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XERXES F T,*C INSTALLATION CHECK*T <br /> CORPORATION Fiberg'ass Underground Storage Tanks <br /> Single-Wall (SWT), Double-Wall (DINT), Multicompartment(MCT) and OiUWater Separators (OWS) <br /> Complete this checklist,and keep it with copies of any written authorizations for variations and/or deviations received from Xerxes, <br /> - Date of installation ' 2-3 – Tank Size and Capacity—I UDd <br /> - Tank Type SWT DWT MONITORING-FLUID DRY MCT OWS (Circle those that apply.) UL Number Z(2 F/S� <br /> - Site Owner19 CiI(y��,_ <br /> - Site Address 1399 A)Q(LL MA 0) ler <br /> - installing Contractor Liv, <br /> On-Site Supervisor ��l�f�l�� d�l�lo l�vb�cll l�l�. Mu ke 1�ry��424 �P <br /> 1. <br /> •• e Verified by: <br /> A. Visual Inspection:No evidence of damage(holes,cracks,gouges)in tank.(Document any damage found.)..................................... <br /> S. Mortftoring•Fluid Tanks: 1.Check and record monitoring-fluid level in reservoir. .............................................................................. <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 crushed stone as specifieed 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 intemai Aameter of the tank is messrW and d=meried(Initial i tmal Diarr>o er in Section 4 below).... <br /> G. Geotextile Utilized: (indicate one.) 1.Yes 2,No.......................................................................................................................... <br /> H. Hole Condition: (indicate one,) uryho (Water Is not anticipated to reach tank-area is not subject to flooding.)................ <br /> 2.Wet hole(Excavation may trap water-area is subject to flooding.)...................................... <br /> I. Traffic Loads: (Indicate one.) 1.Traffic loads anticipated.......................................................................................................... _ <br /> 2.No traffic loads anticipated. ....................................................................... <br /> J. Anchoring: Performed in accordance with installation instructions. t_Deadmen 2.Full slab............................. <br /> 10 K. Fittings and Otter Metal Components: Coated to protect against corm on...................................................................................... <br /> 2.. DURING e mull Verified by: <br /> B. Tank Spacing: Tanks are spaced correctly from each other and from excavation according to instructions......®.............................. _ <br /> A- Backffil-material bed is level and Is a minimum of 12 Inches deep,over native soil or slab,before setting tank..................... <br /> C. Visual Inspection: No evidence of damage Is found after setting in hole................................................................................. ........... -- Z— <br /> D. HoltWown Straps: Positioned and seared according to Installation instructions.(See SECTION 6.4.of lnsWation Manual.)......... <br /> E. Backfill Compacted: Material has been tamped and/or compacted to fill all voids around tank.......................................................... <br /> F. Tank is property ballasted during backfilling: (wet-tiole lnstaliation only)......................................................................................... <br /> G. Tank(s)are buried at proper depth to conform to appropriate conditions: (wet,dry,traffic or no traffic)....................................... <br /> POSTINSTALLATION Verified by: <br /> A. Physical Test: Airlsoap test is completed according to installation Instrvctions.................................................................................... <br /> E litternal Diameter Measurement The irtemal cfrarreler of the tank's m>easired and docxrnarkId(Final Diarneier in Section 4 below)............. <br /> C. Monitoring•Fiuld Tanks: 1.Check and record monitoring-fluid level In the reservoir-Z�Cnchse)......................................... — -- <br /> 2.Check for monitoring fluid inside tank............................ ................... ....... —D. Installation Manual: Deliver Installation Manual and 0*erating Guidelines to owner. ..................................................................4. DEFLECTION ....... _MEASUREMENT �--- <br /> All tanks must be measured to determine vertical deflection. Foli�v deflection-measurement instructions(Section 14)in the Installation Manual. An <br /> initial intemaAiameter measurement is taken and recorded as a point of reference, Subsequent internal-diameter measurements show tank deflection and <br /> can be compared to the table below. Take each measurement from tine same fitting using the same procedure. <br /> J14 CENTER rEND <br /> External Tank INTERNAL-DIAMETER MEASUREMENTS <br /> Diameter 4 6 8 10 12 Initial Internal Diameter(before backfilling) 1/ /7- <br /> Final <br /> 7_(Ft) Final intcamal Diameter(after backfi€ling)Allowable I !nidal Internal Diameter minus <br /> Deflection 1112 314 11-1/4 1.112 1.314 Final Internia��e+ r= P. Mark cha location where internal-diameter <br /> (l") Verified by: measurements were taken. <br /> 27 <br />