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RHS-EHD - UNDER[ JND TANK CLOSURE/ABANDONM INSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> �/!Lr/JjCLLt (�rl. ra' <br /> strc/ i'C2/ <br /> E OWNER NAME OWNER PHONE # <br /> N CONTRACTOR - CON. PHONE# >' <br /> E rCG.,5 r ori �� �-c o s o b 6 - ?1`// <br /> R SJLHD PERMIT # EPA # 9a Ss� FIRE PERMIT # <br /> A a ' <br /> i /O 'GOo2 (j i <br /> L <br /> INSPECTOR C DATE TANK # 39 <br /> R RINSED (Y/N) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE !tG <br /> SGy f r //so�> 41s <br /> • d'vc< <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED Y N) METHOD ��` /�� AMOUNT USED <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL STEED , FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION GOOD, POOR, HOLES) <br /> N <br /> S PIPE MATERIALTsTEEL FIBERGLASS, OTHER) # FEET ,o <br /> P T <br /> I PIPING CONDITION (GOO POOR, HOLES) <br /> N <br /> G T DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> i <br /> F A <br /> I N r- s7 0 C9 e-t'v� car d'r's o/v�4e'h <br /> E K <br /> L <br /> D EXCAVATION SIZE: /SX X $" YDS OF SOIL: <br /> S <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 /> LII <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> II N 2 <br /> �I 0 # OF HOURS SINCE DEWATERING: <br /> �i _ 0 OTHER SAMPLE: <br /> t� LABORATORY: SAMPLERS NAME: <br /> i <br /> !� CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> H 23043 (10/89) DRAW SITE MAP ON REVERSE <br />