Laserfiche WebLink
' PHS—EHD — UNDF ,ROUND TANK CLOSURE/ABAN[f' ENT INSPECTION <br /> (SHADED ARS O BE FILLED IN FOR THE F, <br /> T/AN�K,y ONLY) <br /> � c <br /> cU c— <br /> OWNER NAMEQ <br /> r OWNER PHONE <br /> E . S rw� <br /> N CONTRACTOR ! CON. PHONE# �1 q15--;3y—y3jy 1 <br /> E Gef fe1� �rr�l'' <br /> R SJLHD PERMIT # EPA # f " �`�"` <br /> A F I RE PERMIT # <br /> L <br /> INSPECTOR �- DATE !6 TANK # 3S - l—� _ 3 <br /> RINSED ( YON) METHOD RINSE AMOUNT <br /> r ,. <br /> S RINSATE DISPOSAL SITE <br /> E MANIFEST # r' —OR— OTHER <br /> AV VAPOR PURGE (Y/N) METHOD P AMOUNT USED <br /> P L. E. L. READING AT REMOVAL (MUST BE ( 20%) <br /> O <br /> T R COMMENTS _ <br /> A <br /> N TANK MATERIAL (STEEL FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> / O TANK CONDITIO (GOOD POOR, HOLES) <br /> N <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET_._.(-W,�d� <br /> P T <br /> I PIPING CONDITIONGOOD POOR, HOLES) r!�" <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> A _ � � � SAMPLE # <br /> F <br /> N <br /> E � — <br /> K , <br /> L <br /> D EXCAVATION SIZE: '31 X <br /> S X � YDS OF SOIL: <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M SAMPLE # <br /> s P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION <br /> I X X YIDS OF SOIL <br /> O H DEPTH TO G. W. : <br /> N 2- FT SAMPLING METHOD <br /> G # OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23043 ( 10/89) DRAW SITE MAP ON REVERSE <br />