Laserfiche WebLink
ri1o.7�'.7rrmySia�Armmmmmmmmmi6cialv�«asr�ri�rnrr�dirmi6mumrtrAmmmmammarartria.-' �i rov�a'mmmmmmnrm�rm�l (/-7 <br /> U/�'Ty. whizz T <br /> OWNER NAME e �� I OWNER PHONE �cf 20 b <br /> NON. PHONE* <br /> R S,iLHD PERMIT it ( E A 04 L? 970141 FIRE PERMIT 7 <br /> INS?EO T DR DATE /O- � I TANK 39 <br /> R R i NSZD' Y N) I METHOD �� �� /rte I R I�7SE AM/CUN i 2 G�'J� <br /> N RINSATE <br /> DISPOSAL SITE /e74rd/eAvK, 144, Grid Wap <br /> S <br /> E ICA- <br /> MAN-r==37 Y -O R- 0THE'R <br /> V VAPORS PURC-ED (Y/N) I METHOD ( AMOUNT USED l S <br /> A <br /> P L. L. READING AT REMOVAL (MUST 3E ( 20� <br /> Q : U _ O <br /> F <br /> T R CCMME.NTS <br /> A _ <br /> N TANK MATERIAL (STE__ F73ERGLASS, OTHER) ! TANK o_ _a <br /> { C ' <br /> / Q TANK GCNDiTICN (GCC , PQCR HCL'aS — 7p hum,5jK6N; 70 GopNT <br /> N <br /> S PIPE MATERIACSTcaL, FZ3ERC-LASS, OTHER) I C# FE=, <br /> ? I T <br /> PIPING CCNDITZCN CGOCD, POOR, HOLES) <br /> G DEPTH I SCiL TYPE I QBSERVATiON I SAMPLE # <br /> A S I I D I N - <br /> _ N I I I <br /> E K I I <br /> L <br /> D EXCAVATMN SIZE: X X I YDS OF SO-7L: I <br /> i A DEPTH I SAIL TYPE I CSSERVATiCN I SAMPLE 4 I <br /> N M P <br /> S P 11 eql;4 6, G / ! ' <br /> P L P <br /> T E i I 1 <br /> C N ! I I <br /> T G TRENCH DIMENSION X X I YDS OF SOIL <br /> i <br /> Q H DEPTH TC 3. 1.4. r-, I SAMPLING METHCO J <br /> N 2 <br /> 0 0 OF HOURS SiNC_ OEWAT=RING: <br /> r <br /> 0 D1HER SAMPL_: <br /> LA5CRA70RY : W; TSG I SAMPLERS NAME: <br /> It-` <br /> iJ CSL'25 :N F%LaC' ML'�TURE: vCLL'ME: •�.�N G/� <br /> cr <br /> DRAW S:TE MAP ON REVERSE <br />