Laserfiche WebLink
YUnLlc: kiXATTH SERVICES-ENVIRONMENTAL HEALTH DIVISION <br /> SITE NAME r ADDRESS -7O [f CITY <br /> OWNER � � ' OWNER PHONE # <br /> CONTRACTOR /l. c4- CONT./ CONT. PHONE # <br /> FIRE PERMIT/ <br /> REMOVAL_ CLOSURE IN PLACE TEMPORARY CLOSURE <br /> INSPECTOR ).Q{ r + i a - DATE TANK # 39 _50 ,;5le <br /> R RINSED Y N) METHOD XtkSY-A-M-03INY �cJ <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # OR OTHER <br /> V VAPORS PURGED CYN) METHOD cAMOUNT USED ,5Q/h5 <br /> A <br /> P READING AT REMOVAL L.E.L. : 02 : <br /> 0 <br /> R COMMENTS <br /> C TANK MATERIAL FIBERGLASS, OTHER) <br /> 0 <br /> N TANK CONDITIONOOD POOR, HOLES) <br /> S <br /> T PIPE MATERIAL TEFL FIBERGLASS, OTHER) # FEET <br /> PIPE CONDITION (GOOD, POOR, HOLES) hele- S <br /> DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> A <br /> N wo a <br /> K <br /> TKI 40 <br /> S EXCAVATION SIZE X X YDS OF SOIL J` <br /> A <br /> M DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> P P <br /> L I <br /> I P <br /> N E <br /> G <br /> TRENCH DIMENSION X X YDS OF SOIL <br /> DEPTH TO G.W. : FT. SAMPLING METHOD <br /> H <br /> 2 # HOURS SINCE DEWATERING: <br /> 0 <br /> OTHER SAMPLE: S�OG-f<p r <br /> LABORATORY: SAMPLERS NAME: (KCL q Ae-&-ve Wo <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23-0043 (REV 2/23/94) PROVIDE SITE MAP <br />