Laserfiche WebLink
PHS-EHD - UNDFI ROUND TANK CLOSURE/ABAND rNT INSPECTION <br /> y�yl(SHADED ARES ❑a BE FILLED IN <br /> FOR THE F2 TANK ONLY) <br /> ilvOld �2129, ''�'f r <br /> �1rrn �Ur I 71 u / v Jb � , /Z Lt� <br /> OWNER NAME - G�cccc�{ OWNER PHONE # C' LG�reP <br /> E S f��y„ ,�h /� <br /> � - 3a <br /> N CONTRACTOR II CON. PHONE# y 14-n <br /> R <br /> A SJLHD PERMIT # EPA FIRE PERMIT # <br /> L YZ <br /> INSPECTOR C ' <br /> nr DATE i 16 TANK # <br /> =j. <br /> R RINSED ON) METHOD l RINSE AMOUNT <br /> I r ' /P 1N;� •/v <br /> N RINSATE DISPOSAL SITE /y am <br /> /`� e4 <br /> E MANIFEST # -OR- OTHER <br /> A VAPORS PURGED (Y N) METHOD n_ r�Q AMOUNT USED <br /> +�7z- <br /> P L. E. L. READING AT REMOVAL (MUST BE ( 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL (STEE <br /> K C FIBERGLASS, OTHER) TANK SIZE <br /> EMO <br /> / 0 TANK CONDITION (GOOD, POOR, HOLES) <br /> N <br /> S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER} # FEET <br /> P 7 <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION <br /> T SAMPLE # <br /> F <br /> I N <br /> E K Lw � <br /> L <br /> D - <br /> S .�,. <br /> I A DEPTH SOIL TYPE OBSERVATION <br /> N M p SAMPLE # <br /> S P I , <br /> P L P <br /> E ; E n <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF 50IL <br /> I <br /> O <br /> HEDEPTH G. W. ; FT SAMPLING METHOD <br /> N L <br /> G # OF HOURS SINCE DEWATERING: <br /> O 1 OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME; <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> EH 23043 { 14/89} DRAW SITE MAP ON REVERSE <br />