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UN11tKGlWUND 'TANK CLOSURE/AWP' LAMENT INSPECTION <br /> (SHADED L A TO BE FILLED IN FOR THE (RST TANK ONLY) <br /> 11 <br /> i <br /> G < OWNER 'NAME <br /> E <br /> OWNER PHONE <br /> �/Glrl2 a cfa �h 9 S <br /> N < CONTRACTOR S CON. PHONEp <br /> E �ao9� Sod - 9 <br /> R t SJLH PERMIT p EPA p C9C��obr3 FIRE PERMIT p <br /> INSPECTOR C, OZ DATE <br /> 5/!y/ g- 7 TANK p 39 <br /> R RINSED (9N) METHOD <br /> I RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S /�c°c1 e�rdo%a rvi Co, <br /> E MANIFEST_! ' 6e J -OR- <br /> OTHER <br /> V VAPORS PURGED ©/N) METHOD �«i r <br /> A AMO NT_ UND/ <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL S EEL, FIBERGLASS, OTHER) TANK SIZE a <br /> K C coo ed <br /> / O TANK CONDITION GOOD, OOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL STEEL FIBERGLASS, OTHER) p FEET <br /> P T <br /> I PIPING CONDITION (GOOD,(POOR HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE p <br /> F A <br /> I <br /> N <br /> E K <br /> L <br /> D 3- EXCAVATION SIZE: X X YDS OF SOIL: <br /> J <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE p <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 /> O H DEPTH TO <br /> N 2 SAMPLING METHOD <br /> 0 p OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> ZylghfC l kPS <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: <br /> Ell 23 043(7/88) DRAW SITE MAP AN REVERSE <br />