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X E RX E S° TANK INSTALLATION CHECKLIST , sotgle wall,000ble wau,owwater <br /> CORPORATION " Separators,and MCT Fiberglass <br /> Underground Storage Tank(s) <br /> The instalWig contractor must read the installation manual and complete this checklist to validate the Xerxes warrmty.The tank owner most retain a copy of <br /> ithis checkest and a copy of a0 deviatlan euthorhatlon to substantiate any warranty claim. <br /> • Date of linstaflabon _ /L 1 / 0 l - _.._ Tank She and Capacity <br /> • Tank Type SWT BWT 110= MY MCT OWS (circle those that apply) LL Number <br /> • Sind owner .. <br /> • Stte AJdresa 0 CawZ <br /> • blsuUbigContractor A... r c.. 14100 04D eNgto P- a.�J 4 �3Z0 <br /> V <br /> SS ` Car a'• no <br /> • supervisor grails t M !l� C—(Z� <br /> INSTALLATIONvatilled by: <br /> A. Wanted Inspection.No evidetx:s of damage(holes,cracks,gouges)In tank(document any damage found).......................... <br /> B. Brb s Tanks: 1.Check and record brine level in reservoir,(ItshoWd be at the label arrow) ................................ it <br /> 2.Crock for brute Inside tank ...................................................................... Irp <br /> C. Physical Test Pre-Installatlon air/soap test completed in accordance with Installation Instructions .............................. 'a _ <br /> U. Backfill material(Indicate which type) 1.Pea gravel or crushed stone as specified by XERXES............................. <br /> 2.Other(requires specific approval by XERXES(describe)) ......................... <br /> E Excavation.Bole dimensions are correct Per Installation Instructions for appropriate conddlons ............................... l Q� <br /> i. internal Measurement The inside d)anetSp-OLMe tank has been measured and documented(Dimension"A"Below) ................. <br /> C. FBI fabric Utilized.(Indicate anal t Yes 2.Nu ............................................................. <br /> H. Hole Condition.(hugcate nne) i.Ory ale.Water not anticipated to reach tank.Area not subject to flooding................. <br /> 2.Wet hole.Excavation may trap water.Area subject to flooding .......................... T�D <br /> L Traffic Loads.(Indicate one) 1.Traffic Wads anticipated........................................................ 7p <br /> 2.No traffic loads .............. .............................................. <br /> J. Anchoring.Performed In accordance with Installation instructlons. 1.Deedmen ...................................... <br /> ZFull SM ....................................... <br /> 2. OURING INSTALLATIONVol � <br /> A. Backfin material bed Is level and Is a minimum of 12"deep,over native soil or slab,before setting tank .......................... <br /> B. Tank spacing.Tanks aro spaced correctly from each other and excavation walls accordinq to instructions ...................... �rP <br /> C. Visual Inspection.No evidence at damage found atter setting In hole ..................................................... Tb <br /> O. Straps and tie-downs positioned and secured according to Installation Instructions(wet hale) ................................. <br /> E. SacknU compact ad.Material has been tamped and/or compacted to lin all Voids around tank ................................ <br /> T. Tank properly ballasted during backfLMng(wet hole installation only) .................................................... <br /> G. Tanks)buried at proper depth to conform to appropriate condition.(wet,dry,traffic or not) ................................ <br /> POST-3. I Vetilled Dr. <br /> A. Physical Test Alrlsoap test completed according to Installation Instructions ............................................ <br /> B. ynerme Measurement.The inside diameter of the tank has been measured and documented.(Dimenshon'Tl"Below) ................ ry <br /> C. Brine Tanks: 1.Check and record brine level in the reservoir (Inches) ........................................ :12, <br /> 2.Meek for brand beside tank .................................................................... <br /> 4. MEASUREMEVT OF DEFIRTION <br /> An tanks most be measured to determine vertical deflection.Follow deflection measurement Instructions in the Installation manual.An nodal denection <br /> measurement Is taken and recorded as a point of reference.Subsequent measurements show tank deflection and can he compared to the table below.Take <br /> earh measurement from Me same tftMQ using the same procedure. <br /> Turf AUDWARIF WASURB WS EMF CFl m Elio <br /> DIAMETER OBUCTaaI I.D.Before Back" "A• <br /> 1/ (FT.) (K) <br /> \� 4' Ire* I.D.Aner Becknmig 'r <br /> r 3/'r ouuclmNa ( ( J <br /> r I•lie .•A.mum.7 1 / <br /> 10' 1.11r MARX TIE IAGTtlN Yylettf D@iECIgN <br /> 1T 1-31r Vermes By: AEABINBY@ITE IYf1E TAllBL <br /> 7861 MW AVFTAE SOUTH,Mgr'EAPOIffi,MMUOTA 515431 • PHONE(812)867-1880 t*11118111 <br />