Laserfiche WebLink
RHS--EHD — UNDER(3" ;'JND TANK CL©SURE/ABANDONM" `'r INSPECTION <br /> (SHADED AREA <br /> T BE FILLED IN FOR THE ,yF�I R,yS�/ - AN,yKONLY) <br /> "i�iiw��"lav"rir a r/v � �ir"Y�lir it rir ri7ir"?v � i it 'y / 1 <br /> OWNER NAME OWNER PHONE # /�!�Co/ _ �6,;4)6,;4)E <br /> N CONTRACT OR,%CS tom, CON. PHONE# <br /> E �33?33f) <br /> R SJLHD PERMIT # : EPA # FIRE PERMIT # �. <br /> A <br /> L <br /> INSPECTOR Ti DATE 9 TANK # 39 — — I <br /> R RINSED "(Y N) METHOD RINSE AMOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED ON) METHOD AMOUNT USED <br />` A <br /> P L. E. L. READING AT REMOVAL (MUST 9 < 20%) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERNAL ,(STEE , FIBERGLASS, OTHER) TANK SIZE <br /> K C r <br /> / O TANK CONDITION (GOOD, POOR, HOLES) <br /> N <br /> x S PIPE MATERIA STE , FIBERGLASS, OTHER) # FEET <br /> P T <br /> r I PIPING. CONDITION (GOOD, POOR, HOLES)r ��� <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br />{, T <br /> F A <br /> 1 , <br /> r I N Z <br /> E K <br /> L <br /> D EXCAVATION SIZE: X X YDS OF SOIL: <br /> S <br /> I A FDEH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> P L P c_ <br /> E I E t <br /> C N <br /> T G DIMENSION X X T_ YDS OF SOIL <br /> I bbb <br /> O H DEPTH TO G. W. : FT SAMPLING METHOD <br /> N 2 <br /> C) # OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> - 11 { <br /> LABORATORY: &,dr, SAMPLERS NAME <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH23043 (10/89) Df�l SITE MAP ON REVERSE [ ) <br />