Laserfiche WebLink
.....nu - U"V'ENGt(UUNll 'TANK CLOSURE/A J.0r'N. <br /> $I►1 MENT INSPECTION <br /> (SHADED A TO BE FILLED IN FOR T1�, l:ST TANK ONLY) <br /> FIM_ WEE9�2 <br /> C <br /> G OWNER NAME �''�P`^Q'� <br /> OWNER PHONE <br /> N : CONTRACTOR TP-J,KF� �- f CON PHONE# CO a nrlc oho C � z �[ <br /> R SJLHD PERMIT # EPA # `l a'F'43 FIRE PERMIT <br /> INSPECTOR DATE 28��5 TANK It 39 <br /> R RINSED (Y/N) METHOD i RINSE AMOUNT <br /> I - — <br /> N RINSATE DISPOSAL SITE <br /> E MANIFEST # ' Cel _ -OR-- OTHER <br /> AV VAPORS PURGED (Y N) METHOD C AMOUNT USED bS <br /> . P L.E.L. READING AT REMOVAL (MUST BE < 20%) —- <br /> 0 <br /> T R COMMENTS -- <br /> A <br /> N TANK MATERIAL { TEEL /' FIBERGLASS, OTHER) TANK SIZE <br /> K C f0 L <br /> / 0 TANK CONDITION GOOD POOR, HOLES) fitr-° mnr rbc( hJ::Q 1'12+-J <br /> P N <br /> I S PIPE MATERIAL ( TEEL', FIBERGLASS, OTHER) # FEET 94—, � <br /> P T <br /> I PIPING CONDtl ',UIN (GOOD, FDOR,) HOLES) <br /> N <br /> G DEPTH TYPE OBSERVATION SAMPLE # <br /> TA r. <br /> I N '� <br /> E <br /> L <br /> D EXCAVATION SIZE: X X <br /> S: YDS OF SOIL :N f aS3 <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M p SAMPLE # <br /> P L P <br /> ----- <br /> . ... e � <br /> E I E Z <br /> C N C <br /> T G ENCH DIMENSION X f..s X YDS OF SOIL Q"&d <br /> I <br /> ' O <br /> H DEPTH TO G.W. ; �p FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: LPVirY-R c�4`�YLGke- SAMPLERS NAME: EP7e7H <br /> CLOSURE IN PLACE MIXTURE: P.. VOLUME: U� $ <br /> Elf 23 0113(7/88) DRAW SITE MAP ON REVERSE <br />