COMPLIANCE INFO_1986-1996 - Laserfiche WebLink

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A 11*4-�IALLAIIUNiNbP�--(.;I"'IONRECOME 4CILITY NAME: ADDRESS: ;2 36 Z-A/Ve, �dD/' 0,4L NEE?,Sg TANKS ULS TANK TERIAL: 1PACITY: PRODUCT: R.E_N.S: INITIAL. INSPEMom A I 3. INSPECTION AID TEST OF SECONDARY CONTAINMENT: HOLIDAY: VACUUM: SOAP: PSI: HRS/MTN: BRINECLIQITD ): OTHER: P N ALL TANKS TO BE INSTALLED AND TESTED IN A=RDANCE 4. PRIMARY TANK TEST: PSI: HRS/MIN: P I WITH MANUFACTURER WRITTEN SPECIFICATIONS 5. TANK APPROPRIATELY PLACED WITH APPROVED BACXFILL CCCR 2635 (A) C3) C4) C6)/ API/PEI) R T 9. MISUSED TANK CPENINGS SEALED AND CCRROSION PROTECTED (CCR 2635) 0 I 10. OVERSPILL PERFORMANCE TEST (CCR 2635 (A) (4)) V A 11. ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2635 (B)) E L 18. TANK ACCESS PORTS BRMIGHT TO GRADE CLOCKED AND WRTEIMGHT) CCCR 2631 CD) (5)) D S 14. TANK INTEGRITY TEST (PASSING BARD COPY) CCCR 2635 CA) (5)) ITEM OR EQUIPMENT INSPECTED DATE 21. "C" FORM AND SUBMITTED (am 2635 CE)) 1. UST PIANS SUBMITTED/ FEES PAID CH+S CODE 25287, CCR 2135 (D) (8) 2. UST INSTAL.LATIaN Puxs APPROVED CCCR 26.15 CE) C5)) INITIAL. INSPEMom PIPING INSPECTIONS 3. INSPECTION AID TEST OF SECONDARY CONTAINMENT: HOLIDAY: VACUUM: SOAP: PSI: HRS/MTN: BRINECLIQITD ): OTHER: 7. SECONDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: OTHER: (CCR 2635 CA) (4)) 4. PRIMARY TANK TEST: PSI: HRS/MIN: 8. LAME TEST ON ALL SUMPS C24 HR. MINIMUM) MRS: CCCR 2635 CA)) 5. TANK APPROPRIATELY PLACED WITH APPROVED BACXFILL CCCR 2635 (A) C3) C4) C6)/ API/PEI) PIPING INSPECTIONS FINAL LNSPECTION 6. PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) (CCR 2635 (B) (4)) 7. SECONDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: OTHER: (CCR 2635 CA) (4)) 8. LAME TEST ON ALL SUMPS C24 HR. MINIMUM) MRS: CCCR 2635 CA)) 9. MISUSED TANK CPENINGS SEALED AND CCRROSION PROTECTED (CCR 2635) 10. OVERSPILL PERFORMANCE TEST (CCR 2635 (A) (4)) 11. ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2635 (B)) FINAL LNSPECTION COMlMEXTS: EH23-006 3/92 12. PERFCQMICE TEST FOR ®ALL® MONITOURING PROBES CCPR 2632 (C) CZ)) 13. PERFORMANCE TEST OF CONTIN000S,MONITORING SYSTEM (PANEL) CCPR 2632 CA) (2)) 14. PERFORMANCE TEST OF LINE LEAK DETECTION (CCR 2632 (D) 2635 (B) CS)) 15_ PERFORMANCE TEST OF AUTOMATIC PCIP SYSTEM SNIT -OFF CCCR 2635 CB) CS)) 16. BALL FLOAT VALVES INSTALLED Cc= 2635 CB) (6)) 17. OVERFILL. PROTECTION I=ALLED/APPRMIED CCCR 2635 CE) C2)) 18. TANK ACCESS PORTS BRMIGHT TO GRADE CLOCKED AND WRTEIMGHT) CCCR 2631 CD) (5)) 14. TANK INTEGRITY TEST (PASSING BARD COPY) CCCR 2635 CA) (5)) 2. MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE CCCR 2632 CE) Cl) CZ)) 21. "C" FORM AND SUBMITTED (am 2635 CE)) 22. MONITORING METHOD FOR ALL TAXI= AND PIPIT APPROVED CCCR 2641-26") 23. ALL CONDITIONS NET; FACILITY PERMIT ISSUED C*ws CODE 25284 CE) CM COMlMEXTS: EH23-006 3/92