Laserfiche WebLink
5JLHu - UNDERGROUND TANK CLOSURE/A$ANUUJ MMA_k <br /> t TD BE FILLED IN FOR THE F� jiT TANK 'ONLX) <br /> (SHADED ARp <br /> j <br /> I Ik. <br /> G <br /> OWNER PHONE <br /> OWNER NAME # - . <br /> E , CON. PHONE#` <br /> N ; CONTRACTOR ` <br /> FIRE PERMIT # ��Z-(p� :t ' <br /> R SJLHD PERMIT # I�. EPA # i, <br /> A <br /> L rt <br /> INSPECTOR . DATETANK # 39 — r <br /> R RINSED (Y N) METHOD " ' - J RINSE AMOUNT �..-_.. <br /> N RINSATE DISPOSAL SITE ------ <br /> S ��.. <br /> E MANIFEST # —OR— OTHER a3 <br /> V VAPORS PURGE ,r (Y N) METHOD �� . ' AMOUNT USED v')6 <br /> A �! <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 COMMENTS T R COMM <br /> N TANK MATERIAL. (STEEL, FIBERGLASS, OTHER) TANK "'S'IZE /iC��" dCc <br /> K C <br /> / O TANK CONDITION (GOOD, POOR, HOLES ) 4 <br /> P N I ' <br /> I S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) . # FEET. , <br /> ' I PIPING CONDITION AGOOD, POOR, HOLES) <br /> N SAMPLE # <br /> DEPTH ,SOIL TYPE OBSERVATION sl <br /> G T <br /> F A R, <br /> I N naao <br /> c� <br /> E K <br /> D EXCAVATION SIZE: X X YDS OF SOIL: <br /> S- AMPLE # <br /> t I A EPTH \SOIL TYPE ��EATION <br /> I N M P <br /> S P I x <br /> E I E <br /> C Nll <br /> T G TRENCH DIMENSION X X YDS OF OIL <br /> 0 H DEPTH TO G.W. : Llnoci_rTV -SAMPL.ING METHOD ---- ` <br /> N <br /> 0 # OF HOURS SINCE DEWATERING: -- <br /> Fo-11 <br /> OTHER SAMPLE: <br /> - -_ <br /> FLABORATORY:'?' - SAMPLERS NAME: <br /> n-1 <br /> r CLOSURE IN PLACE MIXTURE: VOLUME- <br /> DRAW-SITE .:HAP,-ON, REVERSE <br /> OLUME:DRAW-SITE .:MAP:"ON, REVERSE <br /> i f <br />