Laserfiche WebLink
SJLliv - UNDE UUND TANK CLOSURE/A$ANUO NT INSPECTION <br /> (SHADED AREWO BE FILLED IN FOR THE FT TANK ONLY) <br /> SMS <br /> pin <br /> G OWNER NAME ' err r� " f OWNER PHONE #(2 t fr q <br /> E _f [� <br /> NE CONTRACTOR , [I Uv 0,=4 ( CON. PHONE# (�/--0 L/(eq S <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # <br /> A <br /> L <br /> INSPECTOR J . Fac)rl DATE iTANK # 39 - 22 fc G' <br /> R RINSED N METHOD RINSE AMOUNT <br /> I <br /> T-- <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED YIN) METHOD AMOUNT USED f rl_ <br /> A _ "C fJ <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> O <br /> T L R COMMENTS <br /> A <br /> N TANK MATERIAL . TEEL,,-- FIBERGLASS, OTHER) TANK SIZE �� <br /> K C - _RC1 <br /> / 0 TANK CONDITIONGOO `' uO F HOLES)-- <br /> P N .1,.,, <br /> I JS PIPE MATERIAL (S, TEEIa FIBERGLASS, OTHER)P <br /> I PIPING CONDITION (GOOD,(P00 , HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> F A �. f n - �SGY ,!f' Ar w <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE: X z' 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 ,i_„_ x YDS OF SOIL <br /> I <br /> 0 H DEPTH TO G.W. : G 1�-� FT SAMPLING METHOD <br /> 0 # OF HOURS SINCE DEWATERING: <br /> F-o-11 OTHER SAMPLE: <br /> LABORATORY: _ (� � SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: ` <br /> DRAW SITE MAP ON REVERSE <br />