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SJLHD - UN %GROUND TANK CLOSURE/AUN! 'ML••N1' 1N51'1:CTluN / ✓' ' <br /> (SHADED A?!ILKA TO BE FILLED IN FOR THE TIRST TANK ONLY) <br /> G�C��iy2J <br /> G r OWNER NAME �— "" <br /> OWNER PHONE <br /> N ? CONTRACTOR <br /> E CON. PHONEY <br /> R SJLHD ERMIT I d - y5 <br /> EPA y FIRE PERMIT <br /> INSPECTOR DATE TANK y 39 <br /> R RINSED METHOD <br /> I /e. v h w RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST y -OR- OTHER <br /> V VAPORS PURGED a/N) METHOD <br /> A AMOUNT USED <br /> P L.E.L. READING AT REMOVAL (MUST BE C 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STE L, FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD; POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL ST EL FIBERGLASS, <br /> P T OTHER) y FEET <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE y <br /> F A <br /> I N ii ' �- !o veli fi oo' �N <br /> r � <br /> E cs <br /> K s w .-,�f rte✓ <br /> L <br /> D EXCAVATION SIZE: 3S X - ' X <br /> S. .Z YDS OF SOIL: <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE y <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X <br /> I YDS OF SOIL <br /> 0 H DEPTH TO C.W. : FT <br /> N 2 SAMPLING METHOD pp <br /> U/Zc ss f h pS <br /> 0 1 OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: �� Lureh �! SAMPLERS NAME. <br /> S�zcr :/ /'.• v /i <br /> CLOSURE IN PLACE I MIXTURE:• VOLUME: <br /> Ell 2a 01:1(7/88) DRAW SITE MAP ON R'EVERSS <br />