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B�LNu - UNDEr(GF' UND TANK CLOSURE/AB,ANDONMF' ^' INSPECTION <br /> I (SHADED AREA BE FILLED IN FOR THE FIRS _ TANK ONLY) <br /> a <br /> G OWNER NAME OWNER PHONE # 5k <br /> E <br /> N CONTRACTOR CON. PHONE# <br /> E <br /> R t SJLHD PERMIT # EPA # FIRE PERMIT # <br /> L 1_ t <br /> INSPECTOR ' DATE TANK # 39 <br /> IRINSED ( N) METHOD ( � RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> i S <br /> E MANIFEST # -OR- OTHER _- <br /> V VAPORS PURGED i(Y/N) METHODS AMOUNT USED ' <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) - <br /> O <br /> T R COMMENTS <br /> A - <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZEp <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, OLES) <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 <br /> F A 6 <br /> I N <br /> EK R <br /> L v c T1 <br /> D S EXCAVATION SIZE: X YDS OF SOIL: /�a y <br /> I A DEPTH $OIL TYPE OBSkRV�TION SA LE # <br /> N M P <br /> S P I <br /> P L i 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. F i SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> FolX <br /> OTHER SAMPLE: <br /> LABORATORY: -Cr-L SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> i <br /> DRAW SITE MAP ON REVERSE .. <br /> �r� <br />