Laserfiche WebLink
PHS-EHD - UNDERGR ND TANK CLOSURE/ABANDONME*INSPECTION <br /> (SHADED AREA TO DE FILLED IN FOR THE FIRST TANK ONLY) <br /> � �`�'��'�1lHI��Clifii�.vc�,�v�irsrsrlrrl�ur�.vu/rierolrilrwr�li�lraruil%irr rr��s�r�rr�r,�y��Jlr�li�lr lr�liflr�iri�l�l�Sl��i/ + / lr�lr lr � �//!f <br /> i' <br /> OWNER NAME �jG�l r�SL' r OWNER F'HONE #�L �r + f_ y ( -�1�( <br /> i E <br /> f N CONTRACTOR�� CON. PHONE# <br /> E (91("- ) <br /> R , SJLHDPERMIT #,y�,y { EF'A #CAc_-o0 FIRE PERMIT # r <br /> INSPECTOR (f1Wt �DATES ` f��' � _ TANK # 39 Z- <br /> i. .3 RINSED - N)/� f <br /> METHQD � / <br /> s l rOUNT <br /> � :2�4 RINSATE DISPOSAL SITE �emen d Oop <br /> MANIFEST # T q -OR- OTHER i 'i 1+� !• " - ! r <br /> V VAPORS PURGED (YN) METHOD ��i L�(��, AMOUNT USED Jt` (� <br /> A _l 7 c1 <br /> P L. E. L. READING AT REMOVAL (MUST BE < 20%) r <br /> O �L L <br /> T R COMMENTS <br /> ° A <br /> N TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZE <br /> TANK CONDITION GD ( OOD, (OOR, HOLES) <br /> N <br /> A S PIPE MATERIAL �(�STEI�), FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR', HOLES) .t5-.-m„ C( 0 <br /> N <br /> G T DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> F A L r Sa}t. O'Q-iy\ I ods- <br /> I N 3 - C r� 61 <br /> L <br /> D EXCAVATION SIZE: X E X o _� ,fes <br /> S - YDS OF SOIL: /� �'( p0..M�[ <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE ”# <br /> P L P V V\A(V , ;1 0jyR „J <br /> 5 <br /> lo <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 S MPP-IN'G METHOD_~~' <br /> N 2 _ <br /> C) # OF HOURS SINCE DEWATERING: �- <br /> l 0 OTHER SAMPLE: <br /> LABORATORY: I � <br /> 1L�l�i SAMPLERS NAME: �`� P- <br /> LACE <br /> LACE MIXTURE: VOLUME: <br /> H 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />