Laserfiche WebLink
PUBLIC NMENTA*=TH DIVISIO <br />. *LTH SERVICES—ET71RO <br />SITE NAMED <br />'ADDRESS CITY GZ <br />OWNER NAME <br />OWNER PHONE J4 <br />CONTRACTORGSY <br />CONT. PHONE` 7X — <br />FIRE PERMIT 'o <br />REMOVALCLOSURE IN PLACE TEMPORARY CLOSURE <br />INSPECTOR <br />DATE Z7'/�/O,/45 TANK 0 39 <br />R <br />RINSED METHODrP� �r�I sRINSE <br />T <br />AMOUNT r6 -6r <br />I <br />N <br />RINSATE DISPOSAL S= <br />S <br />E <br />E <br />IMANIFEST <br />I <br />OR OTHER <br />V <br />VAPORS PURGED MY) <br />METHOD AMOUNT USED <br />A <br />P <br />READING AT REMOVAL <br />L. E. L. <br />0 <br />I R <br />C <br />11COMMENTS <br />TANK MATERIAL J!S5, <br />FIBERGLASS, OTHER) <br />0 <br />N <br />TANK CONDITION (GOODHOLES) <br />( <br />�to�o�l <br />S <br />T <br />PIPE KA ERI -11, ��, <br />FIBERGLASS, OTHER) Is FEET <br />LPIPE <br />CONDITION (GOO <br />POOR, ,AOLES) <br />S <br />T <br />A <br />N <br />K <br />DEPTH ISOIL TYPE J OBSERVATION SAMPLE <br />EXCAVATION SIZE .5 X X <br />YDS OF SOIL <br />M <br />P <br />L <br />I <br />G <br />P <br />I <br />P <br />DEPTH ISOIL TYPE JOBSERVATION <br />-SAMPLE <br />TRENCH DIMENSION <br />x X YDS OF SOIL <br />L <br />H <br />2 <br />0 <br />DEPTH TO G.W.: FT. <br />SAMPLING METHOD <br />HOURS SINCE DEWATERING: <br />OTHER SAMPLE: <br />LABORATORY: SAMPLERS NAME: <br />CLOSURE IN PLACE MIXTURE: i VOLUME: <br />EH 23-0043 (R.EV 2/23/94) PROVIDE SITE MAP <br />