Laserfiche WebLink
WU UST INSTALLATION INSPECTION RECORD <br /> FACILITY AAME: ADDRESS: <br /> FACILITY (D# TANKS ®U � UR.* TANK MODEL/MATERIAL: <br /> CAPACITY: l/FRCI)UCT: Z.H.S: <br /> A I <br /> P )I ALL TANKS TO 3E INSTALLED AND i E�i E3 IN AC=RDANC <br /> F I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br /> R T <br /> 0 I <br /> V A ?L Lq.. <br /> E L <br /> 0 S <br /> (TEN OR EQUIPMENT INSPECTS) <br /> DATE <br /> i I I 1. UST PLANS SUBMITTED/ FES PAID (H+S CODE 5287) <br /> 12. UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> 13. INSPEC710H AND TEST OF SECONDARY CONTAINMENT: KLIDAY: <br /> VAC,A)M: SOAP: PSI: MRS/MIN: 3RINE(LICUID ANNULAR): OTHER: <br /> 14. PRIMARY TANK TEST: PSI: HRSMIN: <br /> 5. TANK APPROPRIATE.T PLACED WITH APPROVED 3ACXFiLl (API/PEI) <br /> PIPING INSPECTTONS <br /> GG I 6. PRIMARY PIPING 'EST (MINIMM 40 PSI/30 MIN) CCS2636 (e)) <br /> 7. SEMNDARY PIPING CONTAINMENT TEST FSI: 4RS/MIN: OTHER: (C=t 2636 (e)) <br /> I /I 8. LAKE TEST ON ALL S (24 NR. MINI ) MRS: (tom 2635 (a) (4)) <br /> V 9, UNUSEDTANK OPENINGS SEALED AND CORROSION PROTEC'ED FEI <br /> 10. OVERSPILL PER - TEST <CC2 2635 (b) (1) (Cl) <br /> 11. ALL PIPING AND FITTINGS CORROSION PROTECTS) CCS 2636 (b)) <br /> t q�11 12. PIPING SLOPES Ta C:)LLCTZON SUMP CCS 2636 (c)(13) <br /> FINAL iNSPECTION <br /> I I13. PERFORMANCE TEST Ftp "ALL" MONITORING PROSES CCI✓! 2632 tc) t2)) <br /> �✓ 1 4, PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) <CGR 2632 (c) (2)) <br /> t 1 Y I 15. PR CE TEST OF LINE LEAK OETECTICH (CCR 2643 (c) (1)) <br /> 1 16. PERFORMANCE TEST OF AUTOMATIC PW SYSTEM SHUT-OFF <CGt 2636 (J)) <br /> 117. 3ALL FLOAT VALVES INSTALLED <br /> 18. OVERFILL PROTEMICK INSTALLED APPROVED CC;.2 2635 (b) (2)) <br /> I ✓/ 119. TANK APORTS BRWGHT TO GRADE (LOCXEr) ANO ATER.TIGHT) API <br /> 1 I 1Z0. TANK INTEGRITY TEST (PASSING HARD COPY) CCCR 2635 (a) (5)) <br /> tq t Z MONITORING PUN, ISE PMN AND LOG 3OOK ON SITE (C�t 2632 (d)) <br /> t I-`jr I ✓I "C" FORM COMPLETED ANO SUBMITTED (CQ 26135 (d)) <br /> ILSI �23. MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED <CC2 WO-2636) <br /> ALL CONDITIONS MET; FACILITY REMIT ISSUED (N+S CODE ZSZ84) <br /> vLi <br /> C01IMENTS: <br /> =:$23-006 4/45 7 <br />