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NEW US' '-7STALLATION INSPECTION RUNIZIRD <br /> ADDRESS: w.� J G 'TUYI+ <br /> FACILITY NAME: �J�•G L c� <br /> SWEEPS# TANK# 3 OL#J_0 3J(J(� TANK MODEL/IIATERIAL: /n�" <br /> CAPACITY: TR <br /> � T= FT S L_ R.E_H.S: <br /> ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br /> WITH MANUFACTURER WRITTEN SPECIFICATIONS <br /> (`fib <br /> ONI � <br /> E L <br /> D S <br /> ITE( OR EQUIPMENT INSPECTED J ,. <br /> DATE 2 TK <br /> 1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (8) <br /> 2. UST INSTALLATION PLANS APPROVED (CCR 2635 (E) (5)) <br /> INITIAL INSPECTIONS <br /> 9-13�ti 3- INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: Q, k , <br /> VACUUM: ' S011P: PSI: HRS/MIN: BRIME(LIQUID ANNULAR): OTHER: <br /> 4. PRIMARY TANK TEST: A I (` PSI: �{, Lj NRS/MIN: -,f5YKA'—� <br /> _1 -15 V15_ TANK APPROPRIATELY PLACED WITH APPROVED BACKTILL (CCR 2635 (A) (3) (4) (6)/ API/PEI) <br /> 1 PIPING INSPECTIONS <br /> 6• PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIM) S( J L) (CCR 2635 (B) (4)) <br /> 7' SECONDARY PIPING CONTAINMENT TEST PSI: GJ HRS jo OTHER: (CCR 2635 (A) (4)) <br /> /� / ✓ 8_ LAKE TEST ON ALL SUPS (24 HR. MINIMUM) HRS: Z (CCR 2635 (A)) <br /> to_ V/ _ UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED (CCR 2635) <br /> ✓ fbi,10. OVERSPILL PERFORMANCE TEST (CCR 2635 (A) (4)) <br /> 11_ ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2635 (B)) <br /> / FINAL INSPECTION <br /> PERFORMANCE TEST FOR 'ALL' MONITORING PROBES (CCR 2632 (C) (2)) <br /> z_ ✓ 13. PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (A) (2)) <br /> 14. PERFORMANCE TEST OF LINE LEAK DETECTION i10(L4D s (CCR 2632 (D) 2635 (B) (5)) <br /> �. �G j ✓ 15. PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (CCR 2635 (B) (5)) <br /> 16_ BALL FLOAT VALVES INSTALLED (CCR 2635 (B) (6)) <br /> 17. OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635 (E) (2)) <br /> Q_4 18. TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) (CCR 2631 (D) (5)) <br /> 12122. <br /> - TANK INTEGRITY TEST (PASSING HARD COPY) (CCR 2635 (A) (5)) <br /> MONITORING PLAN, RESPONSE PLAN AID LOG BOOK OI SITE (CCR 2632 (E) (1) (2)) <br /> _ `C• FORM COPLETED AND SUBMITTED (CCR 2635 (E)) <br /> MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED .t L4- i (CCR 2641-2644) <br /> ALL CONDITIONS MET; FACILITY PERMIT ISSUED (H+S CODE 25284 (E) (F)) <br /> p � tali <br /> COMMENTS: }y _ /J <br /> E1123-0063 <br />