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' - 5 <br /> PHS—EHD — UNDERGF" D TANK CLOSURE/ABANDONMEINSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> /91w, ,., , , , r>�✓ i f0, � ��'lr /i/.3 iY!/i.��r�T/m/imwwmw <br /> dr/(l!!/J!I!!%/L/.f(/.U/1U!!!U!!L %I%LffiQ// � � ��/!Y • • • //. <br /> 1 i C. IV!-il � J�'' F11}L1 F{C LE <br /> zJ <br /> ? Ll-VL /LF'"J ° i i7 ! 1.LTw,!4-' , IJC`4 Y.1 ry" <br /> OWNER NAME f OWNER PHONE # <br /> N CONTRACTORCLI�G _ CON. PHONE# / <br /> E /4,1 <br /> R SjLHD PERMIT # EPA # FIRE PERMIT # <br /> Li /BGG I'1 cTL uS arc <br /> I , <br /> INSPECTOR �i .�:%i DATE .,,��O �i TANK # 39 — T�l-r? — C ) <br /> R RINSED N) METHOD /? , ��: �'/��L, RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE i <br /> S <br /> # E MANIFEST # —OR-- OTHER <br /> i <br /> I V VAPORS PURGED &%N) METHOD -r...! ' <br /> A AMOUNT USED G�+>>t'I=i1,��ol <br /> �/ <br /> f <br /> P L. E. L. READING AT REMOVAL (MUST BE < 220%) <br /> 0 <br /> T R COMMENTS <br /> N TANK MATERIAL (�TEEL;,FIBERGLASS, ;OTHER) TANK SIZE <br /> / 0 TANK CONDITION (GOOD, FLOOR THOLES), <br /> N <br /> -'� F <br /> jI S PIPE MATERIAL (cS TEEL.,,r IBERGLASS, ;OTHER) # FEET <br /> P T T <br /> f I i i PIPING CONDITION (GOOD, (�0 HOLES) <br /> N <br /> t G i DEPTH SOIL TYPE 1 OBSERVATION SAMPLE # <br /> I T <br /> FA <br /> 5 I F�l N G <br /> E K <br /># Lh <br /> D EXCAVATION SIZE: 27 X 419- -X - 13' YDS OF SOIL: <br /> S <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # F <br /> I r <br /> N M P <br /> i S R I , <br /> P L P , <br /> E I E I <br /> C N <br /> T ! G TRENCH DIMENSION X X YDS OF SOIL <br /> 1 I <br /> j IL <br /> 0 i H DEPTH TO G. W. : FT SAMPLING METHOD <br /> f N 0 # OF HOURS SINCE DEWATERING: <br /> I _ <br /> i 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: I <br />.H 204,3 ( lo/89) DRAW SITE HAP ON REVERSE <br />