Laserfiche WebLink
rIC <br /> VL11 <br /> ~-7:v-.:WNER NAME / <br /> , D�/ OWNER a CNE <br /> b/ #any S' £r-7oa z <br /> V .ti CONTRACTOR I ? <br /> c <br /> 5 art , �: CCN. Pf CNE# g 9y�6/ L% <br /> 3--L.1410 BERM F T # EPA ¢000f pr7vy FIRE PERM I T <br /> ✓iiiGiGailr`r�/ii�r�ycr l�rrrlG.rGlritG /�/+La tliw/y 1!�i /' ,rl6.s .�1 � '✓1iG/:11L�'r!G v '�'161G� Gil: <br /> Lam_ <br /> i <br /> INSPECTOR 4 I DAT— TANK <br /> R RiNSEJ ®/N) ' METHOS r;n ?i 1s 1i �s I RINSE AMOUNT i <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S �Cc h'l O3 <br /> MAN'FEST # l/�?D S5 —OR— OTHER <br /> V VAPORS PURGE) ON) i ME T HQD / ,� ( AMOUNT USED <br /> P L. E. L. READING AT R£.-lQVAL (MUST 9E ( 2014) <br /> O <br /> AT R COMMENTS I <br /> N I TANK MATERIAL STc_ , FIBERGLASS, OTHER) ' TANK SIZE <br /> { C ° eSe <br /> / 0 TANK CONDITION (GOOD, POOR, CL= ) <br /> S PIPE MATERIAL (qgL, FIBERGLASS, OTHER) # FEET, <br /> P T <br /> I i PIPING CCNDITION (GCOD OO HOLES) <br /> G`-; DEPTH I SOIL TYPS OBSERVATION SAMPLE ;# <br /> T 60 I-, G+ �/► <br /> c ` K 1 <br /> j 1 <br /> L <br /> D I EXCAVATION SIZE: X X _� YDS OF SOIL: Q <br /> i S <br /> I I A DEPTH SOIL TYPE ' OBSERVATION SAMPLE :# <br /> N i M P <br /> S i P I <br /> P ! L P <br /> ` <br /> I I ; E <br /> C N <br /> I G FRE <br /> H DIMENSION X X YDS OF SOIL <br /> O � H � DEPTH TO G. ',J. : ' <br /> FT SAMPLING METHOD <br /> N ! 2 <br /> C 0 # OF HOURS SINCE DEWATERING: <br /> f 0 OTHER SAMPLE: 4114 <br /> I <br /> LABORATORY: �G G SAMPLERS NAME: A�— <br /> CLOSURE IN PLACE I MIXTURE: � ` VOLUME: <br /> 2�q C14/89) DRAW SITE MAP ON REVERSE <br />