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T&NK 3 <br /> UNDERGROUND TANK INSPECTION RECORD <br /> NEN TANK INSTALLATION <br /> SITE NAME 1�U.pl,J " T"�'f S/C IrvC <br /> .ADDRESS 7) s E INSPECTOR'S NAME <br /> TTY 1 �.��J - 5�3 <br /> CONTRACTOR; NAME I/ 2IP <br /> L <br /> OWNER; NAME PHONE�.t rD W �SAG �1 <br /> t PHONE <br /> DATEDIS INSPECTOR'S <br /> PPROVED PPNOVED INITIALS <br /> 92 T–o/ n n ITEM OR EQUIPMENT INSPECTED O <br /> 1. Fees paid <br /> 4/� Plans Approved <br /> 91— INITIAL INSPECTION <br /> / /` 1. UL numbers ZZ,z-3&ZkQ 7/tel tank size � 0 <br /> Tank tested upon delivery [Holiday (plasteel) or air 5 PSI (F )] <br /> ✓ Visual inspection of secondary containment. <br /> Tank appropriately placed with approved bockfilt,/ a <br /> j (PING STAGE INSPECTION + R <br /> 7 <br /> Piping-1. Pressure test of ma a&V cordar ([ Imo and y (NFPA 30)1 <br /> 2. Nall float valves installed. <br /> (� k�k/ n 3. Overfill protection installed, describe: <br /> 4. Unused tank opening sealed and cathodicalty protected. <br /> 5. Visual inspection of secondary containment on piping. <br /> 6. Monitoring ports in place and brought to grade. (lockable weather <br /> Z proof covers) <br /> 7. Fill and vent piping brought to grade. <br /> B. Product line leak detector in place. (Hard wired) <br /> 9. Approved tank teak monitoring device installed. <br /> 10. All galvanized piping and fittings 9 property wrapped. <br /> 11. Pressure decay test an calplete tank and product delivery system. <br /> INAL INSPECTION <br /> 1. Precision test successfully completed and hard copies received. (NFPA 329) <br /> 2. Spill protection at fill pipe. <br /> 3. Performance test of ovprfilt protection system. <br /> ' 4. Performance test of product line teak detector. (Hard wired) <br /> pp�J7 5. Performance test of continuous mmonitoring System(s) on tank (s) <br /> 6. Permit to operate application complete. <br /> / 7. Acceptable recordkeeping system. <br /> Caawnts• <br /> EH 23 006 10/09 <br />