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UNDERGROUND TANK. TNSPECTION RECORD <br /> NEW TANK INSTALLATION <br /> e— <br /> SITE NAME ,D.�. L(/✓dtt/ &/— �,C&A"'^''iNSPR, ()H'S NAME <br /> ADDRESS__L3 ( r' N�r <br /> CITY [� ZIP <br /> CONTRACTOR: NAME <br /> TELEPHONE <br /> OWNER: NAME <br /> TELEPHONE <br /> DIS- INSPECTOR'S <br /> DATE APPROVED APPROVED INITIALS 1 <br /> V �, ✓ ITEM OR EQUIPMENT INSPECTED <br /> ft-ps paid. <br /> c <br /> [NITIA1.INSPECTION <br /> 1 Tank tested upon delivery Ifinlidaylasteel) or air at SPSI (FRP)( <br /> 2. Visual inspection of secondary containment. <br /> 1. Tank ap ropriately placed with apprnved backfill. <br /> 4. UL numbers and tank ca acitles recorded. <br /> PIPING STAGE INSPECTION <br /> c <br /> 1. Pressure test of ruin (Primary and Sccondar (NFPA 30)( <br /> 2. Ball float valves installed. <br /> i. Uverfill protection installed. describe: <br /> 4. Unused tank openings scaled and cathodically protected. <br /> 5. Visual inspection of secondary containment on pipinK. <br /> 6. (lockable wether prop <br /> o or s ill I.— and b:uu ht t o rade, covers) <br /> 7. Pill and vent piping hrou ht to grade. <br /> 8. Product line leak detector in place. (Hard wired) <br /> 9. A proved tank leak monitoring device installed. <br /> 10. All galvanized piping and fittings properly wrapped. <br /> 1. Pressure decay test on complete tank and product deliverZ s stem.V <br /> FINdI. INSPECTION <br /> I tiFp� <br /> 1.' Precision test SUCCCSSlU11 Luanlcicd .181d (raid co-pies received13?9C <br /> 2. Sill protection at fill i .r•. <br /> i <br /> 3. Performance tea of nv,rfill rtoteriion ::vstcm. _ <br /> 4. Perfnrmauce test of plocimi line leak delectot. (Hard wired) <br /> tIbrd <br /> S. Performance te::t of toot inu.,: n nit.0 tar s• stems) nn tank(.)Mr rM111 <br /> 6. Permit to o urate applicatim, t nm,lel,. <br /> 7. <br /> Acceptable recordkee in system. <br /> oQ+gxr: <br />