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UNDERGROUND TANK INSPECTION RECORD <br /> (t TM- <br /> /NEW TANK INSTALLATION <br /> SITE NAME n_ NE�i2O�� �1�Y0 INSPECTOR'S NAME ` G<-p1, L),— <br /> '—ADDRESS`.ADDRESS CITY 4,i_ct_ G'f' ZIP <br /> CONTRACTOR: NAME --f.tea Pr (� S-It PHONE / <br /> OWNER: NAME _ C LiPvi'O r PHONE <br /> DIS INSPECTOR'S <br /> DATE PPROVED PPRDVED INITIALS <br /> ITEM OR EQUIPMENT INSPECTED <br /> /�t`/� �� 1. Fees paid [� <br /> Lti <br /> (!�t -� Plans Approved <br /> INITIAL INSPECTION <br /> i�l7�u <br /> . UL numbers 37y Y3 r,[C_ tank size 5 y.r• UL <br /> Tank tested upon delivery [Holiday (plastee t) or air at 5 PSI (FRP)I <br /> 9 ( _ _ -/11 Visual inspection of secondary containment. <br /> -7 7 �+ Tank appropriately placed with approved backfill. <br /> (PING STAGEINSPECTION <br /> 5rs� <br /> 1. Pressure test of piping. [Primary and Secondary (NFPA 30)) <br /> ���y ✓ 2. Ball float valves Ins tatted. <br /> 3. Overfill protection installed, describe: <br /> �y 4. Unused tank opening sealed and cathodicat(y protected. <br /> A60 5. Visual inspection of secondary containment on piping. <br /> y y C 0 6. Monitoring ports in place and brought to grade. (lockable weather proof covers) <br /> 7. Fill and vent piping brought to grade. <br /> w B. Product line leak detector in place. (Hard wired) ! <br /> ,�./ i <br /> 9. Approved tank teak monitoring device installed. <br /> 0 10. All galvanized piping and fittings properly wrapped. <br /> 1. Pressure decay test on complete tank and product delivery system. <br /> INAL INSPECTION <br /> �'� ✓// 4 Sy/�1 e 1. Precision test successfutty completed and hard copies received. (NFPA 329) <br /> g. 2. Spill protection at fit( pipe. <br /> b� Y / 3. Performance test of overfill protection system. <br /> 4. Performance test of product line leak detector. (Hard wired) <br /> 5. Performance test of continuous monitoring systems) on tank (s) <br /> 6. Permit to operate application complete. <br /> 7. Acceptable recordkeeping system. <br /> Comments: <br /> EN 23 006 10/B9 <br />