Laserfiche WebLink
SULHu - Uf4b6, ^'4UUNU 'TANK CLOSURE/ABANDONMSNT INSPECTION <br />(SHADED AREt. TO BE FILLED IN FOR THE FT -`?T TANK ONLY) <br />R ri � <br />G OWNER NAME OWNER PHONE # <br />E <br />N ; CONTRACTOR, CON. PHONE# <br />E <br />R SJLHD..PERMIT # EPA # FIRE PERMIT # <br />A... .. ; <br />L <br />INSPECTOR 7D C DATEl'j/� /� TANK # 39 - <br />R RINSED (Y ) METHOD Iii" I--' � RINSE AMOUNT <br />I <br />N RINSATE DISPOSAL SITE �fU),j <br />S <br />E MANIFEST # -OR- OTHER <br />V VAPORS PURGEDY N) METHOD S 'rte AMOUNT USED cQ o <br />A <br />P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br />0 <br />T R COMMENTS <br />A <br />N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) FTANK SIZE /�- <br />K C <br />/ 0 TANK CONDITION ( G , POO , HOLES ) s�,�- eo-ros�o,- <br />P N <br />I S PIPE MATERIAL (S EEL, FIBERGLASS, OTHER) # FEET 10a, <br />P T <br />I PIPING CONDITION (GOOD OOR HOLES) (ter,-�-os�c� �id`P.►•� <br />N <br />G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br />T f_ <br />F A <br />I N j r <br />E K -�L cr - d <br />L c- a °-'� zr N <br />D EXCAVATION SIZE: X X YDS OF SOIL: 7!j <br />S- <br />I AEPTH SOIL TYPE OBSERVATION SAMPLE # <br />N M P <br />S P I <br />P L P <br />E I E <br />C N ' <br />T G TRENCH DIMENSION X X YDS OF SOIL <br />I <br />0 H DEPTH TO G.W.: %)C T SAMPLING METHOD <br />N 2 <br />0 -# OF HOURS SINCE DEWATERING: -� <br />07OTHER SAMPLE: <br />LABORATORY: Cf�f 1ti2- SAMPLERS NAME: _. <br />CLOSURE IN PLACE I MIXTURE: VOLUME: <br />DRAW SITE MAP ON REVERSE <br />