Laserfiche WebLink
rvatri�, a�-- is arc�vi�.c.�—r.a..�...a,�• ,+n.. .....�.. ..� — <br /> SITE NAME Q� AW ADDRESS CITY <br /> OWNER NAMEOWNER PHONE # <br /> Nw km" <br /> CONTRACTOR CONT. PHONE # <br /> FIRE PERMIT # <br /> REMOVALCLOSURE IN PLACE TEMPORARY CLOSURE <br /> INSPECTOR DATE, t TANK # 39 <br /> R RINSED ON) METHOD WR sz AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> E MANIFEST # ofy3 ca Z I n OR OTHER <br /> V VAPORS PURGED &W) METHOD AMOUNT USED .Z� <br /> A <br /> P READING AT REMOVAL L.E.L. : 02: /D <br /> 0 <br /> R COMMENTS <br /> C TANK MATERTAT, FIBERGLASS, OTHER) <br /> 0 <br /> N TANK CONDITION (GOOD, HOLES) <br /> S <br /> T PIPE MATERIAL (S F= Za <br /> PIPE CONDITION (GOODtj§W$-,>HOLES) <br /> DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T - Igo <br /> A Fr I sic?' I <br /> Nc f <br /> K <br /> S 1EXCAVATION SIZE U X _ X FDS OF SOIL tc'z <br /> A <br /> M DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> P P h � <br /> L I <br /> I P <br /> N E <br /> G <br /> TRENCH DIMENSION % X YDS OF SOIL <br /> DEPTH TO G.W. FT. SAMPLING METHOD <br /> H <br /> 2 # HOURS SINCE DEWATERING: <br /> 0 <br /> OTHER SAMPLE <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: 7 VOLaME: <br /> EH 23-0043 (REV 2/23/94) PROVIDE SITE MAP <br />