Laserfiche WebLink
NEW US's STALLATIQN INSPECTION RE D <br />FACILITY NAME:ADDRESS: /® <br />SWEEPS;d ® TANKA :Jp �/ UL# 3 q- TNN: MODEL/MATERIAL: <br />CAPACITY: , ppp PRODUCT: / � R.E.H.S: <br />A I <br />P N ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE .. <br />P I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />R T <br />0 I <br />V A <br />E L <br />D S <br />ITEM OR EQUIPMENT INSPECTED <br />DATE <br />1. UST PLANS SMUTTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (B) <br />2. UST INSTALLATION PLANS APPROM (CCR 2635 CE) C5)) <br />INITIAL INSPECTIONS <br />�8 INSPECTION AND TEST OF SECONDARY CONTAINMENT: <br />VACUUM: SOAP: PSI: HRS/NIN: <br />HOLIDAY: <br />INEC QUID ANNULAR):h OTHER: <br />PRIMARY PIPING ST (MINIMUM 40 PSI/30 MIN) <br />(CCR 2635 (B) (4)) <br />4. PRIMARY TANK 'TEST: PSI: <br />HR !3C7 <br />SECONDARY i, 1 E , OTHER: <br />r/ <br />®r 5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL <br />(CCR 2635 (A) (3) (4) 06)/ API/PEI) <br />PIPING INSPECTIONS <br />FINAL INSPECTION <br />12. <br />6. <br />PRIMARY PIPING ST (MINIMUM 40 PSI/30 MIN) <br />(CCR 2635 (B) (4)) <br />moj <br />(CCR 2632 (A) (2)) <br />SECONDARY i, 1 E , OTHER: <br />Mi' i <br />1v, <br />Ii <br />a <br />LAKE TESTONSUMPS HR. MINIMUM)Hits:. <br />Mi" 2635 <br />I. <br />Ir... � ��� <br />+ <br />�-. ♦V �1 •` a::. h, " �i "1 it. .. i.� , .. ,. ��. <br />ii' :G it <br />OVERFILL PROTECTION INSTALLED/ <br />(CCR 2135 (E) (2)) <br />18. <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />(CCR 2631 (D) (5)) <br />1. <br />ALL PIPING +1 FITTINGS CORROSION PROTECTED <br />ii' 2635 <br />FINAL INSPECTION <br />12. <br />PERFORMANCE TEST FOR "ALL• MONITORING PROBES <br />(CCR 2632 (C) (2)) <br />13. <br />PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) <br />(CCR 2632 (A) (2)) <br />14. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR 2632 (D) 2.635 (B) (5)) <br />e'IA15. <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT—OFF <br />(CCR 2635 (B) CS)) <br />6. <br />BALL FLOAT VALVES INSTALLED <br />(CCR 2635 (B) (6)) <br />17. <br />OVERFILL PROTECTION INSTALLED/ <br />(CCR 2135 (E) (2)) <br />18. <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />(CCR 2631 (D) (5)) <br />19. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR 2635 (A) (5)) <br />20. <br />MONITORING PLAN, RESPONSE PLN! AND LOG BOOK ON SITE <br />(CCR 2632 (E) Cl) (2)) <br />21. <br />'C' FORM COMPLETED AND SUBMITTED <br />(CCR 2635 (E)) <br />22. <br />s <br />MONITORING METHOD FOR ALL TANKS NID PIPING APPROVED <br />(CCR 2641-2644) <br />23. <br />ALL CONDITIONS MET; FACILITY PERMIT ISSUED <br />(N+S CODE 25284 (E) CF)) <br />COMMENTS: <br />EH23-006 3/92 (REVISED 11\92) <br />8 <br />