Laserfiche WebLink
FHS-EHD - UNDERGRI 'D TANK CLOSURE/ASANDONMEi INSPECTION <br /> (SHADED AREA TO _ FILLED IN FOR THE FIRST NK ONLY) <br /> rp <br /> %U!✓lU///J!/l:/4�/(J/!//!/!//JU///J!//8 H L L K t�u�Yu/Ja!!/Idla/vi//JdJ//!/a///!i/I�L'!.///!/U!U!✓/!/!L'!U!/!/UL/!!!U/� <br /> !( OWNER NAME OWNER PHONE # <br /> N CONTRACTOR CON. PHONE# <br /> ' E <br /> i <br /> I R S.ILHD PERMIT # EPA # FIRE PERMIT # <br /> A Ver/rr .Gi Gtri,/�/�//6 Ji�r�r G� �j�� G " Gt/G i G G G /��� / �G.G..G 1G`L��j�✓/�i�ir w'!��`���i�G'Y'/lG <br /> L IEtYIU V HL ILK 11 I tli�+f } Ll UStJ KC <br /> r � <br /> j INSPECTOR' DATE TANK # 39 - <br /> � I <br /> i <br /> I1 R I RINSED (Y/N) METHOD _ II i' RINSE AMOUNT <br /> I I <br /> I N RINSATE DISPOSAL SITE <br /> S1YYU <br /> E I MANIFEST # -OR- OTHER <br /> I i <br /> I <br /> V VAPORS PURGED (Y/N) METHOD ��1�11,'� '� AMOUNT USED <br /> i A I <br /> P L. E. L. READING AT REMOVAL (MUST BE < cU%) <br /> 0 I <br /> T R COMMENTS <br /> N I l TANK MATERIAL (STEEL, FIBERGLASS, OTHER) TANK SIZE <br /> ekp- <br /> / i 0 I TANK CONDITION (GOOD, POOR, HOLES) <br /> I <br /> j S l F'IF'E MATERIAL (STEEL, FIBERGLASS, OTHER) I # FEET <br /> P I T <br /> i I l I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> I <br /> G I i DEPT SOIL TYPE OBScRVATION }� SAMPLE # <br /> j I . T I v ✓,:, `l <br /> F A <br /> I N I I <br /> E K <br /> L 1 j I I <br /> D I I EXCAVATION SIZE: X XI 's YDS OF SOIL: <br /> S <br /> I ffI A I DEPTH SOIL TYPE I OBSERVATION SAMPLE # j <br /> N M P <br /> S P I <br /> P j L P <br /> ' E I E I i <br /> C I N t <br /> { T i G I I TRENCH DIMENSION X X YDS OF SOIL <br /> I I <br /> 0 I H l DEPTH TO G. W. FT SAMPLING METHOD <br /> N 2 <br /> I U I # OF HOURS SINCE DEWATERING: <br /> i I + 0 1 OTHER SAMPLE: <br /> ; <br /> II I <br /> t I LABORATORY: SAMPLERS NAME: <br /> I ' ` <br /> j CLOSURE IN PLACE ! MIXTURE: ( VOLUME: i <br />-EH 2-7043 ( 10/89) DRAW SITE MAP ON REVERSE <br />