Laserfiche WebLink
PUBLIC MUTE SE.RVrCES—ENV'IRONICENTAL HEALTH DIVISION <br /> SITE NAME-0-11 �� I ADDRESS �4 wlSt ` CITY -�fU <br /> OWNER NAME 101 OWNS PHONE r yI (p • 7/ <br /> I <br /> CONT. PHONE <br /> FIRE P4MIT <br /> REMOVAL /\ CLOSURE MY PUCE TMIPORARY C,.T OSURE <br /> INSPECTOR gA7j DATE JG.22, O 7 M&AfiE-t-39 mk OI <br /> R RSNSED (v LETHOD R2NSE AMOUNT <br /> I <br /> N R-T�ISATE DISPOSAL SITE <br /> S <br /> E 11K..A.NIr EST r OR O <br /> THERR <br /> V VAPORS ?URGED (Y 1=0D �AMOUNT USED <br /> P READING AT RM=%OVAL I L.S.L. : -T 02: <br /> O <br /> R comm=-S <br /> j c TlL\TX M-ATMIRTZAL (ST=, :-:3ZRGIASS, OTH) i <br /> o , <br /> j Y I TAlYK CONDITION (CtCOD, POOR, SOLES) <br /> S <br /> T I PIPE MA""%—MTXL (STEL, GLAS OTH."..2) s == <br /> i <br /> j PI?E CONDITION (GCOD, ?COR, HOLES) <br /> I <br /> DEPTH So= T`-'E I OBSMWATION ( SAl`�Lr. T I <br /> l I I i <br /> ' N <br /> S IZXCAVATION SIZE Y Y YDS OF SOIL <br /> A <br /> DOTH SOm T`roE ( CBS=-I=ON I SAMPLE T <br /> I P P <br /> r r I4fri I ti 5 Loy k b vl I `1 I I <br /> I fill 11"it'+z <br /> r P I I <br /> N I I <br /> G � � <br /> mENc3 onaNSICN ?-Ff X �;*F f X 1 -\-,MS OF SOIL I <br /> DEPTH TO G.W. : FT. I SAMP=G METHCD <br /> i H <br /> 2 HOURS SINCE DEWATERING: <br /> � 0 <br /> oTH SAMPLE: <br /> I <br /> I <br /> LABORATORY <br /> CLOSURE LY PTMACE �TURE: I VOLDME: <br /> EH 23-0043 (REV 2/23/94) PROVIDE SITE MAP <br />