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• 1 <br /> ONIiERGROUND TANK ?NSPECTION RECORD <br /> NFm 'TANK INSTALLATION <br /> SITE NAME� ,Q INSPECTUR'S NAMADDRESS R g® W <br /> eeea CITY 2 I P <br /> CONTRACTOR: NAME <br /> EPNONE <br /> OWNERt NAME <br /> TELEPHONE <br /> DIS- INSPECTOR'S <br /> DATE. APPROVED APPROVED INITIALS <br /> I+ �---- <br /> [TEN OR EQUIPMENT INSPECTED <br /> h 8 <br /> IN l'f lAl. INSPECTION <br /> e-/fF <br /> Tank tested upon delivery Illolidaylasteel) or air at SPSI FRP <br /> 6 -a� 2. Visual inspection of secondary containment. <br /> 3. Yank appropriately placed with approved backfill. <br /> 4. UL numbers and tank ca actties recorded. <br /> 2 r �t PIPING ST eE [NSP I <br /> 1. Pressure test of pipiny. [Primaryand Sccondar NFPA 30)1 <br /> Ball float valves installed. <br /> 3. Uverfill protection installed, describe: <br /> W Unused tank o+eoin s scaled and catholitcally protected. <br /> Visual inspection of secondary containment on piping. <br /> 7 (lockable weather proo <br /> Planitarinit ports fit place and biourla to itrade. covers <br /> 7. Fill and vent ptPinit brought to xrade. <br /> Product line leak detector in place. Hard wired) <br /> 9. Aroved tank leak monitoring device installed. <br /> U. All xalvattized pipingand fittings property wrapped. <br /> 11. Pressure deca-y test on Complete tank and product delivery s SLemt701 <br /> 4C//Oncr �'F/1� �� FINAL INSPECTION <br /> q po 9 i <br /> (/ I. Precision Lest successtull um+leted aced hutd cu ies received. s <br /> O 7. ti+til pro,ecliot& at lilt Y . <br /> 7 <br /> 3. Performance t erct ea over i 11 a sa yr t iuu ::vst em. <br /> 7 4. Peri-it mance test of Illcedeeee Itne• Ivak deiectot. (Ila rd wired) <br /> t rJ <br /> S P rlorw��ppn a temof t:e+utiuuuu:: eweneitortn� �:yttem(::) on tank(�)�°,.ru <br /> kk <br /> 6. Peamit o carate a+ 1 ica t ion a om elete. <br /> 7Acceiptable ratcordkeepillm. svt6tem. <br /> ORliNf4: <br />