Laserfiche WebLink
: SJLHD — UN' GROUND 'DANK CLOSURE/ALtANr `4ENT INSPECTIUN <br /> . (SHADED Ai( TO DE FILLED IN FOR THE S4RST TANK ONLY) <br /> �h <br /> G OWNER NAME EL <br /> OWNER PHONE <br /> N = CONTRACTORCON. PHONE 1 'a <br /> E <br /> R SJLHD PERMIT I EPA 1 FIRE PERMIT Y e - racy <br /> L s s • s • " � <br /> L By. <br /> INSPECTOR L�nr DATE 'a TANK f 39 - I Li O <br /> R RINSED Y/ ) METHOD �� RINSE AMOUNT-`P SS <br /> cl <br /> I a- <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST I -OR- OTHER <br /> V VAPORS PURGED N) METHOD D AMOUNT USED a5ib3 , <br /> A <br /> .P L.E.L. READING AT REMOVAL (MUST BE < 201) 2>01z(e1q <br /> 0 <br /> T R COMMENTSV%C P • Mme''p%ggrk 'T'#_C` ft,C 0 L Rt• <br /> A <br /> N TANK MATERIAL �EE FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD, POOR HOLES) <br /> P N <br /> I S PIPE MATERIAL (STEE , FIBERGLASS, OTHER) I FEET <br /> P T <br /> I PIPING CONDITION (GOOD POOR HOLES) <br /> N <br /> C DEPTH SOIL TYPE OBSERVATION SAMPLE V <br /> T <br /> F AhVh r•C. <br /> I N <br /> E K 4,0l <br /> L at" <br /> D EXCAVATION SIZE: X X YDS OF SOIL: <br /> s: <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> 0 H DEPTH TO C.W. : FT SAMPLING METHOD <br /> N 2 <br /> 0 t OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> 1 LA80RATORY OgIlpo <br /> SAMPLERS NAME: <br /> CLOSURE IN PLACE I MIXTURE: VOLUME: <br /> DRAW SITF. NAP ON R'EVFRSF. <br />