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.01 <br /> PHS-EHO - UNDERt UND TANK CLOSURE/ABANDONM J INSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> OWNER NAME OWNER PHONE # <br /> E <br /> N CONTRACTOR CON. PHONE# <br /> E + ' <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # , <br /> A . , <br /> L <br /> I NSPECTOR '4 ,lrl DATE �' S q v TANK # 29 - 3 a - o �- <br /> R RINSED (2N) METH RINSE MOU T <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> AV VAPORS PURGED (Y/N) METHOD AMOUNT USED r dr <br /> OL. E. L. READING AT REMOVAL (MUST P 20%) <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL QSTEE FIBERGLASS, OTHER) TANK SIZE toy b O D <br /> K C <br /> / N TANK CONDITION (GOOD, POOR, HOLES) <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P - T <br /> N PIPING CONDITION (GOOD, FLOOR, HOLES) <br /> O <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> i <br /> F A <br /> I N . <br /> E K ►. �. �� <br /> L <br /> D EXCAVATION SIZE: X X YDS OF SOIL: <br /> S <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 /> O H DEPTH TO G. W. . FT SAMPLING <br /> N w .._ .�, METHOD <br /> 0 # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 232043 (10/89) DRAW SITE MAP ON REVERSE <br />