Laserfiche WebLink
PHS--EHD - UNDO ~„ROUND TANK CLOSURE/ABANDONT INSPECTION <br /> (SHADED AREA`70 HE FILLED IN FOR THE- F IRS- T TANK ONLY) <br /> rM MEIII Aim j IF f <br /> t <br /> OWNER NAM OWNER PHONE # <br /> EJI'M400 'of <br />�I N CONTRACTOR �e D CON. PHONE# , <br /> E <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # , <br /> A. , <br /> L , r <br /> INSPECTOR DATE L TANK # <br /> €` R RINSED Y N} METHOD�� R INS AM NT <br /> I i ' <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED &N) METHO �) i AMOUNT USED <br /> A H <br /> P L. E. L. READING AT REMOVAL (MUST BE Y( et) <br /> D <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZE �C <br /> K C _ <br /> / N TANK CONDITION (GOOD POOR HOLES) } 1Y <br /> 1” S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> p T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) P <br /> N " <br /> GDEPTH SOIL TYPEOBSERVATION !� SAMPLE # <br /> f T 6 <br /> I FA <br /> I N <br /> 4 E } <br /> K <br /> L 'r <br /> D EXCAVATION SIZE: <br /> S X X � YDS OF SOIL: <br /> T A DEPTH SOIL TYPE OBSERVATION F <br /> N M p ,k SAMPLE # <br /> S P I <br /> P L PDNNA <br /> F <br /> E i E I <br /> C N t <br /> T G # <br /> 3 TRENCH DIMENSION X X !' <br /> I YD'S OF SOIL <br /> O H DEPTH TO G. W. : _ FT SAMPLINGMETHOD I <br /> N 2 i <br /> G # OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: ? <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: ;, VOLUME: <br /> i� <br /> EH 02043 ( 10/89) DRAW SITE MAP ON REVERSE ' <br />