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,_._...� . .i►.. . Vt{v Vii:. aI ►rn CjLVSUnh;/AyANOUNI'ItAIT IivSl'El:'A'lUN <br /> (SHADED ARF" ,,TO BE FILLED IN FOR THE F'+'ST TANK ONLY) <br /> 0 131 S. C7c S <br /> G OWNER NAMEt�qeIpoj { /+ ' . ,TOWNER PHONE <br /> E <br /> N t CONTRACTOR84L� +CON. PHONE# (2,009 q,6��hS <br /> E <br /> R { SJLHD PERMIT # EPA �j#Cf 6000& FIRE PERMIT # <br /> A � �� ' <br /> L <br /> s <br /> INSPECTOR DATE TANK # 39 - 1 - -0 <br /> R RINSED NN) METHOD T+"� �� RINSE AMOUN B'5S-i6= <br /> I ". _. <br /> N RINSATE DISPOSAL SITE �ifos ni( tree <br /> S <br /> E MANIFEST # �dSSI�Cio� --OR-- OTHER <br /> H - V VAPORS PURGED Y N) METHODAMOUNT USED" JbS <br /> A o <br /> P L.E.L. READING AT REMOVALI (MUST BE < 20%) np <br /> 0 r <br /> T R COMMENTS = <br /> A <br /> N TANK MATERIAL (STEEL, ERGLAS , OTHER) I TANK SIZE IQ1� <br /> Ut- <br /> K CSolp <br /> / 0 TANK CONDITION GOOD, POOR, HOLES 1In +a''"t � 1c � oe <br /> P N r oua <br /> I S PIPE MATERIAL (STEEL, IB RGA , OTHER) # FEET <br /> P T <br /> I PIPING CONDITION G OD POOR, HOLES) OC C 6OV5 66(0 <br /> N " <br /> G DEPTH SOILTYPE OBSERVATION SAMPLE # <br /> T <br /> F A <br /> I N l 51 c�'� ,-, c cl t o $-- <br /> E K { <br /> L --�E7 <br /> D EXCAVATION SIZE: ' XAL, X YDS OF SOIL: �Sp" <br /> 3- <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P " r <br /> S P I <br /> P L P ' <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION c X X YDS OF SOILS�f�� <br /> I <br /> O H DEPTH TO G.W. : SAMPLING METHOD r <br /> N 2 <br /> 0 1 OF HOURS SINCE DEWATERING: <br /> OTHER SAMPLE: - <br /> i <br /> LABORATORY: SAMPLERS NAME: C: <br /> CLOSURE IN PLACE7 MIXTURE: h_ VOLUME: <br /> _71 <br /> DRAW SITE <br /> ON REVERSE <br /> EII 23 043(7/88) <br />