Laserfiche WebLink
iNEW UST fNSTALLATION RECORD 6 <br />FACILITY NAME <br />FACILITY ADDRESS _ L 5F- V (C IZ�IZ �t �� • r`7� ► <br />SWEEPS # _���� TANK # —oz U.L. #.,-3/0,a /( ,} q PRODUCT <br />11 DATE ( APPROVED I DISAPPROVED I RENS I ITEM OR EQUIPMENT INSPECTED 11 <br />1. UST INSTALLATION PLANS SUBMITTED & FEES PAID <br />2. UST INSTALLATION PLANS APPROVED <br />INTI7AL INSPECTION <br />"- 1. HOLIDAY TEST (PLASTEEL) <br />2. AIR TESTED @ S PSI (FRP) <br />[� <br />3 ✓ 3. VISUAL INSPECTION OF 2' CONTAINMENT <br />4131ql 4. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL <br />PIPING STAGE INSPECTION <br />3 <br />1. PRESSURE TEST (10 AND 20 PSI (FRP)] <br />�6 <br />V/ <br />r::�; f <br />2. BALL FLOAT VALVES INSTALLED <br />l <br />✓ <br />�P <br />3. OVERFILL PROTECTION INSTALLED, DESCRIBE: GT'it�l/�1,4 <br />` <br />�i!/fllA-TL�Iid7LL�l� <br />y�! q <br />` <br />V/ <br />priov <br />4. UNUSED TANK OPENING SEALED & CATHODICALLY PROTECTED <br />c% <br />P <br />S. VISUAL INSPECTION OF 20 CONTAINMENT ON PIPING <br />Nl <br />6. MONITORING PORTS IN PLACE & BROUGHT TO GRADE (LOCKABLE <br />wH 23 006 (REV 4-1-91) <br />WEATHER PROOF COVERS) <br />�j <br />T <br />7. FILL & VENT PIPING BROUGHT TO GRADE <br />8. PRODUCT LINE LEAK DETECTOR INPLACE (HARD WIRED) <br />7%(b� <br />✓ <br />C c <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 />�l <br />I. PRECISION TEST SUCCESSFULLY COMPLETED AND HARD COPIES <br />RECEIVED (NFPA 329) <br />�6 <br />V/ <br />r::�; f <br />2. SPILL PROTECTION AT FILL PIPE <br />3. PERFORMANCE TEST OF OVERFILL PROTECTION SYSTEM <br />4. PERFORMANCE TEST OF PRODUCT LINE LEAK DETECTOR (HARD <br />WIRED) <br />7061 �6 <br />` <br />V/ <br />r� <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 />wH 23 006 (REV 4-1-91) <br />w <br />