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�-/000 <br /> UNDERGROUND TANK. TNSPECTION RECORD Xxg Xe5 <br /> NEN.TANK INSTALLATION <br /> SITE NAME r' -� �� ECT H S NAME <br /> ADDRESS �L% ��% .L �/l�� CITY ZIP <br /> CONTRACTORt NAME TELEPHONE <br /> OWNERr NAME TELEPHONE <br /> DIS- INSPECTOR' <br /> DATE APPROVED APPROVED INITIALS <br /> (SEM OR EQUIPMENT INSPECTED <br /> 7- FlAnq An <br /> G' <br /> �We INITIAL. INSPECTION <br /> 1, Tank tested upon delivery Iffolidaylasteel) ur air t SPSI (FRPLW <br /> Z 2. Visual inspection of secondary containment. <br /> �d <br /> 7. Tank appropriately placed with apprnved backfill. <br /> e/ 6. UL numbers and tank ca acitles recorded. <br /> PIPING STAGE INSPECTION <br /> r <br /> 1. Pressure test of piping. lPrimaryand Secondary (NFP A 3(1)] <br /> 2. Ball float valves Installed. <br /> 3. Vverfill protection inxtalled. descrlltd: <br /> L�/ t✓ <br /> A. Unused tank openings sealed and cathodically protected. <br /> / S. Visual inspection of secondary cuntainecnt on pipinjr. <br /> Monlrorinst PQrts In place andbt uu hl to grade. lc=ril1t <br /> e .real Mr prop <br /> 7. Pill and vent piping hrou ht to Arade. <br /> 8. Product line leak detector in place. Hard wired) <br /> 9. Approved tank leak monitoring device installed. <br /> 10. All galvanixed piping and fltllu s property wrapped. <br /> 11. Pressure decay test on cam lett tank and product deliver s etemIbp, <br /> FINAL II:SPECTION <br /> 1 / I t <br /> � I. Precision test sui<csxlull .•.roleted .11.41 hard i.•.les reietved.ls;s <br /> 7. Spill rot ect too at fill .� . <br /> J. Performance text of nverflll u..tortiou :•vston. <br /> ♦. Perfotmaocc to.t ..f H odes . Itae leak dcteitol. (Hard wired) <br /> S. Performance tett ,.itr. ttacdtt <br /> . f tnntlnuuur: r«.. tint v• steAfs) nn tank(-.)� •• <br /> 6. Petmlt to u wrale a t 1 tc..tI..r. .— .lute. <br /> 7. Acceptable recordkee !n s btu.,. <br /> f 0"Wr3: <br /> I - <br />