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OWNER -NAME OWNER PHONE <br />CONTRACTOR CON. PHONE# <br />SJLHD PERMIT <br />avz 1; FIRE P RMIT # <br />err/ �V'w � <br />Vim <br />T <br />A <br />N <br />K <br />P <br />I <br />N <br />G <br />F <br />I <br />E <br />L <br />D <br />I <br />N <br />S <br />P <br />E <br />C <br />T <br />N <br />L <br />G <br />EXCAVATION SIZE: <br />DEPTH SOIL TYPE <br />P <br />I <br />P <br />E <br />OBSERVATION <br />YDS OF SOIL: <br />TRENCH DIMENSION <br />INSPECTOR -b <br />DATE TANK # <br />39 <br />OF SOIL <br />R <br />I <br />I <br />RINSED <br />RINSED (bi/N) <br />METHOD-F.-kob (2tlt <br />RINSE AMOUNT <br />]N[R;INSATE <br />1 DISPOSAL <br />DISPOSAL SITE <br />E <br />MANIFEST <br />M ST 41 <br />V <br />A <br />APO <br />RS PURGED VAPORS (Y;N) <br />METHO- <br />I <br />AMOUNT USED <br />P <br />0 <br />L.E.L. READING AT REMOVAL (MUST BE < 20%) <br />v '141 <br />R <br />COMMENTS <br />'i <br />C <br />TANK MATERIAL (STEEL,.tl:&ERGLA" <br />, OTHERD <br />TANK SIZE <br />0 <br />N <br />TANK CONDITION 1 <br />) <br />POOR, HOLES) /jc dov"O'U-5 <br />S <br />PIPE MATERIAL (STEEL, <br />- <br />FIBERGLASS, OTHER) <br />4t FEET <br />T <br />PIPING CONDITION (GOOD, POOR, HOLES) <br />T <br />DEPTHSO OIL TYPE <br />OBSERVATION <br />SAMPLE <br /># <br />L <br />G <br />EXCAVATION SIZE: <br />DEPTH SOIL TYPE <br />P <br />I <br />P <br />E <br />OBSERVATION <br />YDS OF SOIL: <br />0 # OF HOURS SINCE DEWATERING: <br />2 0 OTHER SAMPLE: <br />11 <br />I lalulno TnDv• <br />. SAMPLERS NAME: — <br />CLOSURE IN PLACE IE: <br />EH 23043 (10/89) DRAW SITE MAP ON REVERSE <br />I . <br />VOLUME: Ailo <br />SAMPLE # <br />rl <br />0�a <br />TRENCH DIMENSION <br />- x <br />X <br />YDS <br />OF SOIL <br />I, <br />H <br />"I <br />DEPTH TO G. aLun�LvXFT <br />SAMPLING <br />METHOD <br />0 # OF HOURS SINCE DEWATERING: <br />2 0 OTHER SAMPLE: <br />11 <br />I lalulno TnDv• <br />. SAMPLERS NAME: — <br />CLOSURE IN PLACE IE: <br />EH 23043 (10/89) DRAW SITE MAP ON REVERSE <br />I . <br />VOLUME: Ailo <br />SAMPLE # <br />rl <br />0�a <br />