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PUBLIC SM14 ICE S-MONlMMl-;L FgmkLTS DIVISION <br />SITE N? -`4E LLAjL, <br />?ADDRESS <br />Q I l J I^ CITY -- <br />i <br />I <br />0W -=Z- NAS <br />i <br />OWN -z -"Z PHONE <br />r <br />j� CONTE.XCTOR <br />I CO3'i's_'. PHONE <br />! <br />FIRE ?E' - mm <br />R"'KCV C..r.CS'JRr `Y ?LACr <br />TEMPCR..ARY CIASUtZE <br />rVSPE'CTOR <br />DA'T'E ?r <br />� TANK r 39 <br />i <br />R <br />i <br />R�'VSED /Y} ML;sOD <br />R�-FTSE AMOUNT <br />i <br />, <br />N I <br />RTNSATz' DISPOSAL S1_.n <br />S1KANZr <br />EST r <br />OR <br />C'T'S^ <br />7 I <br />V.',i_�ORS PURGZD IT/N.) <br />�"L.CD <br />` I AMOUNT` USED <br />�7 i <br />3 <br />P <br />i <br />R—Ek DLVG kT Rr�OV3L <br />I L.?.L.: = 0. I 02: <br />C� <br />i <br />O <br />i R ! <br />comm rS <br />i <br />O <br />V l <br />^'� CCNDII'2CN GvCD <br />: CCR, EOL.ES) <br />S <br />r+ <br />o (S Z , <br />, <br />0`1'�='Q) <br />j <br />o2E COND=CN G.7OD <br />?CCR, HOLES) <br />�' <br />2 <br />{ OEPTr ' SO • • . Tv_7r <br />OBSL"RVATION S;LNIPLE r <br />f <br />i <br />I <br />K <br />{ <br />I <br />I <br />S I <br />i <br />=CA6VA'''I'ON SILL (_J! X � X <br />�IYDS OF SOIL, <br />I <br />V <br />i <br />( <br />DA'L'E I so m. TYPE <br />OBSZaV,-CrON <br />`SAMPLE r <br />I P <br />o i <br />I i i <br />i G <br />j <br />I <br />T �`TCH DI'EYSION X X I FDS OF SOIL <br />j <br />1 <br />!_-. <br />I <br />DEPTH TO G _ r7+ .: <br />r T . <br />' SAMPLIZING =01) <br />' <br />I <br />I 2 r HOURS =CE DEWA'TV—R--rTTG : <br />I 0 <br />f CTE_. SAMPLE.: <br />I <br />i <br />i <br />' I � L�i30F2�' `!'ORY : <br />'�+-oT Ylt Lam' <br />! SAM Tl. -r RS <br />I <br />CLOSURE LY PT -ACE I =x=E: <br />J'70Lua: <br />ES 23-0043 - (REG 2/23/94) ?ROVIDE S= MAP <br />