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� PHS--EHD — UNDER( JND TANK CLOSURE/ABANDONM)•' INSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> s <br /> E OW FR. NPME C� OWNER PHONE # <br /> J ?If 6, - b b <br /> N , CONTRACTOR rDis�� CON. PHONE# _, <br /> E -�S �6pb <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # a <br /> A <br /> L <br /> INSPECTOR Ti DATE 11 JTANK # 39 0 <br /> � RINSED (Y/N) ; METHODS,� � RINSE AMOU TcX 5 <br /> N RINSATE DISPOSAL SITE <br /> r_, <br /> E MANIFEST # —OR— OTHER <br /> A VAPORS PURGED u <br /> N} METHOD 1 . <br /> �� AMOUNT USED 3Q rr <br /> C� <br /> O L. E. L. READING AT 'REMOVAL (MUST B < 20;t) Q <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK S E <br /> K C <br /> / O TANK CONDITION (GOOD, POOR OLS <br /> Nl /1 <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P T _ <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G T DEPTH SOIL TYPE ' OBSFRVAT ON rte. SAMPLE # <br /> F A <br /> I N <br /> E K 1 J5,eta s <br /> L <br /> D EXCAVATION SIZE: X X YDS OF SOIL: ' <br /> S <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE, # <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T r G TRENCH DIMENSION ' X YDS OF SOIL <br /> I <br /> D H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> LABORATORY: '6 CC �� SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />