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NEW UST INSTALLATION INSPECTION RECORD <br />FACILITY 'P*Jw: ANASTASIO' S AM MINI MARS: 3425 -TracvqTvd., Trac <br />mss % TANK# ULS DDI ZK HODEL/NATERIAL: x <br />es <br />CAPACITY: 1 0, GuJ Gal PRODUCT: Reg Unlcade3 Gas # R.E.H.s: <br />INITIAL INSPECTIONS <br />21.97' <br />A <br />P <br />I <br />N <br />ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE ' <br />VACUUM: 1,o SOAP: PSI: "/NIX: <br />P <br />I <br />WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />6 <br />R <br />T <br />_ ✓ <br />0 <br />O <br />I <br />(CCR 2635) <br />-/J <br />V <br />A <br />CCCR 205 CA) CO) <br />./3-4j3 <br />E <br />L <br />(CCR 2635 (B)) <br />D <br />S <br />(CCR 2631 CO) C5)) �. <br />;� 9. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />ITEM OR EQUIPMENT INSPECTED <br />DATE <br />20. <br />MONITORING PLAN; RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCR 2632 CE) C1) C2))� <br />mtfl <br />21. <br />'C" FORM COMPLETED AND SUBMITTED <br />1. LUST PLANS SUBMITTED/ FEES PAID (NIS CODE 25287, CCR 2635 CO) C8) <br />22. <br />MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED <br />2. UST INSTALLATION PLANS APPROVED (CCR 2635 CE) C5)) <br />INITIAL INSPECTIONS <br />21.97' <br />3. INSPECTION IUD TEST OF SECONDARY CONTAINMENT: <br />HOLIDAY: <br />(CCR 2635 (B) (h) <br />VACUUM: 1,o SOAP: PSI: "/NIX: <br />BRINE(LIQUID ANNULAR): , .``.. OTHER: <br />� <br />CCCR 2635 (A) (4)) <br />6 <br />4. PRIMARY TAMC TEST: PSI: <br />NRS/NIN: <br />_ ✓ <br />0 <br />5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL <br />(CCR 2635 CA) C3) (4) (6)/ API/PEI) <br />PIPING INSPECTIONS <br />.. FINAL INSPECTION <br />6. <br />PRIMARY PIPING TEST (MINIMUM 40 Pam NIX) %^0 S <br />(CCR 2635 (B) (h) <br />V 7. <br />SECONDARY PIPING CONTAINMENT TEST PSI: I{� /MIN: 0 OTHER: <br />CCCR 2635 (A) (4)) <br />6 <br />,i 8. <br />LAKE TEST ON ALL SiMPS C24 HR. MINIMUM) NRS: <br />CCCR 2635 CA)) <br />0 <br />9. <br />UNUSED TANK OPENINGS SEALED AID CORROSION PROTECTED <br />(CCR 2635) <br />-/J <br />10. <br />OVERSPILL PERFORMANCE TEST <br />CCCR 205 CA) CO) <br />./3-4j3 <br />t/ I/]"- <br />ALL PIPING AM FITTINGS CORROSION PROTECTED <br />(CCR 2635 (B)) <br />.. FINAL INSPECTION <br />COMMENTS: <br />EH23--006 3/92 (REVISED 11\92) <br />8 <br />12. <br />PERFORMANCE TEST FOR •ALL' MONITORING PROBES <br />(CCR 2632 CC) C2)) <br />13. <br />PERFORMANCE TEST OF CONTINUOUS MONITORING Sn7m (PANEL) <br />(CCR 2632 CA) C2)) <br />6 <br />14. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR 2632 CD) 2635 CB) C5)) <br />M <br />5. <br />PERFORMANCE TEST OF MMHIATIC PIMP SYSTEM SHUT-OFF <br />(CCR 205 CB) C5)) <br />-/J <br />16. <br />BALL FLOAT VALVES INSTALLED <br />CCCR 2635 CB) CO) <br />�I <br />7. <br />OVERFILL PROTECTION INSTALLED/APPROVED <br />CCCR 2635 (E) CM <br />18. <br />TANK ACCESS PORTS BROUGHT TO GRADE CLOCKED AID WATERTIGHT) <br />(CCR 2631 CO) C5)) �. <br />;� 9. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />CCCR 2635 CA) CS)) <br />20. <br />MONITORING PLAN; RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCR 2632 CE) C1) C2))� <br />21. <br />'C" FORM COMPLETED AND SUBMITTED <br />CCCR 2635 CE)) <br />22. <br />MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED <br />(CCR 2641-2614) <br />23. <br />ALL CONDITIONS NET; FACILITY PERMIT ISSUED <br />(N+S CODE 25284 CE) CF)) <br />COMMENTS: <br />EH23--006 3/92 (REVISED 11\92) <br />8 <br />