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SJLHD - UND1%'R0UND `YANK CLOSURE/A14ANDO,,ve'sNT 1NSYEC'1'lUN <br /> (SHADED ARES:TO BE FILLED IN FOR THE F::•rST TANK ONLY) <br /> N T ST,41 jff, m Itum" .1110, <br /> coacd O �!/• do IME-!C <br /> i <br /> G OWNER NAMEOWNER PHONE I <br /> E Q P fiu j oris 2C7 3/-3673 <br /> N CONTRA TORCON. PHONE II ' <br /> EPrN <-kr Za9-9yg -6 2 v <br /> R t SJL PERMIT # EPA FIRE PERMIT # <br /> L <br /> INSPECTOR C O DATE 6 ��� TANK Y 39 - 2.3'71 - OZ�---_- <br /> R RINSED (Y/ METHOD' ` RIND 01440UNr <br /> - I <br /> N RINSATE DISPOSAL SITE Re Sert/�eS -- <br /> S <br /> E MANIFEST M -OR- OTHER <br /> V VAPORS PURGE ( ) METHOD AMOUNT USED s�hs <br /> A <br /> P L.E.G. READING AT REMOVAL (MUST BE < 20%) <br /> O <br /> T R COMMENTS <br /> A <br /> N TANK MATERIA (STEEL FIBERGLASS, OTHER) TANK SIZE � <br /> K C 00 <br /> / 0 TANK CONDITION GOOD POOR, HOLES) <br /> PN <br /> I S PIPE MATERIAL TEE , FIBERGLASS, OTHER) II FEET `o <br /> P T <br /> I PIPING CONDITION (GOOD P00 HOLES) <br /> N <br /> G DEPTH SOIL TYPE OBSERVATION SAMPLE # <br /> T <br /> F A Gf/scc� cn ecu. <br /> I N / 5 E <br /> r <br /> -E K <br /> L <br /> DZ SIZE: X 3�X Z YDS OF SOIL: SO-1 C)ycvs <br /> S: <br /> tI _ 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 /> SAMPLING METHOD <br /> O H DEPTH TO C.W. : FT <br /> N 2 ,��ss �rS <br /> 4 M OF HOURS SINCE DEWATERING: <br /> ,Ejr.1� OTHER SAMPLE: <br /> LABORATORY• A � ` <br /> SAMPLERS NAME: r� <br /> CLOSURE IN PLACE MIXTURE: VOLUME: <br /> DRAW SITE MAP ON f7EVEl2SE <br /> Ell '':J 0-110/88) <br />