Laserfiche WebLink
SJLHD — Ut 'F-"ROUND 'TANK CLOSURE:/ALW/ N'_ 's 'N'T INSPECTIUN <br /> (SHADED ., PO BE FILLED IN FOR THE it. >T TANK ONLY) <br /> G OWNER NAME OWNER PHONE 9 <br /> E <br /> N CONTRACTOR CON. PHONE# <br /> E �t <br /> R ft SJLHD PERMIT I EPA I FIRE PERMIT 4 <br /> L "` . <br /> INSPECTOR �" � DATE L/ ,� TANK Y 39 - Q - O-L <br /> R RINSED ,(Y�/N) METHOD RINSE AMOUNT <br /> N RINSATE DISPOSAL SITE , <br /> S <br /> E MANIFEST Y -OR- OTHER <br /> V VAPORS PURGED (Y N) METHOD D AMOUNT USED <br /> A <br /> P L.E.L. READING AT REMOVAL (MUST BE < 20%) <br /> 0 <br /> T R COMMENTS <br /> A <br /> N TANK MATERIAL%(ST , FIBERGLASS, OTHER) TANK SIZE <br /> K C �pl �Cjo <br /> / 0 TANK CONDITION (GOOD,(PO , HOLES) <br /> P N <br /> I S PIPE MATERIAL (STEEL, FIBERGLASS, OTHER) # FEET�J�A <br /> P T <br /> I PIPING CONDITION (GOOD, POOR, HOLES) IA <br /> N <br /> G T DEPTH SOIL TYPE OBSERVATION SAMPLE 9 <br /> F A _ o i Gt <br /> I N <br /> E K <br /> L <br /> D s- <br /> EXCAVATION SIZE: X X YDS OF SOIL : <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 2 <br /> 0 1 OF HOURS SINCE DEWATERING: <br /> aOTHER SAMPLE: <br /> LABORATORY* SAMPLERS NAME <br /> CLOSURE IN PLACE MIXTURE VOLUM <br /> 1'11 2:1 013(7/88) DRAW SITE MAP ON REVERSE <br />