Laserfiche WebLink
r� , <br /> PHS-EHD - UNDERCs''.. �- ND TANK CLOSURE/ABANDONM�r •INSPECTION <br /> t (SHADED AREA T5eBE FILLED IN FOR THE FIRST TANK ONLY) <br /> In 211 <br /> OWNER NAME OWNER PHONE # Ca0 j . 36 p M a <br /> ECONTRACTOR CDN. PHONE# _5 a , <br /> R S,JLHD PERMIT # EPA # FIRE PERMIT # ;j i <br /> A <br /> L , <br /> INSPECTOR S' DATE �O�3�' g'9 TANK # 39 - <br /> R RINSED (Y ) METHOD . RINSE AOUNT <br /> I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # -OR- OTHER <br /> V VAPORS PURGED (Y N> METHOD AMOUNT USED <br /> A <br /> P L. E. L. READING AT REMOVAL (MUST < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIA TEE , FIBERGLASS, OTHER) TANK SIZE,' - <br /> K C <br /> / ,20 <br /> O TANK CONDITION (GOOD, POOR, HOLES) <br /> N <br /> -: S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET <br /> P T <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 tf <br /> L it <br /> D EXCAVATION 5IZE: <br /> S X X —7— YDS OF SOIL <br /> I A DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> N M P <br /> S P I <br /> P L P _ . 3 <br /> E I E <br /> T G TRENCH DIMENSION X < X YDS OF SOIL , <br /> I _ <br /> -j- <br /> O Til <br /> DEPTH TO G. W. : FT SAMPL I NG METHOD <br /> N <br /> # OF HOURS SINCE DEWATERING: <br /> OOTHER SAMPLE: <br /> Fes LABORATORY: SAMPLERS NAME: <br /> i <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> a <br /> EH 22043 (10/89) DRAW SITE MAP ON REVERSE <br />