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f RHS-EHD - UNDER[ TANK CLOSURE/ABANDONM(,l NSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> OWNER- NAME OWNER RHONE r�o` 36,8._ <br /> N , CONTRACTOR/E n G CON. PHONE# , <br /> R SJLHO PERMIT # EPA # FIRE PERMIT # , <br /> A <br /> L <br /> INSPECTORUC a DATE 3 RU TANK # 39 - - C) <br /> R RINSED ( N) —T—METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y N) METHOD --TAMOUNT USED <br /> A Q D <br /> p L.E. L. READING AT REMOVAL (MUST B ( 2C1X) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL STEEL FIBERGLASS, OTHER <br /> K C ) TANK SIZE Q v <br /> / 0 TANK CONDITION ( OOD POOR, HOLES) �U` <br /> N t <br /> S PIPE MATERIATEEL FIBERGLASS, OTHER) # FEE'C <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N al <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T <br /> F A <br /> SAM <br /> I N <br /> E K t <br /> L <br /> D EXCAVATION SIZE: <br /> S X °�� X .� YDS OF SOIL: <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S P I <br /> P L P <br /> E I E <br /> C 'N <br /> T G TRENCH DIMENSION ' X X YDS OF SOIL <br /> I <br /> 0 H DEPTH TO G. W. : F <br /> N T SAMPLING METHOD <br /> METHOD <br /> G # OF HOURS SINCE DEWATERING: <br /> ❑ OTHER SAMPLE: <br /> LABORATORY: &Q J SAMPLERS NAME- <br /> CLOSURE <br /> AME:CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />