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pHs--EHD — UNDER ~�D TANK CLOSURE/ABAND <br /> ( iDEO. AREA / tN$PECTION <br /> bt FILLED IN FOR THE FIR TANK ZNLy) 0 <br /> r L -NC- <br /> E OWNER Nf�ME lNccC p; OWNER PHONE # 6 <br /> N CONTRACTOR <br /> E b CON. PHONE# <br /> R SJLHD OCRM I T # EPA # <br /> A FIRE PERMIT 0 IaA_ <br /> Lwpm <br /> ..� <br /> INSPECTOR DATE <br /> TANK # 39 <br /> R RINSED Y N) METHOD <br /> '�K/1 GP S <br /> I R�. RINSE AMOUNT : �d <br /> N RINSATE DISPOSAL. SITE <br /> 8 A-r-r�R o GAr� <br /> E MANIFEST # -.11 <br /> OR- OTHER <br /> V VAPORS PURGED Y N) METHODQ� <br /> A �/ SCG AMOUNt <br /> P L.E.L. READING AT REMOVAL (MUST BE ( 20%) . <br /> T R COMMENTS <br /> N TANK MATERIAL STEE FIBERGLAS5, ,aTHER) TANK 8IIE <br /> / O TANK. CONDITION 1000D POOR, HOLES) <br /> N <br /> � • S PIPE MATERIAL STEE FIBERGLASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION GOOD POOR, HOLES) <br /> N r <br /> G DEPTI SOIL TYPE OBSERVATION <br /> T iii 4 .° <br /> F qeAMOGo <br /> I N <br /> E K <br /> L if <br /> D EXCAVATION SIZES X <br /> X YDS OF SOIL:.. <br /> s <br /> I A DEPTH SOIL TYPE 088ERVATION ; <br /> N M P SAMPLE <br /> S P I <br /> P L PApt .,.. <br /> E I E ,,'//.: <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF: SOIL"' <br /> I .. . <br /> 0 H DEPTH TO G. W. <br /> N 2 FT SAMPLING METHOD <br /> 0 # OF HOURS SINCE DEWATERING: <br /> A ria .�.c * <br /> 0 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAMES <br /> CLOSURE IN PLACE MIXTURE: <br /> VOLUME: <br /> EH 23043 (10/89) DRAW SITE MAP ON REVERSE <br />