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APPENDIX E <br /> Tank Installation Checklist <br /> TO INSTALLER:After tank installation,del iverthe Installation Manual with the completed Tank Installation Checklist to the tank owner.Retain a copy <br /> of each for your records. <br /> TO OWNER:After installation,retain the limited warranty,the Installation Manual and completed Tank Installation Checklist for future reference and to <br /> facilitate any warranty claim. <br /> INSTALLATION DATE(S): PERSON COMPLETING FORM: <br /> INSTALLATION ADDRESS: <br /> TANKINFORMATION TANK#1 TANK#2 TANK#3 TANK#4 <br /> Tank type—Single-Wall(SW),Double-Wall(DW) <br /> Tank Usage(Fuel)—Fuel,DEF,Pipeline Sump <br /> Tank Usage(Water)—Potable Water,Water Collection <br /> Tank Usage(Wastewater)—Grease Interceptor,Septic, <br /> Industrial Wastewater/Chemical <br /> Tank Usage(Oil/Water Separator) <br /> Nominal Tank Diameter—give in feet <br /> Nominal Tank Capacity—give in gallons or liters(and note which) <br /> If applicable,UL/ULC#(read from tank label)—yes or no <br /> SITE INFORMATION(See section 1) TANK91 TANK#2 TANK#3 TANK#4 <br /> Primary backfill meets Appendix C requirements—yes or no <br /> Secondary backfill material will be used—yes or no <br /> Secondary backfill meets our requirements—yes or no <br /> Geotextile will be used—yes or no <br /> Excavation—shored or not shored <br /> Tank will see traffic loads(1120 or HS20)—yes or no <br /> Hole condition—dry or wet <br /> Anchoring system will be used—yes or no <br /> If applicable,anchoring system used—dead men or anchor slab <br /> JPREINSTALLATIONINSPECTIONANDTESTING(Seesections3and4) TAN K#1 TANK#2 TANK#3 TANK#4 <br /> Shipping damage—yes or no <br /> Loss of vacuum—yes o r no <br /> Monitoring fluid visible on interior of tank—yes or no <br /> Monitoring fluid visible on exterior of tank—yes or no <br /> Requirements metfor double-wall tanks shipped under interstitial <br /> vacuum—yes or no <br /> Record fluid level in reservoirfor double-wall wettanks <br /> If required,tank passed pressure/soap test—yes or no <br /> Continued on Next Page -=-r---�+ <br /> ZrL XERXES APPENDIX 45 <br />