Laserfiche WebLink
WPHS -EHD — UNDER <br /> UND TANK CLOSURE/ABANDON <br /> T IN <br /> (SHADED AREA TO BE FILLED IN FOR THE FIRST NTANKSONLY) ON <br /> �lCjr1'�/f��rrdo �vc�C1 <br /> � OWNER NAME <br /> OWNER PHONE # <br /> N . CONTRACTOR <br /> E - rryC CON. PHONE# „?%�� -s <br /> R SJLHb ERMIT 0 '-Clod a-vod7;, ` <br /> A . # a9 FIRE. PERMIT # c <br /> L <br /> INSPECTOR � <br /> . C' 'o 7, DATE STANK # <br /> R RINSED Y N) METHOD <br /> RINSE AMOUNT <br /> N R I NSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # <br /> .-OR— OTHER <br /> V VAPORS PURGED (Y. ) ------ -_ ___� <br /> A ,METHOD AMOUNT USED <br /> P <br /> L. E, L. READING AT REMOVAL (MUST BE < {�•,C) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL TEELFINER[;LASS, OTHER) TA <br /> K C NK SIZE I <br /> p TANK CONDITION OOD� PODR�. HALES) S`D0d <br /> N <br /> S PIPE MATERIAL "TEE FIBERGLASS, OTHER} # FEET <br /> P 7 <br /> I PIPINO, CONDITION (GOO <br /> N POOR. HOLES) <br /> G OIL. TYPE <br /> T DEPTH SOBSERVATION - <br /> SAMPLE # <br /> F A sfaC <br /> E K �r <br /> L <br /> p <br /> EXCAVATION SIZES .'. <br /> S - X YDS OF SOIL: 1 <br /> I A DEPTH SOIL TYPE <br /> .N M p OBSERVATIQN <br /> S P I SAMPLE .# <br /> p L p <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION } <br /> I X X YDS OF SOIL <br /> O H DEPTH TO G, W. e _ I <br /> N 2 _ FT SAMPLING METHOD <br /> 0 # OF HOURS SINCE DEWATERING, <br /> O OTHER SAMPLE: .. I <br /> LABORATORY2 <br /> SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURES <br /> VOLUME: <br /> F 23043 (10/89) <br /> DRAW SITE MAP ON <br />