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. PHS-EBD - UNG" pUND TANK CLS - <br /> -E DED ARE <br /> v BE FILLED INFOR/TH F .JT INSPECTION f <br /> •wvrur a <br /> I � � f .�rr <br /> ��a E �I RST TANK ONLY) <br /> / w�trrIry �a �'11II.. <br /> �. ✓ <br /> OWNER- NAME <br /> E OWNER PHGN <br /> N CONTRACTOR E # <br /> PHONE# <br /> R / SJLHD RM I T ## <br /> A ' EPA ` FIRE PERMIT # <br /> I -J � <br /> INSPECTOR " +� <br /> e , DATE Al�g TANK <br /> R RINSED N) <br /> I I METHOD <br /> N r,,/; ! R I NSE AMOUNT <br />' RINSATE DISPOSAL SITE �vF� <br /> S �G <br /> E MANIFEST # S <br /> -OR- OTHER <br /> V j VAPORS PURGED ' C2/N) <br /> f <br /> AMETHOD <br /> AMOUNT USED 6/3O/%s <br /> a L. E. L. READING AT REMOVAL (MUST B�C .C'P <br /> O <br /> A { R COMMENTS <br /> N TANK MATERIAL } <br /> K C f , FIBERGLASS, OTHER) <br /> ` TANK TANK SIZE <br /> / f Q r CONDITION (GOOD, p,Op R 50vv <br /> HOLES) <br /> NIPS <br /> i P T MATERIAL (STEEL, FIBERGLASS, _ <br /> J I f OTHER) # FEE-r <br /> IJ PIPING <br /> CONDITION <br /> N (Soo D, POOR, HOLES) ;' f <br /> G <br /> DEPTH i <br /> i + SOIL TYPE <br /> T OBSERVATION <br /> F I I <br /> ASAMPLEo � i SAMPLE # i <br /> j E K <br /> L l <br />�1 ! S EXCAVATION SIZE: 20 X 3L) — is <br /> I x '�` <br /> / YDS OF SOIL: �zQ C�tc�cfr5� <br /> A TH SOIL TYPE } <br /> N M P OBSERVATION <br /> P I } SAMPLE # <br /> P L P I+ <br /> C N �} <br /> T <br /> I G f TRE DIMENSION <br /> X X YDS OF SOIL I <br /> N i 3 DEPTH TO G, W. <br /> FT SAMPLING <br /> 0 METHOD <br /> OF HOURS <br /> 1 S , <br /> � � l SINCE DEWATERING: `"-c.1""• ! ' <br /> O OTHER SAMPLE: ' <br /> i LABORATORY: <br /> SAMPLERS NAME <br /> CLOSURE IN P i <br /> LACE � MIXTURE: <br />` E3a43 (10/891 VOLUME: + <br /> I <br /> DRAW SITE MAD ON REVERSE <br />