Laserfiche WebLink
1 <br /> SJLHD - UNDERGROUND 'TANK CLOSURE/AUNDONML•'NT INSL'EC-1.1UN <br /> (S1IADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> / �7�i.n ons Ste. v �c /l„ 4� • Saar ,SVZ <br /> C + <br /> OWNER NAME . <br /> E .7�rr.� T��--�4 ...�s OWNER PHONE N S 5 - <br /> 3�/a <br /> N CONTRACTOR S m co CON. PHONE N <br /> E S� Y- 7Gf-3 <br /> R SJLII;Y PERMIT I EPA N <br /> LFIRE PERMIT N <br /> � 7. y <br /> INSPECTOR e , 07/ DATE 3,2(,--rl TANK N 39 - 11K79 - <br /> R RINSED AWN) METHOD RINSE AMOUNT <br /> S3' <br /> 3 RINSATE DISPOSAL SITE <br /> E MANIFtST I -OR- OTHER I ;1 L <br /> V VAPORS PURGED (ZkN) METHOD AMOUNT USED /5ZAS/ <br /> A <br /> •P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> O <br /> T R COMMENTS ' <br /> A <br /> N TANK MATERIA STE , FIBERGLASS, OTHER) TANK SIZE <br /> K C III <br /> / O TANK CONDITION (GOOD _-m , HOLES) <br /> P N <br /> ` :gyp . T PIPE MATERIAL TE , FIBERGLASS OTHER) N FEET <br /> J c�2 <br /> v <br /> I <br /> N PIPING CONDITION (GOOD OLE ) <br /> I <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE N <br /> F A �kc � / <br /> I N <br /> E <br /> L <br /> D EXCAVATION SIZE: X XEl YDS-OF SOIL: <br /> S: <br /> I A DEPTH I SOIL TYP OBSERVATI <br /> N H P SAMPLE N <br /> S P I Sao <br /> P L P <br /> E I E <br /> C N <br /> T G TR NCH DrHENsi5V X X YDS OF SOIL <br /> I <br /> 0 H DEPTH TO C.K. : FT SAMPLING METHOD <br /> N 2 <br /> 0 N OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: �f/ ,07 a Gcn5;, SAMPLERS NAME: �Lictcl�_ <br /> CLOSURE IN PLACE MIXTURE:. --' <br /> VOLUME: <br />