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XERXES � TVK INSTALLATION CHECKI . 7 <br /> CORPORATION Fi0erglass Underground Storage Tanks <br /> Single-Wall (SWT), Double-Wall (DWT), Multi compartment(MCT) and OillWater Separators(OWS) <br /> Complete this checklist,and keep it with copies of any written authotizafJons for var€atlons and/or deviations received from Xerxes. <br /> • Date of Installation — — O 3 Tank Size and Capacity <br /> • Tank Type SWTDWT MONITORING FLUID DRY MCT OWS (Circle those that apply.) UL Number ZO k <br /> - Site Owner ?-Lleueyo ,,yc foae_ Ict%gZcc <br /> Y._ <br /> - Site Address 1344 /UDaLL M4100, It � 1 <br /> • Installing Contractorgh4t, dW W4 <br /> • On-Sits StapervisorAT, 3;e (Ftt2C 441 Col RoSbel( lZ� lu1Cr1'f'ec�. �L IIP <br /> 1. PREINSTALLATION Verified by: <br /> A. Visual inspection:No evidence of damage(holes,cracks,gouges)in tank.(Document any damage found.)..................................... <br /> B. Monftoring-Fluld Tanks: 1.Check and record monitoring-fluid level in reservoir. .............................................................................. s <br /> 2.Check for monitoring fluid Inside and outside of tank............................................................................... <br /> C. Physical Test: Preinstallation air/soap test completed in accordance with installation instructions....................................................... <br /> D. Backfill Material: (Indicate which type.) 1.Pea gravel or gushed stone as spewed by XERXES........................................ <br /> 2.Other(Requires specific approval by XERXES—describe.)................................. <br /> E. Excavation: Hole dimensions are correct per installation instructions for appropriate conditions......................................................... <br /> F internal Diameter Measurement: The iiternal diameter of the tank's measured and doc mooned(Wlial inliomal Diameter in Section 4 below).... _ <br /> G. Gootextila Utilized: (Indicate one.) Ye Z No.......................................................................................................................... <br /> H. Hole Condition: (indicate one.) ry hole(Water is not anticpated to reach tank—area is not subject to flooding.)................ <br /> 2.Wet hole(Excavation may trap water—area is subject to flooding.)...................................... <br /> 1. Traffic Loads: (Indicate one.) 1.Traffic mads anticipated.......................................................................................................... _ <br /> 2.No traffic loads anticipated. ..................................................................... <br /> r� J. Anchoring: Performed in accordance with installation instructions. 1.Deadman 2.Full slab.:................................................. <br /> K. Fittings and Other Metal.Components: Coated to protect against corrosion.., <br /> 2. DURING Verified by: <br /> A. Backfill-material bed is level and is a minimum of 12 Inches deep,over native soil or stab,before setting tank....................... _ <br /> B, Tank Spacing: Tanks are spaced correctly from each other and from excavation according to instructions......................................... <br /> C. Visual InspKton: No evidence of damage Is found after setting in hole.............................................................................................. <br /> D. Holddown Straps: Positioned and secured according to Installation instructions.(See SECTION 6.4.of Insfelfafion Manual.)......... <br /> E. Backfill Compacted: Material has been tamped andior compacted to fill all voids around tank........................................................... <br /> F. Tank Is property ballasted during backfilling: (wet-hole installaton only)........................................................................................ <br /> G. Tank(s)are buried at proper depth to conform to appropriate conditions: (wet,dry,traffic or no traffic)....................................3. POSTINSTALLATION .. <br /> Verified by: <br /> A. Physicai Test: Airlsoap test is completed according to installation instructions................................................................................... <br /> B. k*fftal Diameter Measurement The internal diarr>eter Qf the teal:6 measured and doaxrier#hd(Final hamai Darner in Section 4 below)............. _A25-- <br /> C. Monitoring•Fiuid Tanks: 1.Check and record monitoring-fluid level In the reservoir -3 Y6 (inches)........................................ <br /> % _ <br /> 2.Check for monitoring fluid inside tank.....................................: <br /> D. Installation Manual: Deliver installation Manual and operating Guidelines to owner. ...­................................................ <br /> 4. DEFLECTION MEASUREMENT <br /> All tanks must be measured to determine vertical deflection. Follow deflection-measurement instructions(Section 14)in the Installation Manual. An <br /> initial interna!-diameter measurement is taken and recorded as a point of reference: Subsequent internal-diameter measurements show tank deflection and <br /> ca;r be compared to the table below. Take each measurement from the same fitting using the same procedure. <br /> CENTER E� <br /> External Tank INTERNAL•DiAMETER MEASUREMENTS <br /> Diameter 4 6 8 10 12 Initial Intemal Diameter(before backfilling) / b <br /> (Ft) _ Final Internal Diameter(after backfilling) <br /> Allowable Initial internal Diameter minus 1 <br /> Deflection 112 314 11-114 1.112 1.314 Final Inter. met =D 8C Mark the loczton where interna'tiiarreter <br /> (I") Verified Uy. measurements were taken. <br /> 27 <br />