Laserfiche WebLink
G OWNER NAME <br /> OWNER PHONE # <br /> N CONTRACTOR+fit L �_;1 €7��1 ...' <br /> R ' S SJLHD PERMIT - —�. __— PHONE# <br /> :f t # <br /> A EP,H€rr r�rr.r c� M: :• A <br /> FI <br /> RE D E �_^`_`_•-----. y <br /> �- SJLHD INSPECTORI TANK # _ <br /> R RINSED (Ya �`'� <br /> I i THOD RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE - <br /> # _._._._..... <br /> MANIFEST _ ._._ ... ._...._.. ..._. - ._._..._......_. <br /> -OR- OTHER <br /> V <br /> ` AMOUNT USED-, <br /> VAPORS PURGED ( YIN) �.—`— <br /> A - M [:METHOD D � 1 C <br /> P L. E.L . READING AT REMOVAL (MUST BE C <br /> O ----- - ._..._.-_._ 20%) <br /> T R COMMENTS <br /> A <br /> TANK MATERIAL {STEEL, FIBERGLASS, OTHER} TANK SIZE <br /> K C _-- <br /> / 0 TANK CONDITION (GOOD, POOR, HOLES ) <br /> P N - 21 <br /> I i' S I' PIPE MATERIAL ( STEEL FIBERGLASS OTHER ) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES ) �'� <br /> r — ----------- <br /> G i �l T�j DEPTH --S_OIL —TYPE OBSERVATION — SAMPLE # <br /> r <br /> F A y.�....__. ice.-=.�1+ �� - _ .... - M.------ <br /> Old <br /> l — �' - <br /> I N '1='. .— . .__..___.._.__ —..�H��i l ' Js�:t t�� <br /> ter---- .....----_-____.. <br /> L <br /> D - L :S OF SO <br /> EXCAVATION SIZE: YDI _ <br /> S ; -- x �. .- _.L. ---- <br /> I A H i SOIL TYPE OBSERVATION SAMPLE # <br /> NM P --... _ .....__._. - # _._. ._.__.__ -II <br /> SP I - _ .. ... ... ...._.. . - _. .._.I <br /> P L P - --- - - -- - - _ <br /> T II GTRENCH DIMENSIONS : ' YDS OF SOIL : <br /> 0 ' i H FT ° SAMPLING METHOD <br /> 0 ( # OF HOURS SINCE DEWATERING : <br /> ;f 0 ' OTHER SAMPLE : <br /> �i <br /> LIFLABORATORY: L I — SAMPLERS NAME: <br /> CLOSURE IN PLACE - MIXTURE: -- �_ — 1_-VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />