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UNDERGROUND TANK INSPECTION RECORD ,ffB Q�'L jiaeCaii,64� <br /> NEW TAANK' INSTALLATION <br /> SITE NAME <br /> �--ADDRESS ed S INS-P7E-C�TOzR�'�Sc�N�AME <br /> GA 'C�0 R�) CITY . (� D;376' <br /> / <br /> CONTRACTOR; NAME �� 21P �p <br /> / y <br /> 04NER; NAME .1 b� / �l �� PHONE— <br /> i PHONE <br /> QDATE PPROVED PPROVED "INITIALS S <br /> ITEM OR EUUIPMENT INSPECTED <br /> 1. Fees paid <br /> L"" //'�" Plnns Approved <br /> INITIAL INSPECTION n <br /> UL numbers 7 <br /> L [_ / `�� �l� tank size "' i Z . .Se C(j' t <br /> Tank tested upon delivery [Holida Y (Plus reel) or air at 5 PSI (FRP)] <br /> Visual inspection of secondary cont"i"nent. <br /> / /L!J Tank appropriately placed with approved backfill. <br /> 7 <br /> (PING STAGE INSPECTION �7 Si � <br /> ps <br /> I. Pressure [est of piping. [prinwry and Secondary (NFPA 30)) <br /> \� Z 2. Datl float valves installed. - <br /> 3. Overfill protection installed. describe; _ 27 <br /> 4. Unused tank opening sealed and cathodicalty protected. <br /> d <br /> 7 5. Visual inspection of secondary containment on piping. <br /> Cr 6. Monitoring ports in place and brought to <br /> J grade. (lockable weather proof covers) <br /> 2/J� 7. Fitt and vent piping brought to grade. <br /> 0• Product link leak detector in place. (Hard wired) <br /> 9. Approvetl tank teak monitoring device installed. <br /> 7 <br /> L /e 10. All galvanized piping and fittings properly wrapped. <br /> 11. Pressure decay test On caiplete tank and product delivery systeim. <br /> INAL INSPECTION <br /> I. <br /> Precision test successfully completed and hard copies received. (NFPA 329) <br /> y� 2. Spill protection at fill pipe. <br /> _T 3. Perf ornwnce [est of overfill protection system. <br /> 1 I�s 4. Perfornwnce [est of product tine leak detector. (Hard wired) <br /> 1 5. Perf ornwnce fes[ of continuous monitoring systems) on tank (s) <br /> O 6. Permit to operate application cpiplete. <br /> [d 7. Acceptable recordkeeping system. <br /> Comments• <br /> EH :i 006 ]O�pq <br />