Laserfiche WebLink
PHS-EHD - UNDEW&ROUND TANK CLOSURE/ABANDOjWNT INSPECTION <br />Al"ll (SHADED ARE RW BE FILLED IN FOR THE FI PW TANK ONLY) <br />.............................. -- -- - <br />-%,� OWNER NAME OWNER PHONE # <br />E - <br />N CONTRACTOR CON. PHONE# <br />E <br />R SJLHD PERMIT # EPA # FIRE PERMIT # <br />L <br />INSPECTOR DATE TANK # 39 <br />R RINSED (Yfq) METHOD RINSE AMOUNT <br />I ---- — I <br />N RINSATE DISPOSAL SITE <br />S <br />E MANIFEST # -OR- OTHER <br />V VAPORS PURGED (QN) METHOD AMOUNT USED <br />P L.E.L. READING AT REMOVAL (MUST BE" 20%) <br />a <br />T R COMMENTS <br />A <br />N TANK MATERIAL Q,S�EE SIZE FIBERGLASS, OTHER) TANK <br />K C -- -- 1 <br />0 TANK CONDITIO<(G601)1) POOR, HOLES) <br />N <br />S PIPE MATERIAL((:STE� �L OTHER) FEET <br />FIBERGLASS, <br />P T I # <br />I PIPING CONDITION (GOOD, POOR, HOLES) <br />N <br />G DEPTH SOIL TYPE OBSERVATION <br />T SAMPLE # <br />F A <br />I N <br />E K <br />L <br />D s EXCAVATION SIZE: x -7- x 42, YDS OF SOIL: <br />A DEPTH SOIL TYPE OBSERVATION <br />N M p SAMPLE # <br />S P I <br />P L P <br />E I E <br />C N <br />T G TRENCH DIMENSION X X YD <br />I S OF SOIL <br />0 H DEPTH TO G. W.: FT SAMPLING METHOD <br />N a <br />0 # OF HOURS SINCE DEWATERING: <br />0 OTHER SAMPLE: <br />LABORAL TORY: SAMPLERS NAME: <br />--- wo <br />LCLOSURE IN PLACE MIXTURE: .=. VOLUME:' <br />EH 23043 (10/89) DRAW SITE MAP ON REVERSE <br />