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- until:^i<uUnu 'TANK CLOSUkE/ALAANDOP--�:NT INSPECTIUN <br /> (SHADEDAL <br /> AR `,_TO DE FILLED IN FOR THE I` 'T TNK ONY <br /> ' ) <br /> 11 qE4 OWNER 'NAME S CiOur� �J C OWNER PHONE # <br /> CONTRACTOR CON. PHONE# <br /> E <br /> R < SJLHD PERMIT I I EPA # CACCObgoj FIRE PERMIT # SC}- L(-+ <br /> L . . . . . . . . . . . , . . . O� � <br /> INSPECTOR DATE <br /> � bh(j TANK I 39 <br /> R RINSED (Y ) METHOD _- RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST I le2.lGK-QA-) 0"Le I'OR- OTHER <br /> V VAPORS PURGED (!,A) METHOD Ry /C,�_ I AMOUNT USED /QO 'bs <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 208) <br /> 0 <br /> T R COMMENTS <br /> IJ `7ANK ►19AMIA (StE,64 FI�ERGL�tsS, pp}fER) TANK SIZE ti <br /> / O TANK CONDITION (GOOD, OOR, HOLES) j(��u� C0 �ipN ClliL�i7 � 'i <br /> P N <br /> II T PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) I FEET ovlo ' <br /> I PIPING CONDITION . (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE I <br /> F A AJO O , /ZR`Tl e .. <br /> I N i AJC) obcr v <br /> E K °5'UGNr o�oV- � t <br /> L ' Ak <br /> D EXCAVATION SIZE: S X X YDS OF SOIL: 5 <br /> S- <br /> I A <br /> N M P DEPTH OIL TYPE 0 SERVATION AMPLE I <br /> S PI <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> 0 H DEPTH TO G.W. : SAMPLING METHOD <br /> N 2 <br /> 0 I OF HOURS SINCE DEWATERING: <br /> I <br /> EO OTHER SAMPLE: r <br /> LABORATORY: lid` f}iYYZ SAMPLERS NAME: b(tV'< <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> Ell 23 043(7/88) <br /> i <br />