Laserfiche WebLink
. . 1U l. f �'LC(Vt\U Vt\L ltall\ I.LUJ Ut(L•/tll.�\ WVI'1L'►V 1la : Y L'1.11 U1V <br /> (SHADED' A TO BE FILLED IN FOR T1 " rRST TANK ONLY) <br /> fX <br /> G t OWNER NAME OWNER PHONE # ,6 �� <br /> E <br /> E i CONTRACTOR x h CON. PHONE# 70 7 3`7L( <br /> I <br /> R < SJLHD PERMIT # EPA # FIRE PERMIT # <br /> L <br /> L <br /> INSPECTORS �� DATE'? �' �� TANK # 39 - `0 - C3 <br /> R RINSED (Y/N) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHODAMOUNT USED <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) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD, 42O9HOLES) <br /> P N <br /> I S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T a <br /> F A <br /> I N � <br /> E K <br /> L 1�&44 TEA <br /> D EXCAVATION Si4p.11 — X X YDS OF SOIL: <br /> 3- <br /> I A DEPTH 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 /> O H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> F-o] <br /> OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME. <br /> �U J <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> Ell 23 043(7/88) <br />