Laserfiche WebLink
. . . . . . . . . . . . . . . <br /> -Aw <br /> lu <br /> G OWNER NAME <br /> —E _ !I _OWNER PHONE # T _ <br /> N CONTRACTOR ��� CON. PHONE# <br /> E _ <br /> R ; SJLHD PERMIT # EPA # <br /> 41 A ;r;.*r r FIRE DEPT QF_Rhi 1 ` <br /> L ti ;r;r <br /> JLHD INSPECTOR — TANK # 39 <br /> R RINSED , Y N) METHOD <br /> I RINSE AMOUNT <br /> /— <br /> N RINSATE DISPOSAL SITE ( r <br /> E MANIFEST # —OR—` OTHER <br /> I� V VAPORS PURGED Y N) METHOD _ <br /> 1I <br /> A AMOUNT`� ,, USEDQ{�,.— rJ�-- <br /> P L. E.L. READING AT REMOVAL (MUST BE < 20%) <br /> o __-- Ni¢ <br /> T R COMMENTS <br /> TANK MATERIAL (STEEL, FIBERGLASS OTHER) TANK SIZE <br /> K C ' /j <br /> O TANK CONDITION (GOOD, PO , HOLE <br /> I S PIPE MATERIALTEE , FIBERGLASS, OTHER <br /> P T ) # FEET _ <br /> I <br /> I PIPING CONDITION (GOOD,/POOR, HOLES) � �-���T�` <br /> I N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> I lr <br /> r I F A �"r'4 � '— � �i�`U • Com. � � � l _ . y� <br /> I N <br /> E K ----- ---- -- t'�J <br /> L <br /> I D EXCAVATION SIZE: 1 r c( <br /> S YDS OF SOIL • <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S P I _....._.— ...... — <br /> P L P — <br /> E <br /> C N <br /> T G TRENCH DIMENSIONS : <br /> I ?C_�r_ YDS OF SOIL: <br /> 0 H DEPTH TO G.W. : 54- FT SAMPLING METHOD <br /> N 2 <br /> —0— I—OF—'HOURS—SINCE--DEWATERrN . <br /> F-ol OTHER SAMPLE: <br /> LABORATORY./1 �, `,'� <br /> SAMPLERS NAME: w <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: ' <br /> i <br /> 7 DRAW SITE MAP ON REVERSE <br />