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csJ la flL — uuUc.R Ua<L Javli iHa.r ...L UDu"/NyH/vuJlvllupi lavvc 6l.'l'i uLvV ' j <br /> (SHADED AREA BE FILLED IN FOR THE FIR^ 1 TANK ONLY) / <br /> L o S 6L3 S A(; <br /> G t OWNER NAME M K!3 L� OWNER PHONE # d ,�2�Z (,'A <br /> 6f/e <br /> ECON. PHONE# x/62/� <br /> N < CONTRACTOR ��� f,-/,L- �''"`^� <br /> E , IA( 5 HRae/� <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # ,01.8. <br /> 3 , , , , , <br /> A <br /> L -- <br /> INSPECTO DATE// 2g 8� TANK # 39 - � -7 <br /> R RINSED (YIN) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y/N) METHOD v/l A� AMOUNT USED �U <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 SIZE DUO A) <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL ( EL, FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPT SOIL TYPE OBSERVATION " SAMPLE # <br /> T � . <br /> F A .r - <br /> I N <br /> E K <br /> L �^ <br /> D EXCAVATION SIZE: X �J X YDS OF SOIL: <br /> S S MPLE # <br /> I A DEPTH SOIL TYPE OBSERVATION <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 /> OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: Fr �✓ (a, ,iJ <br /> CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> EH 23 043(7/88) <br />