Laserfiche WebLink
I <br />G OWNER NAME OWNER PHONE # <br />E _ <br />N CONTRACTORS�6'K-_t�C>o STCE7 CON. PHONE# ---_- --- <br />E <br />R SJLHD PERMIT # EPA # FIRE DEPT ftVP_.r-j <br />A <br />MwL <br />SJLHD INSPECTOR / _ �tz <br />d <br />/ TANK # 39 - - <br />R RINSED (Y N) METHOD RINSE AMOUNT <br />I <br />N RINSATE DISPOSAL SITE <br />S <br />E MANIFEST # -OR- OTHER <br />V VAPORS PURGED (Y/ ) METHOD v0(CCAMOUNT USED <br />A __ <br />P L.E.L. READING AT REMOVAL (MUST BE C 20%)- <br />0 <br />T R COMMENTS <br />A <br />N TANK MATERIAL �S'TEEL,1FIBERGLASS, OTHER <br />C )- TANK SIZE _j <br />/ 0 TANK CONDITION OD, POOR, HOLES) `t <br />PN._.. _.___..__ .... <br />I JS PIPE MATERIA T I, FIBERGLASS, OTHER) # FEET <br />P _ <br />I PIPING CONDIT { 0 D, POOR, HOLES) `�--- --------- - <br />N _ <br />G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br />JT_.._..._ _' I_ <br />-- t <br />L <br />D S n EXCAVATION SIZE: ox � -� � YIDS OF SOIL: <br />I A DEPTH SOIL TYPE OBSERVATION SAMPLE #- <br />NM P - _--._- _-- <br />SP I _._...... _....._.__..----._._...._-____- <br />P L P <br />__._ ... _._._....._._.._._.__...._.__ <br />E I E <br />C N <br />T G TRENCH DIMENSIONS:i YQS OF SOIL: <br />I L <br />0 N H DEPTH TO G. W. : FT SAMPLING METHOD <br />2 <br />0 # OF HOURS SINCE DEWATERING: <br />LABORATORY: �Q.uc.-SAMPLERS NAME: <br />CLOSURE IN PLACE MIXTURE: VOLUME: <br />DRAW SITE MAP ON REVERSE <br />