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"c NEW UST INSYALLATION RECORD <br /> '4FACILTIY NAME P��CAZ rn PPaV rJC <br /> FACII.iTY ADDRESS —/7/00 <br /> SWEEPS # TANK# U.L.# PRODUCT <br /> DATE APPROVED DISAPPROVED REHS ITEM OR EQUIPMENT INSPECTED <br /> 1. UST INSTALLATION PLANS SUBMITTED &FEES PAID <br /> 2. UST INSTALLATION PIANS APPROVED <br /> INITIAL INSPECTION <br /> 1. HOLIDAY TEST(PLASTEEL) <br /> 2. AIR TESTED @ 5 PSI (FRP) <br /> 3. VISUAL INSPECTION OF 20 CONTAINMENT r: <br /> 4. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL <br /> PIPING STAGE INSPECTION <br /> I. PRESSURE TEST 110 AND 20 (NFPA 30)] <br /> 2. BALI.HAAT VALVES INSTALLED <br /> 3. OVERFILL PROTECTION INSTALLED, DESCRIBE: <br /> .4. UNUSED TANK OPENING SEALED & CATHODICALLY PROTECTED <br /> S.'VISUAL INSPECTION OF 20 CONTAINMENT ON PIPING <br /> 6.:MONITORING PORTS IN PLACE &BROUGHT TO GRADE (LOCKABLE <br /> WEATHER PROOF'COVERS) <br /> 7. FILL&VENT PIPING BROUGHT TO GRADE <br /> 8. PRODUCT LINE LEAK DETECTOR INPLACE (HARD WIRED) <br /> 9. APPROVED UST LEAK MONITORING DEVICE INSTALLED <br /> 10.ALL GALVANIZED PIPING &FITTINGS PROPERLY WRAPPED <br /> 11.PRESSURE DECAY TEST ON COMPLETE UST& PRODUCT DELIVERY <br /> SYSTEM <br /> FINAL INSPECTION <br /> 1. PRECISION TEST SUCCESSFULLY COMPLETED AND HARD COPIES <br /> RECEIVED (NFPA 329) <br /> 2. SPILL PROTECTION AT FILL PIPE <br /> 3. PERFORMANCE TEST OF OVERFILL PROTECTION SYSTEM <br /> 4. PERFORMANCE TEST OF PRODUCT LINE LEAK DETECTOR (HARD <br /> WIRED) <br /> S. PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM(S) ON <br /> TANK(S) <br /> 6. PERMIT TO OPERATE APPLICATION COMPLETE <br /> 7. ACCEPTABLE RECORD KEEPING SYSTEM <br />