Laserfiche WebLink
' 60i,tiu - uLiu RuuL4u '1'ANn CLOSURE/ABANDONMENT INSPECTIUN <br /> f (SHADED AROTO BE FILLED IN FOR THE T TANK ONLY) <br /> fir ' <br /> own=19=00m <br /> G i OW;NAE OWNER PHONE # <br /> E CON. PHONE# <br /> N < CO <br /> E <br /> R < SJEPA # FIRE PERMITALINLey DATE � 8JTANK # 39 - lel L - u <br /> R ) METHOD TZPLL� AMOUNT C <br /> I <br /> N RINSATE DISPOSAL SITE / (LU j; cz2j <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y N) METHOD �, I � AMOUNT USED <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 208) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL ( TEEL, FIBERGLASS, OTHER) TANK SIDE /1 ✓l <br /> K C V <br /> / 0 TANK CONDITION (GOOD, POOR HOLES) Ct r/Z r9, <br /> P N <br /> I S PIPE MATERIAL EEL, FIBE ASS, OTHER) Fl FEET I <br /> P T <br /> I PIPING CONDITION (GOOD, OOR, OLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A <br /> I N n d � o ✓ Sb� <br /> E K m 1 Na <br /> L <br /> D EXCAVATION SIZE: _L,L-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 /> O H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> ❑O OTHER SAMPLE: <br /> LABORATORY: 1 vA � SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: — <br /> DRAW SITE MAP ON REVERSE <br />