Laserfiche WebLink
(SHADED AREA TO DE FILLED IN FOR TRE FIRST TANK ONLY) <br />��t'�����k$ili)��X <br />1'1'�N'A�� •�CLl VULa� Ori N5I <br />AD i • SS���'�➢VJI3CY�9;�'i�3�'F <br />0 SaN P� <br />F'I'ry,�BYSYc��7C4(4c�I�f• <br />l Y <br />G OWNER NAME , / t <br />V 1 <br />OWNER PHONE I . zq 43.5 C/l yt <br />N <br />E <br />R <br />Li <br />CONTRACTOR p ! CON. PHONE ZYQ�` C �a� / <br />V 0 4_ � L (-O r- /� 7 O 0 <br />SJLHD PERHIT 1 FIRE PERMIT I <br />S U R I NP� �ftE2�Gi <br />INSPECTOR DATE 21Z I f`e <br />I TANK 1 39 - <br />R <br />RINSED Y N) <br />METHOD yI)5AAI &4"-l`NR0 <br />RINSE AMOUNT <br />N <br />RINSATE DISPOSAL SITE <br />S <br />E <br />MANIFEST 1 7( 7 07� . -OR- OTHER <br />V <br />A <br />P <br />VAPORS PURGED (Y/N) <br />METHOD bl2G AMOUNT USED '-7 O <br />!! <br />L.E.L. READING AT REMOVAL (MUST BE < 20%) <br />T <br />O <br />R <br />COMMENTS <br />A <br />N <br />TANK MATERIAL (STEEL, FIBERGLASS, OTHER) <br />TANK SIZE 7�)Q Q <br />v <br />K <br />/ <br />C <br />0 <br />TANK CONDITION((GOOD POOR, HOLES) / <br />P <br />I <br />N <br />S <br />PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) <br />1 FEET <br />P <br />I <br />T <br />PIPING CONDITION (GOOD, POOR, HOLES) <br />N <br />G <br />DEPTH SOIL TYPE OBSERVATION SAMPLE 1 <br />T <br />F <br />A <br />I <br />N <br />E <br />K <br />L4 <br />D <br />EXCAVATION SIZE: 54,X X <br />-1a ds <br />YDS OF SOIL: y Y <br />I <br />N <br />S- <br />A <br />DEPTH SOIL TYPE OBSERVATION SAMPLE 1 <br />M <br />P <br />S <br />P <br />I <br />P <br />L <br />P <br />E <br />I <br />E <br />C <br />T <br />N <br />G <br />1 11 <br />TRENCH DIMENSION X _ X <br />YDS OF SOIL <br />I <br />0 <br />N <br />H <br />2 <br />0 <br />DEPTH TO C.X.: FT SAMPLING METHOD <br />1 OF HOURS SINCE DEWATERING: <br />O <br />OTHER SAMPLE: <br />LABORATORY: �G <br />SAMPLERS NAME: <br />CLOSURE IN PLACE <br />I MIXTURE: 77 <br />VOLUME: <br />DRAW SITE NAP ON REVERSE <br />