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• NEW UST INSTALLATION INSPECTI0N RECORD <br /> FACILITY NAME: 7— ADDRESS, 7 �3 � <br /> FACSLI9Y ID# TANKS��� � UL*A -1 L)I& TANKU <br /> MOD /MATERIAL: �'�'w �� JOL -X <br /> CAPACITY: �G OCG) CL-(, PRODUCT: t-QL� UL R.E.H.S: <br /> A I <br /> P N ALL TANKS TO 3E INSTALLED AND TESTED IN ACCOROANCE <br /> P I WITH MANUFACTURER WRITTEN SPECIFICATIONS A/ C,N <br /> RT <br /> 0 I <br /> V A <br /> E L <br /> D S6/0 <br /> ITEM <br /> opo <br /> [TEM OR EQUIPMENT INSPEL'TED <br /> DATE <br /> )_j,Tq I 1. UST PIANS SUBMITTED/ FEES PAID (H-5 =6 5287) <br /> I?r'1y [)./' PDX UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> , jJ 771 ✓ INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br /> u I yAa":i I h SOAP: PSI: HRS/MIN: 3RINE(LIOUID ANNULAR): OTHER: <br /> 4. PRIMARY TANK TEST: PSI: HRS/MIN: <br /> TANK APPROPRIATELY PLACED WITH APPROVED 3ACXFILL (API/PEI) <br /> 7 r� PIPING INSPECTIONS <br /> /�/ �� h ✓I PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) COCl 2636 (e)) <br /> /1 Lir XI S'cC)NDARY PIPING CONTAINMENT TEST PSI: HRS/NIH: OTHER: (CC.2 2636 (e)) <br /> vyik LAKE TEST ON ALL SUMPS (24 HR. MINIMUM) HRS: (CCR 2635 (a) (4)) <br /> U' I✓ 9. UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED PEI <br /> 1O, OVERSPILL PERF43RHANM TEST (CL"R 2635 (b) (1) (C)) <br /> [NG AND FITTINGS CORROSION PROTECTED (CCR 2636 (b)) <br /> �✓ 7T YI PIPING SLOPES TO COLLECTION SUMP (COR 2636 (c)(1)) <br /> FINAL INSPECTION <br /> 13. PERFORMANCE TEST FOR "ALL" MONITORING PROBES (CCR 263Z (c) (2)) <br /> 14, PERFORMANCE TEST OF CONTINUOUS MONITORING SYST PANEL) (CCR 2632 (c) (2)) <br /> 15. PERFORMANCE TEST OF LINE LEAK DETECTION (CCR 2643 (c) (1)) <br /> 16. PERFORMANCE TEST OF AUTOMATIC PUMP SY SHUT-OFF (C'u'2 2636 (9)) <br /> 17. BALL FLOAT VALVES INSTALLED <br /> Ila. OVERFILL PROTECTICM INSTAL /APPROVED (CCR 2635 (b) (2)) <br /> 19. TANK ACCESS PORTS BROU T TO GRADE (LOCKED AND WATERTIGHT) API <br /> 2O. TANK INTEGRITY (PASSING HARD COPY) (CCR 2635 (a) (5)) <br /> 121. MONITORING P , RESPONSE PLAN AND LOG 300K ON SITE (CCR 2632 (d)) <br /> 22. .C� FOR PLETED AND SUBMITTED (CC2 2635 (d)) <br /> 23. MONI ING METHOD FOR ALL TANKS AND PIPING APPROVED (CCR 26.30-2656) <br /> 24. XL CONDITIONS MET; FACILITY PERMIT ISSUED (H+S CODE 25254) <br /> COMMENTS: <br /> EH23-7O6 9/95 T <br />