Laserfiche WebLink
(S HADED A., TO BE FILLED IN FOR THE ST TANK ONLY) <br /> s nnsry eAc _ <br /> G < OWNER NAME �I (ICY 1 SL' OWNER PHONE # <br /> E <br /> N CONTRACTOR /� ) Ca` ,�5� CON. PHONE# 2f✓`l � s/�S 5�&6 <br /> E C` `T <br /> R < SJLHD PERMIT # EPA # FIRE PERMIT # <br /> L �A U4 . . <br /> INSPECTOR _ DATE TANK #s 39 <br /> I-AVi( A 10 2�1 &� <br /> I RINSED METHODw� ` RINSE AMOUNT �f�J <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (f-Y-YN) METHOD �k AMOUNT USED <br /> A YJC� Vic• <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> K C TANK MATERIAL FIBERGLASS, OTHER) TANK SIZE' "C <br /> / 0 TANK CONDITIONG00 , POOR, HOLES ) <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 � 1 �g <br /> I N - <br /> E K <br /> L <br /> D S- <br /> EXCAVATION SIZE: 2 X I(c X YDS OF SOIL : <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 /> 0 H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> F-olO SAMPLE: <br /> LABORATORY: (– L SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br />