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UNDERGROUND TANK. INSPECTION RECORD Z-- sasses <br />N{V. TANK INSTALLATION <br />e ; (Ar <br />1TE NAME .. ! i FS e Or 0 5 � ' INSPE s NAME <br />ADDRESS^� W L f! ,'tea? ..., CITY J -- zip <br />CONTRACTOR t MANE A L5 (_0 w <"-T ®� TELEPHONE <br />OWNERt NAME TELEPHONE <br />Dig- I Illsrccma° <br />110 OR MI?HrXT INSPECTED <br />rvi <br />ah <br />,:_Aft A� <br />- <br />a <br />rini. IGSPF.CTION <br />Precision test succ°• mull �.�w.l.rtcd •I.,J hatd <br />A°t <br />rf/� y f- 7VtIPIMC STAGE INSPECTION1. P <br />u'testo r <br />NEPA DAc <br />✓� <br />7 <br />\sill prolecticill st till .s .• <br />2, <br />pfill flgf vjjXgs Installed. <br />1. <br />Pur(orwancc tu%l 0.1 nv.•rrllt u..sr.slsos r.vttcw. <br />t® <br />D. <br />Uverffll pcote�ttan tnafalted. describe: <br />Pa•rl„t..aut� trot ..f o..dm• Isar Ir,.4 dusectot. <br />Iflard wlted) <br />J. <br />Unused tank o ntn t sealed and cathodical) rotected. <br />A. <br />S. <br />Visual instwetton of secondary cuntatnwcnt on ptninf. <br />�~ <br />1Atergable <br />k fu tem. <br />(tocaebje watMf Ptoo <br />Cove/a <br />). <br />Fill and vent u(ninit hrou ht to gradr. <br />8. <br />Product line leak detector in place. Hard wired) <br />lU <br />Approved tank leak monitoring device installed. <br />All S&lvaniced Ptptns and fitttu s property wrapped. <br />Il. <br />Pressure decay test on cow tate tank and product <br />delivery r stew.(H`P l <br />ah <br />,:_Aft A� <br />- <br />1. <br />rini. IGSPF.CTION <br />Precision test succ°• mull �.�w.l.rtcd •I.,J hatd <br />:...te. re:a•Ived.g�t <br />7 <br />\sill prolecticill st till .s .• <br />1. <br />Pur(orwancc tu%l 0.1 nv.•rrllt u..sr.slsos r.vttcw. <br />A-Wr <br />4. <br />Pa•rl„t..aut� trot ..f o..dm• Isar Ir,.4 dusectot. <br />Iflard wlted) <br />'1 <br />P orwan e t e:11 of a -tilt I nu..u•: s.,nu t ..s t ur %7-stem(n) on tank(n) is <br />A. <br />Prswll to Ulm -rate a s Iscal f.as s..w,lrte. <br />1Atergable <br />k fu tem. <br />ah <br />,:_Aft A� <br />- <br />