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AN -NEW UST INSTALLATION INSPECTION RECORD <br />FACILITY NAME:t ,, -^� C ADDRESS: r� � E . <br />FACILITY ID# TANK# UL# 0 TANK MODEL/MATERIAL: <br />CAPACITY: 102 0 © G PRODUCT: R.E.H.S: ' <br />INITIAL INSPECTIONS <br />!� <br />` <br />A <br />I <br />VACUUM: SOAP: PSI: HRS/MIN: BRINE(LIQUID ANNULAR): � OTHER: <br />'�- <br />P <br />P <br />N <br />I <br />ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br />SECONDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: OTHER: <br />(CCR <br />2636 <br />WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />2632 <br />O <br />A <br />J <br />l �✓'(l �f l /,%L1 [ L C/IM CIG <br />2635 <br />E <br />L <br />2632 <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />PEI <br />15. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />D <br />S <br />{� <br />ITEM OR EQUIPMENT I UPN ECTED� <br />DATE <br />(b) (1) (C)) <br />PERFORMANCE TEST OF AUTOMATIC PUMP SjgE NUT- F <br />11. ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCR <br />2636 <br />1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287) <br />17. <br />12. PIPING SLOPES TO COLLECTION SUMP <br />2. UST INSTALLATION PLANS APPROVED <br />INITIAL INSPECTIONS <br />!� <br />` <br />INSPECTION AND TEST OF SECONDARY CONTAINMENT:I HOIAY: fj <br />c IL cd <br />PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) <br />VACUUM: SOAP: PSI: HRS/MIN: BRINE(LIQUID ANNULAR): � OTHER: <br />'�- <br />PRIMARY TANK TEST: P re S ,sa t,,c- PSI: -9 HRS/MIN: I" <br />1, <br />TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (API/PEI) <br />PIPING INSPECTIONS <br />COMMENTS:— <br />EH23-006 9/95 <br />IM <br />m <br />PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) <br />(CCR <br />2636 <br />(e)) <br />a• i�i <br />•'�. <br />SECONDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: OTHER: <br />(CCR <br />2636 <br />(e)) <br />2632 <br />(c) (2)) <br />LAKE TEST ON ALL SUMPS (24 HR. MINIMUM)- HRS: <br />(CCR <br />2635 <br />(a) (4)) <br />(CCR <br />2632 <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />PEI <br />15. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR <br />0. OVERSPILL PERFORMANCE TEST <br />(CCR <br />2635 <br />(b) (1) (C)) <br />PERFORMANCE TEST OF AUTOMATIC PUMP SjgE NUT- F <br />11. ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCR <br />2636 <br />(b)) <br />17. <br />12. PIPING SLOPES TO COLLECTION SUMP <br />(CCR <br />2636 <br />(c)(1)) <br />COMMENTS:— <br />EH23-006 9/95 <br />IM <br />m <br />FINAL INSPECTION <br />•'�. <br />PERFORMANCE TEST FOR "ALL" MONITORING PROBES <br />(CCR <br />2632 <br />(c) (2)) <br />l 1 <br />1 <br />PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) <br />(CCR <br />2632 <br />(c) (2)) <br />15. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR <br />2643 <br />(c) (1)) <br />' <br />PERFORMANCE TEST OF AUTOMATIC PUMP SjgE NUT- F <br />(CCR <br />2636 <br />(g)) <br />17. <br />BALL FLOAT VALVES INSTALLED <br />OVERFILL PROTECTION INSTALLED/APPROVED <br />(CCR <br />2635 <br />(b) (2)) <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />API <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR <br />2635 <br />(a) (5)) <br />21. <br />MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCR <br />2632 <br />(d)) <br />"C" FORM COMPLETED AND SUBMITTED <br />(CCR <br />2635 <br />(d)) <br />23. <br />MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED <br />(CCR <br />2630-2636) <br />24. <br />ALL CONDITIONS MET; FACILITY PERMIT ISSUED <br />(H+S <br />CODE <br />25284) <br />COMMENTS:— <br />EH23-006 9/95 <br />IM <br />m <br />