Laserfiche WebLink
PHS-EHD - UNDERGRr"ND TANK CLOSURE/ABANDONME' INSPECTION <br /> (SHADED AREA TG.2 FILLED IN FOR THE FIRST ` rANK ONLY) <br /> E OWNER NAME OWNER PHONE # <br /> N '. CONTRACTOR a <br /> E CON. PHONE# <br /> R SJLHD PERMIT # EF'A # <br /> A FIRE PERMIT # <br /> INSPECTORDATE TANK # 39 <br /> �- . rn�lh _ 179 3 <br /> R RINSED Y N) METHOD <br /> I � �L Fss� R I NSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S �nekson <br /> E MANIFEST # <br /> -DR- OTHER <br /> V VAPORS PURGED &)N) METHOD p,, Ice <br /> A AMOUNT USED <br /> P L..E. L. READING AT REMOVAL (MUST BE ( �GX) 0_/w <br /> 0 J z' . [ , <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL .(STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K C /e 00n GC Le <br /> / 0 TANK CONDITION (GOOD, POOR, OLES <br /> N <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P T <br /> I <br /> N PIPING CONDITION (GOOD, POOR, HOLES) <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> I N j F Oslo <br /> E K <br /> L ttoper/io✓ 20 OOe t O <br /> D X EXCAVATION SIZE: L£Y X r0 <br /> S .13_ YDS OF SOIL: <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P - SAMPLE # <br /> S P I ire mx cw 4v9 or co e� <br /> P L P SfrPt c <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X <br /> I YDS OF SOIL <br /> 0 H DEPTH To G. W. : <br /> N FT SAMPLING METHOD <br /> U # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: <br /> EH 3043 ( 10/69) DRAW SITE MAP ON REVERSE <br />