Laserfiche WebLink
' PUBLIC HES' 'H SERVICES-ENVIRONMENTAL LTH DIVISION <br /> SITE NAME ADDRESS Z7� / CIY <br /> T <br /> OWNER NAME caI OWNER PHONE ri <br /> CONTRACTOR JU,j &,✓ CONT. PHONE ` <br /> FIRE PERMIT #. <br /> AL CLOSURE IN PLACE TEMPORARY CLOSURE <br /> INSPECTOR DATE TANK # 39 <br /> R RINSED &N) METHOD RINSE AMOUNT Z60Z7 <br /> I <br /> N RINSATE DISPOSAL SITE (:",, �/O�pf �Lw y7 j S� Bl✓� �yh,Qr�C <br /> S <br /> E MANIFEST # 9 S ZCs Zo OR OTHER <br /> V VAPORS PURGED (Y METHOD METHOD AMOUNT USED <br /> A <br /> P READING AT REMOVAL L.2-L. : 02 : <br /> R COMMENTS )q! F 7 Id L <br /> C TP.NK .MATERIAL (STEEL, FIBERGLASS, OTHER) <br /> 0 <br /> N TANK CONDITION (GOOD, POOR, HOLES) �/)2 <br /> S <br /> T PIPE MATERIAL (STEEL, F GLAS , OTHER) # FEET <br /> PIPE CONDITION (GOOD, OOR HOLES) <br /> DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> A <br /> W <br /> K <br /> S EXCAVATION SIZE X X YDS OF SOIL <br /> A <br /> M DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> P P <br /> L I + - - �3. <br /> •' <br /> 11 P o m�i,•r Z_ <br /> � <br /> N E G-3 <br /> G °F ' 404 <br /> TRENCH D75ION Z� X X Z YDS OF SOIL <br /> DEPTH TO G.W. : FT. SAMPLING METHOD <br /> H <br /> 2 # HOURS SINCE DEWATERING: <br /> 0 <br /> OTHER SAMPLE: <br /> i <br /> LABORATORY: SAMPLERS NAME: M <br /> CLOSURE IN PLACE I MIXTURE. VOLUME: <br /> EH 23-0043 (REV 2/23/7) PROVIDE SITE MAP <br />