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PHS—EHD — UNDE ROUND TANK CLOSURE/ABANDD,,.--NT INSPECTION <br /> (SHADED AREW- 3 BE FILLED IN FOR THE FIh . f TANK ONLY> <br /> ,� S E +ween � fa,-f -•�' W "'T'�Y , ,.� <br /> � , OWNER NAME - OWNER PHONE # <br /> E <br /> N CONTRACTOR 'O z <br /> E he+ �� r,�,� CON. PHONE# <br /> R SJLHD PERMIT # EFTA # <br /> A C#a000ZZ -1033 FIRE PERMIT # 3/26 <br /> INSPECTOR <br /> C'. DATE 5/31/QO TANK # C9 <br /> R RINSED (Y ) METHOD <br /> I & /� RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE <br /> S P�J,sf ^�ti��r;N 5i'�60 .2yfi� S� ecr�fo CA 95 Z <br /> E MANIFEST # <br /> -OR- OTHER <br /> V VAPORS PURGED(2Y)N) METHOD <br /> A AMOUNT USED <br /> P L. E. L. READING AT REMOVAL (MUST BE <br /> 0 "UX) <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K COO�r <br /> / 0 TANK CONDITION (GOOD, POOR LES) <br /> N <br /> S PIPE MATERI (STEEL FIBERGLASS, OTHER) # FEET,,-,. �O/ <br /> P T <br /> I PIPING CONDITION (GOOD POOR, OLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T - SAMPLE # <br /> F AJ <br /> E <br /> K <br /> L <br /> D EXCAVATION SIZE: n <br /> S --� X �3 X _12 YDS OF SOIL: v U/S <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M P SAMPLE # <br /> S G I c" e <br /> E I <br /> C N <br /> T G TRENCH DIMENSION $ � <br /> I X f X 3 r YDS OF SOIL c�5 <br /> 0 H DEPTH TO G. W. : <br /> N 2 FT SAMPLING METHOD <br /> U # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br /> LABORATORY: <br /> �G+I ,- Lc. SAMPLERS NAME : <br /> CLOSURE IN PLACE MIXTURE: ` <br /> VOLUME: <br /> EH 23043 ( 10/89) DRAW SITE MAP ON REUFRSr <br />