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PHS—EHD — UNDERAND TANK CLOSURE/ABANDONME6 INSPECTION <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST TANK ONLY) <br /> ��c'�'�i�i'wi���ea �e��evi,+eev.�rrvcvsaviaiawivruerrru ,v � "a°.areae,�errfrcrr",r.+reaevJ,vrurfr • • rivrvevivivfrr riiu�/ <br /> E -fi' T ,JCS tof <br /> N CONTRACTOR CON. PHONE# <br /> E <br /> R SJLHD PERMIT # EPA # FIRE GERM I T # 1 3 <br /> ft <br /> germ <br /> INSPECTOR DATE ''"1 �'~ +� TANK # a9 — l — 6-3 I <br /> I R RINSED (Y/V) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # —OR— OTHER <br /> V VAPORS PURGED ON) METHOD AMOUNT USED <br /> r <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST BE ( 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL TEFL FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / O TANK CONDITION (GOOD, OQ R, HOLES) mu <br /> s:. N <br /> S PIPE MATERIA (STEL, FIBERGLASS, QTH R) # FEET <br /> i I T <br /> i P'IP'ING CONDITION (GOOD,—P00 HOLES)4&,� ,/,� <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # I <br /> E K ' <br /> i Li I c + <br /> I D EXCAVATION SIZE: X L X YDS OF SOIL: <br /> �� <br /> S <br /> 7 <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> P L P <br /> ' E I E ? I <br /> C N <br /> T 6 TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> 0 H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 # OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: <br /> i <br /> LABORATORY: �'1�%(J�M� J SAMPLERS NAME: <br /> [A CLOSURE IN F'LACE MIXTURE: VOLUME: <br /> i <br /> EH 23343 ( 1 ]/89) DRAW SITE MAP ON REVERSE <br />