Laserfiche WebLink
PHS-EHD - UNDERf�UND TANK CLOSURE/ABANDONMeS4T INSPECTION <br />(SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br />EOWNER NAME Q <br />OWNER PHONE # <br />N ..CONTRACTOR <br />E <br />WQ�7jyf j`l((jjJ CON. PHONE#C��9 9�3-�3�(� <br />R .� S.ILHD PERMIT # EPA # <br />A FIRE GERMIT # <br />INSPECTOR <br />R RINSED (Y/N> METHOD <br />I BINS FlMU NT <br />N RINSATE DISPOSAL SITE <br />S <br />E MANIFEST # -OR- OTHER <br />V VAPORS PURGED (Y/N) METHOD <br />A AMOUNT USED <br />P L.E.L. READING AT REMOVAL (MUST BE ( 20%) <br />0 �S �t L <br />T R COMMENTS <br />A <br />IN <br />K C TANK MATERIA - TEED FIBERGLASS, OTHER) TANK SIZE /6 <br />/ O TANK CONDITION (GOOD, OOR HOLES) `^L� ( QV <br />N <br />S PIPE MATERIAL (STEEL,)FIBERGLASS, <br />P T OTHER) # FEET <br />I PIPING CONDITION (GOOD, OR HOLES) I <br />N e <br />G DEPTH SOIL TYPE OBSERVATION <br />T SAMPLE # <br />F A h2 <br />I N <br />E K W <br />L Ky <br />D EXCAVATION SIZE: X 1Q X <br />S .Z YDS OF SOIL: <br />I A DEPTH SOIL TYPE OBSERVATION <br />N M P SAMPLE # <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 />0 H DEPTH TO G. W.: FT <br />N SAMPLING METHOD <br />0 # OF HOURS SINCE DEWATERING: <br />0 OTHER SAMPLE: <br />LABORATORY: SAMPLERS NAME: <br />CLOSURE IN GLACE MIXTURE: <br />VOLUME <br />EH 23043 (10/89) DRAW SITE MAP ON REVERSE <br />