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PHS—EHD — UNDER"'20UND TANK CLOSURE/ARAN-' N; <br /> ((SHADEID�gA�r 1i B'y EU,y FFIyL�L;yEIyD� IN FOR THE T INSPECTION <br /> �:I'tii7'.1L1v"1��r.Cv�i.1v'.�J%�i':�v��ri'.1r.1L:4�r1�i'�i �R�t TANK ONLY) <br /> E <br /> OWNER- NAME <br /> � lo OWNER PHONE # ' <br /> N CONTRACTOR <br /> E CON. PHONE# <br /> R SJLHIY'GE RM I T # <br /> A . EPA # FIRE PERMIT # <br /> I NSPECTOR •a <br /> DATE 1..2 ,f TANK # <br /> R RINSED /N) <br /> I METHOD RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> E MANIFEST # <br /> —OR— OTHER <br /> V VAPORSPURGED Y./N) METHOD <br /> A / ` C AMOUNT USED <br /> P L.—E.L. READING AT REMOVAL (MUST PE < --0%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEE , FIBERGLASS, <br /> K C OTHER) TANK SIZE <br /> / 0 TANK CONDITION (GOOD, POOR HOLES) <br /> N <br /> S PIPE MATERIAL STEEL FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, 00 <br /> N HOLES) <br /> G DEPTH SOIL TYPE OBSERVATION <br /> F q SAMPLE # <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: /r,1 ` X /_0S X YDS OF SOIL: <br /> I A .� <br /> DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S P I c •� z <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION <br /> I I __ X X YDS OF SOI L !l <br /> N H DEPTH TO G. W. : FT <br /> SAMPL I NG ME'f HOD <br /> G # OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> LABORATORY: <br /> c�(,7 SAMPLERS NAME:(—,,,// <br /> CLOSURE IN PLACE MIXTURE: c<<� <br /> VOLUME: <br /> —1 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />