Laserfiche WebLink
j,il, — U144L V rsU TAr oskli, _,.:dLU1JMLs, 'I iN-, r:CTIU14 <br /> (SHADED 2&"O BE FILLED IN FOR THE FIf '" TANK ONLY) . . <br /> �iE <br /> G < OWNER NAME OWNER PHONE # <br /> E <br /> N t CONTRACTOR CON. PHONE# <br /> E <br /> R { SJLHD PERMIT # EPA # FIRE PERMIT # <br /> A <br /> L _ <br /> INSPECTOR DATE <br /> R RINSED (Y N) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # —OR— OTHER <br /> VVAPORS PURGED (YN) METHOD �)_ AMOUNT USED <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A � — <br /> N TANK MATERIAL (STEED FIBERGLASS OTHER) TANK SIZE <br /> ���) <br /> K C � <br /> / 0 TANK CONDITION ( (GOOD, POOR, HOLES) <br /> P N <br /> I S PIPE MATERIAL STEEL FIBERGLASS, OTHER) # FEET <br /> P T <br /> II PIPING CONDITION(fGOO�D . ' POOR, HOLES ) <br /> N <br /> G DEPTH SOIL TYPE BSERVATION SAMPLE # <br /> T <br /> F A 7 •"m f, s <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: X _ X YDS OF SOIL: <br /> S— <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X _ X YDS OF SOIL <br /> I <br /> OH DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> EH 23 043(7/88) <br />