Laserfiche WebLink
J <br />SJLHD — UNDERGROUND 'TANK CLOL URE/AUNDONML''NT 1NSPECTIUN <br />(SHADED Ar TO BE FI LI, ED IN FOR THE d ST TANK ONLY) <br />I91 2, DRAW SITE MAP ON REVERSE <br />0-"'-188)N <br />G OWNER NAME I <br />OWNER PHONE N !S5 <br />N <br />CONTRACTORPHONEN <br />M� o <br />CON. ' <br />R <br />'< SJLHD PERMIT <br />'Vi ` A N m.FI PTERMIT N <br />...... <br />L <br />UR I NItY%- <br />; <br />INSPECTOR �,f f <br />DATE > / <br />TANK N 39 - 776 ✓ - �_ <br />R <br />I <br />RINSED ON) METHOD: " ; Ts;�, r RINSE AMOUNT <br />N <br />RINSATE DISPOSAL SITE <br />RPl JJ�f[ SP <br />S <br />'v'T C �.N <br />MANIFEST N -OR- OTHER <br />E <br />V <br />VAPORS PURGED (Y N) <br />METHOD <br />Ur, S-� <br />AMOUNT USED <br />A <br />it (hS <br />L.E.L. READING AT REMOVAL (MUST. BE < 20%) <br />P <br />0 <br />COMMENTS <br />T <br />R <br />A <br />K <br />C <br />TANK MATERIAL (STEEL, FIBERGLASS, OTHER) <br />c <br />TANK SIZE 1 <br />/ <br />0 <br />TANK CONDITION (GOOD POOR, HOLES) <br />P <br />N <br />PIPE MATERIAL�(STEEL FI ERGLASS, OTHER) <br />r <br />N FEET <br />I <br />S <br />P <br />T <br />I <br />PIPING CONDITIO (GOOD POOR, HOLES) .' p( <br />N <br />G <br />DEPTH <br />SOIL TYPE <br />OBSERVATION <br />SAMPLE N <br />T <br />F <br />A <br />/' <br />e-) No J•cN <br />a. <br />I <br />N <br />D <br />S <br />EXCAVATION SIZE: LZ X aQJX ^-lam • <br />YDS OF SOIL: nr, <br />I <br />A <br />DEPTH <br />SOIL TYPE <br />OBSERVATION <br />SAMPLE N <br />N <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 />N <br />TRENCH DIMENSION X ,_ X YDS OF SOIL <br />T <br />G <br />I <br />0 <br />H <br />DEPTH TO C.W.: FT SAMPLING METHOD <br />N <br />2 <br />N OF HOURS SINCE DEWATERING: <br />0 <br />OTHER SAMPLE: <br />LABORATORY:<urwwt— <br />r ri�s <br />SAMPLERS NAME: tt// <br />, <br />CLOSURE IN PLACE MIXTURE: <br />VOLUME: <br />I91 2, DRAW SITE MAP ON REVERSE <br />0-"'-188)N <br />