Laserfiche WebLink
NEN UST INSTALLATION INSPECTION RECORD - p' <br /> FACILITY NAME: Q S — ADDRESS: A 73 Lit, C <br /> FACILITY (D# <br /> V TANK# ULS TANK MODEL/M IAL: <br /> CAPACITY: PRODUCT: Q u L R.E.H.S: `� ) <br /> l ODd <br /> A [ <br /> P N ALL TANKS i0 BE INSTALLED AND TESTED IN ACCORDANCE <br /> P I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br /> R T <br /> 0 I <br /> V A <br /> E L <br /> 0 S <br /> ITEM OR EauiPMENT INSPECTED <br /> DATE <br /> 1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287) <br /> 2. UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> 3, INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br /> VACUUM: SOAP: PSI: HRS/MIN: BRIME(LIOUID ANNULAR): OTHER: <br /> 4, PRIMARY TANK TEST: PSI: HRS/MIN: <br /> 5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (API/PES) <br /> PIPING INSPECTIONS 140 f <br /> VO j t -Jtp-I+, 6. PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) (CCR 2636 Cell <br /> SP` I 7. SECONDARY PIPING CONTAINMENT TEST PSI: NRS/MIN: OTHER:J (CCR 2636 (e)) <br /> �Q '��IK.O QI ✓ LAKE TEST ON ALL SUMPS (24 HR. MINIMUM)- HRS: (CCR 2635 (a) (4)) <br /> ✓ UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED PEI <br /> 1po 1, OVERSPILL PERFORMANCE TEST (CCR 2635 (b) (1) (C)) <br /> 1 I 1L ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2636 (b)) <br /> 12. PIPING SLOPES TO COLLECTION SUMP (CCR 2636 (041)) <br /> FINAL INSPECTION <br /> f_�„ v *3, PERFORMANCE TEST FOR "ALV' MONITORING PROBES (CCR 2632 (C) (2)) <br /> oV '��� 9 1 � - PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (C) (2)) <br /> Q 1 1 u15. PERFORMANCE TEST OF LINE LEAK DETECTION (CCR 2643 (C) (1)) <br /> VA <br /> 16. PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT,aF—, CCR 2636 (9)) <br /> 17. BALL FLOAT VALVES INSTALLED r6 mzryCd„ <br /> OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635 (b) (2)) <br /> V� TANK ACCESS PORTS 3ROUGHT TO GRADE (LOCKED ANO.WATERTIGHT) API <br /> IDD <br /> '� p TANK INTEGRITY TEST (PASSING HARD COPY) And, - � <br /> ( Y( !j dd (CCR 2635 (a) (5)) <br /> OO I ��../ J1. MONITORING PLAN, RESPONSE PLAN AND LOG 300K ON SITE (CCR 2632 (d)) <br /> 22. "C" FORM COMPLETED AND SUBMITTED - (CCR 2635 (d)) <br /> 23. MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (CCR 2630-2636) <br /> 24. ALL CONDITIONS MET; FACILITY PERMIT ISSUED (H-S CODE 25284) <br /> COMMENTS: <br /> EH23-006 9/95 <br /> 10 <br />