Laserfiche WebLink
P Zoe <br /> S.JLHu - Udu�l< Niru rnn� t.�usu�QRf,T!!E FIRS�TASK ONLY),y ✓ <br /> (SHADED AREA BE FILLED I N F . ; . . ... .. . . ; <br /> . . . �m,f � <br /> L R- 952D ' <br /> D� 5 <br /> G i OWNER NAME r)rn J �►�U OWNER PHONE v( _o9 q /a ( 24 <br /> E � CON. PHONEI ' <br /> N CONTRACTOR b1 <br /> G <br /> E i ff FIRE PERMIT1,;74 ,63 <br /> �S <br /> R t SJLHD PERMIT 1 EPA 1 A� G �N <br /> INSPECTOR/ DATE 3 23 g9 TANK 1 39 <br /> R RINSED Y/ ) METHOD RINSE AMOUNTf[`U <br /> I E �►�rR. F1rilL V 1 LCf <br /> NL RINSATE DISPOSAL SITE R � <br /> S <br /> E MANIFEST -OR OTHER <br /> V VAPORS PURGED (Y/N) METHOD AMOUNT USED <br /> .A <br /> .P L.E.G. READING AT REMOVAL (MUST BE < 20%) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL. (STEEL, FIBERGLASS, OTHER} M FEET �Vy� <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) /vre{A (/ilex eXG�'r✓Ano r <br /> . NF <br /> SAMPLE I <br /> G DEPTH SOIL TYPE OBSERVATION <br /> J <br /> F 1, qf <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: X X YDS OF SOIL: <br /> S- SAMPLE <br /> I A DEPT SOIL TYPE OBSERVATION <br /> N M P <br /> S P I <br /> P L P <br /> E V E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> i I �� FT SAMPLING METHOD `r <br /> O H DEPTH TO G.W. : <br /> N 2 - <br /> 0 1 OF HOURS SINCE DEWATERING: <br /> aOTHER MPL (,t/fiT� <br /> LABORATORY: SAMPLERS NAME: �, 6�A <br /> J <br /> CLOSURE IN ,PLACE MIXTURE: VOLUME: <br /> DRAY SITE MAP ON REVERSE <br /> ...w .►.r nw•s/rr100N <br />