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PHS-EHO <br /> UNDRE <br /> (SHADED AREA UND TANK CLOSURE/ABANDONM•T INSPECTION <br /> y py�y� TOv� BEpy!yIL�L�ED IN FOR THE FIRST TANK <br /> / ' - t! .iv7�'1� ,Gi, /y1i.Gi'r1 jp,.ylGY✓y�iy �, ,i <br /> E NER <br /> CONTRACTOR OWNER PHONE # <br /> ASJLHD PERMIT 4 CON. PHONEilt <br /> ' <br /> L EPA # ; <br /> FIRE PERMIT # <br /> INSGECTOR <br /> DAT � •--_. �f L�{.i (�� ,• , ,� �' - �` - �,,��_-; <br /> � y�- ' ' i •� <br /> RE - <br /> RINSED "(Y/N) l TANK # 39 _ <br /> I ME THOU - <br /> N RINS " -- <br /> S ATE DISPOSAL SITE - ' RINSE AMOUNT- . <br /> E MANIFEST # (` <br /> V VAPORSGORGED �DR OTHER <br /> A \( j�/N) METHOD, /` <br /> --__"�-- <br /> ,, _t ; , <br /> L. E. L. READING AT REMOVAL AMOUNT USED <br /> R, <br /> 0 (MUST BE <br /> T R COMMENTS cUX) <br /> NTANK MATERIAL ,(STEEL' <br /> K C , FIBERGLASS <br /> / O TANK CONDITION (GOOD + OTHER) TANK SIZE <br /> N , POOR, HOLES) M <br /> S LIGE MATERIAL (STEEL <br /> P T , FIBERGLASS, OTHER) <br /> I PIPING CONDITIDN (GOOD # FEET <br /> N , POOR, HOLES) <br /> G DEPTH SOIL TYPE <br /> T ORSERVATION <br /> F A SAMPLE # <br /> I N <br /> E K <br /> L <br /> D EXCAVATION CZE; X <br /> S X YDS OF SOIL: <br /> I A DEPTH SOILTYPE <br /> N M P OBSERVATION <br /> S G I SAMPLE # <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSON X <br /> I X YDS OF SOIL <br /> 0 H DEPTH TO G. W. <br /> N FT SAMPLING METHOD <br /> U # OF HOURS SIICE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: (S <br /> C SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE . <br /> VOLUME: <br /> A 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />