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PHS-EHD = UNDER . �JND TANK CLOSURE/ABANDONI , f INSPECTION 1 <br /> (SHADED AREAP-BE FILLED IN FOR THE FIRS TANK ONLY) <br /> peffs,ff"allIfif), TIVIVIE <br /> f �t' <br /> f , j2 <br /> E <br /> OWNER- NAM E OWNER PH NE # <br /> E � �- <br /> N CONTRACTOR� �/j CON. PHONE# �aaQ <br /> E <br /> R SJLHD . PERMIT # EPA # ' FIRE PERMIT # I <br /> A <br /> L <br /> INSPECTC]R Tf PS DATE d TANK # 39 �-- <br /> a- <br /> R RINSED (Y/N) METHOD RINSt AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST: # -OR- OTHER <br /> AV VAPORS PURGED (Y/N) METHO AMOUNT USED ! � ' <br /> P L. E. L. READING AT REMOVAL (MUST tk < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEE FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / 0 TANK CONDITION (GOOD' O OLES) .� <br /> N ` 1 <br /> S PIPE MATERIALSTEEL FIBERGLASS, OTHER) # FEET , <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) / <br /> N <br /> G ''DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F T �. 4 � <br /> I N rc , T a kJ <br /> E K 1 T <br /> L r <br /> D .EXCAVATION SIZE: X X YDS OF SOIL: <br /> S <br /> I A -DEPTH SOIL TYPE OBSERVATION SAMPLE # I <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 G. W. : _ FT SAMPLING METHOD <br /> N 2 <br /> IF <br /> 4 # OF HOURS SINCE DEWATERING: <br /> 0 OTHER SAMPLE: <br />! <br /> LABORATORY., j,�t` SAMPLERS NAME: <br /> E <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23043 (10/89) DI ) SITE MAP ON REVERSE <br />