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;: `'pHs—EHD -- UNDERj ND TANK CLOSURE/ABANDON1 INSPECTION _ <br /> (SHADED AREA TOE FILLED IN FOR THE 1=IRST ,TANK ONLY) <br /> HE <br /> MFFff?'"Lyf <br /> F f <br /> OWNER NAME GN rOWNER PHONE <br /> N CONTRACTOR _ CON. PHONE# <br /> E � L <br /> R SJLHD PERMIT # EPA # FIRE PERMIT # 1417c <br /> L - <br /> IN DATEi TANK # 39 <br /> R RINSED NN4 METHOD ���� ��¢ R I NSE AMOUNT <br /> ' I I <br /> N RINSATE DISPOSAL SITE <br /> S <br /> E MANIFEST # —OR— OTHER <br /> V VAPORS PURGEDY/N) METHOD �� AMOUNT USED <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE ( EU%) <br /> 0 <br /> T . R COMMENTS - <br /> N TANK MATERIAL STE , FIBERGLASS, OTHER) TANK SIZE <br /> K C <br /> 4 1 O TANK CONDITION i , POOR HOLES) <br /> N <br /> ." S PIPE MATERIAL (STEEL IBERGIASS, OTHER) # FEET <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) <br /> N 1"/A � <br /> � � <br /> n <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A <br /> I N <br /> E K <br /> L <br /> D EXCAVATION SIZE; X X QFYIDS OF SOIL: <br /> s <br /> I A DEPTH SOIL TYPE OBSERVATION' SAMPLE # <br /> N M P <br /> S P I <br /> P L P <br /> E I E <br /> C N <br /> T G TRENCH DIMENSION X X YDS OF SOIL <br /> I <br /> 0 H DEPTH TO G. W. : . FT SAMPLING METHOD <br /> N i <br /> U #. OF HOURS SINCE DEWATERING: <br /> O OTHER SAMPLE: <br /> LABORATORY: SAMPLERS NAME: <br /> CLOSURE IN PLACE MIXTURE: VOLUhiE: <br /> ;EH 23043 (10/89) DRAW .SITE MAP ON REVERSE <br />