Laserfiche WebLink
SERVICES -ENVIRONMENT TH DIVISION <br />SITE NAME/J.cerri ' 6I <br />ADDRESS % ?,/() ;!�j L ICITY S . <br />OWNER NAME / ,,% <br />JOWNER PHONE '710'? - .S ` 'J —3 2. 4 7i <br />CONTRACTOR y, -yl, C <br />J <br />CONT . PHONE 9/6--37Z- / WYiS <br />FIRE PERMIT a 6 i6 <br />REMOVAL_ CLOSURE IN PLACE TEMPORARY CLOSURE <br />INSPECTOR ���� DATE 6_//-y6 TANK39 // 2S' c� Z- <br />R <br />RINSED (qN) METHOD �' l <br />RINSE AMOUNT <br />Z <br />N <br />RINSATE DISPOSAL SITE <br />S <br />E <br />V <br />A <br />P <br />O <br />R <br />C <br />0 <br />N <br />S-- <br />T <br />MANIFEST # TysJ OR OTHER <br />VAPORS PURGED N) IME=OD AMOUNT USED -3 Co <br />READING AT REMOVAL ' L.E.L.: 02: O <br />COMMENTS <br />TANK MATERIAL TE , FIBERGLASS, OTHER) <br />TANK CONDITION (GOOD 00 HOLES) I dU> V94-"46 14 <br />-- ---- — <br />P TP EMATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br />PIPE CONDITION (GOOD, POOR, HOLES)�- <br />i <br />S <br />T <br />N1 <br />K <br />DEPTH SOIL TYPE (OBSERVATION SAMPLE <br />14 1:.b <br />lei �' - <br />lf <br />� � <br />EXCAVATION SIZE. �3®X 3 Z, X 11 , <br />YDS OF SOIL /,15V <br />A <br />M <br />P <br />L <br />I <br />N <br />G <br />P <br />I <br />P <br />E <br />DEPTH SOIL TYPE OBSERVATION SAMPLE <br />TRENCH DIMENSION X X YDS OF SOIL== <br />H <br />2 <br />0 <br />DEPTH TO G,W.: FT. SAMPLING METHOD <br />J4 HOURS SINCE DEWATERING: <br />OTHER SAMPLE: <br />LABORATORY: SAMPLERS NAME : G, cfc <br />CLOSURE IN PLACE MIXTURE: VOLUME: <br />I <br />EH 23-0043 (REV 2/23/94) PROVIDE SITE MAP <br />