laserfiche WebLink
,`-P4iS-EBD - UNDERf, }1ND TANK CLOSURE/ABANDONt+t►�i INSPECTION <br /> (SHADED AREA u BE FILLED IN FOR THE FIRST TANK ONLY)WTommufaral" <br /> Oil <br /> E OWNER- NAME 60g< c�c` OWNER PHONE # ;r _31 <br /> N CONTRACTOR CON. PHONE# <br /> EC.9G o00 <br /> 11 <br /> R SJLHD PERMIT # EPA FIRE PERMIT # 33� <br /> L <br /> INSPECTOR DATE1 /(v/�lJ TANK # 39 <br /> R RINSED N) METHOD J('� RINSE AMOUNTQj,)O <br /> N RINSATE DISPOSAL SITE C �} chi CQS .� <br /> S <br /> E MANIFEST # -OR- OTHER <br /> AV VAPORS PURGED Y/N) METHOD �� AMOUNT USED S <br /> P L.-E. L. READING AT REMOVAL (MUST BE < 20X) O X) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL, IBERGLASS OTHER) TANK SIZE n„� / <br /> K C ��J / <br /> / 0 TANK CONDITION GOOD, POOR, HOLES) A)/ ObV/bZS (Jeje s 170 <br /> N <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH tOlL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A - b5 / Go <br /> I N <br /> E 13, <br /> K O t�rc TI Cas ' IB'So <br /> L Su r '�X <br /> D EXCAVATION SIZE: -�2 X 3' X `I YDS OF SOIL: <br /> S <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S P I <br /> P L P <br /> E I E 3 KlnPTY„, <br /> C N <br /> T G TRENCH DIMENSION X X <br /> I YDS OF SOIL <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 , <br /> G # OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23.043 ( 10/fig) DRAW SITE MAP ON REVERSE <br />