Laserfiche WebLink
Vol �. v�Ir✓ 1'nlvn (-LAu`.UA1!./s3,iAivL +L•►r'i <br /> (SHADED ARF, �TO BE FILLED IN FOR THE a -ST TANK ONLY) <br /> 5 <br /> G tOWNER NAME OWNER PHONE I <br /> ; <br /> E <br /> N i CONTRACTOR CON. PHONE# <br /> E /K� rGrnyY� !rt <br /> R i SJLHD PERMIT # EPA # FIRE PERMIT # EMi <br /> A <br /> L <br /> INSPECTOR U� DATE TANK #. 39 <br /> R RINSED (Y ) METHOD HL- RINSE AMOUNT 35 <br /> I <br /> N RINSATE DISPOSAL SITE S�+.t ' Sam. �gNGSGa <br /> S <br /> E MANIFEST # `-5 f7 r2q -OR' HER <br /> V VAPORS PURGED UYN) METHOD CAMOUNT USED �� <br /> A <br /> P L.E.G. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T LRJI <br /> COMMENTS <br /> A <br /> N TANK MATERIA ( STEE FIBERGLASS, OTHER) TANK SIZE. D Oho <br /> K C <br /> / O TANK CONDITIO {GOOD POOR, HOLES) <br /> p N <br /> I S PIPE MATERI ,,(STEEL FIBERGLASS, OTHER) # FEET NpNC�. <br /> P T <br /> I PIPING CONDITIO (GOOD POOR, HOLES) ter, <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> F A <br />� I N _ <br /> E K071=Lg with= <br /> L <br /> D EXCAVATION SIZE: 0 X �'- X YDS OF SOIL: 6 <br /> S- <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> 1 P L P <br /> E I E <br /> t C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br />� I <br /> i O H DEPTH TO G.W. : FT SAMPLING METHOD <br /> N 2 <br /> w 0 # OF HOURS SINCE DEWATERING: <br /> Fo� OTHER SAMPLE: r <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON REVERSE <br /> Ell 23 043(7/88) ' ;`_ <br />