Laserfiche WebLink
t t <br />0 NEW UST INSTALLATION RECORD 46 <br />FACILITY NAME <mr1 ghcL <br />FACILITY ADDRESS -//)3:3 'QDebLo - 1 <br />SWEEPS # oi� TANK # i U.L. # I PRODUCTy/G <br />DATE APPROVED DISAPPROVED REHS ITEM OR EQUIPMENT INSPECTED <br />1. UST INSTALLATION PLANS SUBMITTED & FEES PAID <br />V 2. UST INSTALLATION PLANS APPROVED <br />INITIAL INSPECTION <br />PIPING STAGE INSPECTION <br />1. HOLIDAY TEST (PLASTEEL) <br />1. PRESSURE TEST (10 AND 20 PSI (FRP) l I ®= (moi. `� = S c <br />✓ <br />"� <br />2. AIR TESTED @ S PSI (FRP) <br />C�( <br />2. BALL FLOAT VALVES INSTALLED <br />3. VISUAL INSPECTION OF 20 CONTAINMENT <br />x4'L31ql4. <br />3. OVERFILL PROTECTION INSTALLED, DESCRIBE: GO l'r !N <br />TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL <br />PIPING STAGE INSPECTION <br />FINAL INSPECTION <br />1. PRECISION TEST SUCCESSFULLY COMPLETED AND HARD COPIES <br />RECEIVED (NFPA 329) <br />1. PRESSURE TEST (10 AND 20 PSI (FRP) l I ®= (moi. `� = S c <br />✓ <br />"� <br />2. SPILL PROTECTION AT FILL PIPE <br />?' <br />2. BALL FLOAT VALVES INSTALLED <br />3. PERFORMANCE TEST OF OVERFILL PROTECTION SYSTEM <br />3. OVERFILL PROTECTION INSTALLED, DESCRIBE: GO l'r !N <br />4. PERFORMANCE TEST OF PRODUCT LINE LEAK DETECTOR (HARD <br />WIRED) <br />✓ <br />4. UNUSED TANK OPENING SEALED & CATHODICALLY PROTECTED <br />Z <br />pv <br />S. VISUAL INSPECTION OF 20 CONTAINMENT ON PIPING <br />7. ACCEPTABLE RECORD KEEPING SYSTEM <br />6. MONITORING PORTS IN PLACE & BROUGHT TO GRADE (LOCKABLE <br />WEATHER PROOF COVERS) <br />PV <br />7. FILL & VENT PIPING BROUGHT TO GRADE <br />7 /�j <br />✓� <br />8. PRODUCT LINE LEAK DETECTOR INPLACE (HARD WIRED) <br />�/fb/g <br />✓ <br />�� <br />9. APPROVED UST LEAK MONITORING DEVICE INSTALLED <br />10. ALL GALVANIZED PIPING & FITTINGS PROPERLY WRAPPED <br />11. PRESSURE DECAY TEST ON COMPLETE UST & PRODUCT DELIVERY <br />SYSTEM <br />FINAL INSPECTION <br />hH L3 VVb (KCV 4 1 ylJ <br />F <br />Q <br />1. PRECISION TEST SUCCESSFULLY COMPLETED AND HARD COPIES <br />RECEIVED (NFPA 329) <br />�� �' <br />✓ <br />"� <br />2. SPILL PROTECTION AT FILL PIPE <br />?' <br />3. PERFORMANCE TEST OF OVERFILL PROTECTION SYSTEM <br />4. PERFORMANCE TEST OF PRODUCT LINE LEAK DETECTOR (HARD <br />WIRED) <br />✓ <br />S. PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM(S) ON <br />TANK(S) <br />6. PERMIT TO OPERATE APPLICATION COMPLETE <br />7. ACCEPTABLE RECORD KEEPING SYSTEM <br />hH L3 VVb (KCV 4 1 ylJ <br />F <br />Q <br />