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ITEM OR EQUIPMENT INSPECTED <br />t <br />� IFo� <br />INITIAL INSPECTION / J` ! 12 <br />Tank tested u n deliver Hnilda lasteel or air Gat SPS1 F PD1 <br />Ea <br />l ). <br />UNDERGROUND TANK.INSPECTION <br />RECORD <br />®all float valvel Installed. <br />3. Tank appropriately placed with approved backfill. <br />NEW,TANK INSTALLATION <br />S. <br />SITE NAME _ <br />/� <br />Petah to u carate opp I tcat Ion t om .lets. <br />INSPECTON'S NAME <br />ADDRESS_ 1700�t <br />( <br />CiTY® ZIP <br />CONTRACTOR: <br />NAME <br />L /F <br />TELEPHONE <br />?ockable <br />OWNERt <br />NAME <br />TELEPHONE <br />7. Fill and vent piping hrou ht to grade. <br />I <br />8. Product line leak detector in place. (Hard wired) <br />DATE APPROVEDI <br />APPROVEDI INITIALS <br />ITEM OR EQUIPMENT INSPECTED <br />sp <br />l <br />t <br />� IFo� <br />INITIAL INSPECTION / J` ! 12 <br />Tank tested u n deliver Hnilda lasteel or air Gat SPS1 F PD1 <br />Ea <br />l ). <br />2. visual inspection of secondary containment. <br />J. <br />®all float valvel Installed. <br />3. Tank appropriately placed with approved backfill. <br />Per(;.tma/tce te:il a.f ,ludo., Ittic Ivak dclectot. (Itard wired) <br />S. <br />4. UL numbers and tank ca acities recorded. <br />sp <br />l <br />t <br />� IFo� <br />1. <br />PIPING STAGE INSPECTION <br />1. Pressure test of piping. (Primaryand Secondary (NFPA 30)) <br />l ). <br />5,111 protectiott at. fill •t .r. <br />J. <br />®all float valvel Installed. <br />4. <br />Per(;.tma/tce te:il a.f ,ludo., Ittic Ivak dclectot. (Itard wired) <br />S. <br />3. Uverfill protection installed, descrOtb: <br />6. <br />Petah to u carate opp I tcat Ion t om .lets. <br />C <br />Ace e table r cordkee i eig s stem. <br />4. Unused tank oESnings scaled and cathadically Erotected. <br />S. Visual ins ection of secondary containment on piWnIE. <br />L.� <br />?ockable <br />uaather prop <br />an bre u ht to rade. (lovers <br />7. Fill and vent piping hrou ht to grade. <br />8. Product line leak detector in place. (Hard wired) <br />9. Approved tank leak monktorkng device installed. <br />10. All alvanized piping and fittings properly wra ed. <br />C`-- <br />t N!•p <br />It. Pressure deco teat on complete tank and product deliver s stem. ) <br />sp <br />l <br />t <br />� IFo� <br />1. <br />FINAL INSPECTION <br />Precision test successtuil ...m letcd and hard cooter. recelved1W <br />l ). <br />5,111 protectiott at. fill •t .r. <br />J. <br />Performance tCRI Qt nc4ff 111 .1 .•l e.'t Itat ::VRI Cm. <br />4. <br />Per(;.tma/tce te:il a.f ,ludo., Ittic Ivak dclectot. (Itard wired) <br />S. <br />Mrd <br />Performance te:ct of contlnuuu: m..nitrnenr system(s) nn lank(.• -to <br />6. <br />Petah to u carate opp I tcat Ion t om .lets. <br />7. <br />Ace e table r cordkee i eig s stem. <br />sp <br />l <br />