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UNDERGROUND TANK.INSPECTION Rf4VjtD <br />VNV. TANK INSTALLATION <br />_,TZ NAMERA)K p�S IOGCTa 412P02T NANEaZLNSPECTUIt'S NAMfi <br />ADDRESS UCO o5C- A 12Po2 j 111 X14`( CITY S OoGc OLA ZIP T5ZOSo <br />CONTRACTOR$ K"s JL Ias Cog(J. TELI;PNONE ((4 <br />OWNER, NAME TELEPHONE <br />r <br />OLt- INitLCT'OR' <br />PROVRO A! ROVLO LN1 IALS <br />121f1 -Olt _EQU1rN[NT INS"MD <br />FINAL, IGSPECTION <br />pp <br />Precision test auccesaiYll ..maltted alai hard io.tes received. mt <br />INITIAL 1NSrwT10t1 <br />n a a aal or air at !S rR! <br />rot ect loo it <br />i l 1 <br />r <br />1.' <br />FINAL, IGSPECTION <br />pp <br />Precision test auccesaiYll ..maltted alai hard io.tes received. mt <br />INITIAL 1NSrwT10t1 <br />n a a aal or air at !S rR! <br />rot ect loo it <br />i l 1 <br />aspectloft 2f #qC*f_4sfy containment, <br />Tank oppr9pristyly pl*Cq4w h o roved batkftll. <br />(19ft-volvel loptallvd, <br />overfill efIlun rvstcw. <br />4 <br />14.__UL pumborg ondtank ckpacitlay recorded. <br />1111.d41rl lour leak delecto . (Hard vlred) <br />r <br />1.' <br />FINAL, IGSPECTION <br />pp <br />Precision test auccesaiYll ..maltted alai hard io.tes received. mt <br />PIPINC STACE INSeECTt(M <br />1. su e piping. Primar and Seconda[ NrPA 10ii <br />rot ect loo it <br />i l 1 <br />). <br />(19ft-volvel loptallvd, <br />overfill efIlun rvstcw. <br />4 <br />Perfuems"Cu tout •.f <br />1111.d41rl lour leak delecto . (Hard vlred) <br />S. Overfill protection tnatalled. descrlhd: <br />■an est f <br />•11411 1 nuua t .Mf I 1 11.11 110 • '41s1 rm n an tank( a )tiriJ.11 <br />L. <br />Pelmlt to owrate applicatiflo <br />Complete. <br />4. Unu ed tank openings scaled and cathodicall rotected. <br />ACA:rptobll reCordketp1mK_yybtwm, <br />S. Visual lns ctlon of secondary containment on pipiniL. <br />(lockobl0 „etkW $ woo <br />P"fa <br />7 ► ll and v*nk Dtpinxbrought to jLrade. ' <br />a. Product line leak detector to lace. Wird v1Ced <br />9. Approved tank leak moattorinr device tnatalled. <br />lt�A alvaniced piping and (ittln • prop -arty prop-artywrapped. <br />M�!p <br />1. Pressure deco a st on complete _tank and product delivery myatem1301 <br />1 <br />1 !!!��rr <br />1.' <br />FINAL, IGSPECTION <br />pp <br />Precision test auccesaiYll ..maltted alai hard io.tes received. mt <br />--?—Spill <br />rot ect loo it <br />i l 1 <br />). <br />tor(ormanct lem—of <br />overfill efIlun rvstcw. <br />4 <br />Perfuems"Cu tout •.f <br />1111.d41rl lour leak delecto . (Hard vlred) <br />•o <br />■an est f <br />•11411 1 nuua t .Mf I 1 11.11 110 • '41s1 rm n an tank( a )tiriJ.11 <br />L. <br />Pelmlt to owrate applicatiflo <br />Complete. <br />ACA:rptobll reCordketp1mK_yybtwm, <br />