Laserfiche WebLink
NEW UST INSTALLATION INSPECTION RECORD <br />FACILITY NAME: m �S F-kX6 / v ADDRESS: �� / l)SA ,L <br />FACILITY ID# TANK# UL#TANK MOOEL/MATERIA <br />CAPACITY: / .:') ^A /-,1) PRODUCT: R.E.H.S: <br />INITIAL INSPECTIONS <br />! <br />A <br />I <br />VACUUM: SOAP: PSI: HRS/MIN: 8(tiNE{LIQUID ANNULAR): OTHER: <br />& _5/` , ;,nuv, <br />P <br />N <br />ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br />SECONDARY PIPING CONTAINMENT TEST PSI: Li <br />P <br />I <br />WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />15. <br />R <br />T <br />HRS: <br />(CCR 2635 (a) (4)) <br />0 <br />I <br />9. <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />V <br />A <br />� <br />0. <br />E <br />L <br />(CCR 2635 (b) (1) (C)) <br />I- <br />0 <br />S <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />19. <br />(CCR 2636 (b)) <br />/4lI <br />ITEM OR EQUIPMENT INSPECTED <br />DATE <br />PIPING SLOPES TO COLLECTION SUMP <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR 2636 (c)(1)) <br />I21. <br />1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287) <br />(CCR 2632 (d)) <br />V114) <br />2. UST INSTALLATION PLANS APPROVED <br />INITIAL INSPECTIONS <br />! <br />V1 <br />3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br />VACUUM: SOAP: PSI: HRS/MIN: 8(tiNE{LIQUID ANNULAR): OTHER: <br />& _5/` , ;,nuv, <br />CCR 2636 (e)) <br />4. PRIMARY TANK TEST: I PSI: 1�4 HRS/MIN: <br />7. <br />SECONDARY PIPING CONTAINMENT TEST PSI: Li <br />5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (APT/PEI) <br />PIPING INSPECTIONS <br />I <br />V1 <br />6. <br />PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) <br />& _5/` , ;,nuv, <br />CCR 2636 (e)) <br />3M �f <br />7. <br />SECONDARY PIPING CONTAINMENT TEST PSI: Li <br />HRS/ IN: OTHER: <br />(CCR 2636 (e)) <br />15. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />LAKE TEST ON ALL SUMPS (24 HR. MINIMUM) <br />HRS: <br />(CCR 2635 (a) (4)) <br />6. <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF <br />9. <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />PEI <br />f ®�IA_ <br />� <br />0. <br />OVERSPILL PERFORMANCE TEST <br />(CCR 2635 (b) (1) (C)) <br />I- <br />(CCR 2635 (b) (2)) <br />1. <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />19. <br />(CCR 2636 (b)) <br />/4lI <br />L�l <br />12. <br />PIPING SLOPES TO COLLECTION SUMP <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR 2636 (c)(1)) <br />FINAL INSPECTION <br />SH23-006 9/95 T <br />PERFORMANCE TEST FOR "ALL" MONITORING PROBES <br />(CCR 2632 (c) (2)) <br />�1 ai <br />J <br />4. <br />PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) <br />(CCR 2632 (c) (2)) <br />15. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR 2643 (c) (1)) <br />y <br />6. <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF <br />(CCR 2636 (9)) <br />b <br />7. <br />BALL FLOAT VALVES INSTALLED <br />8. <br />OVERFILL PROTECTION INSTALLED/APPROVED <br />(CCR 2635 (b) (2)) <br />19. <br />TANK ACCESS PMTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />API <br />20. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR 2635 (a) (5)) <br />I21. <br />MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCR 2632 (d)) <br />22. <br />"C° FORM COMPLETED AND SUBMITTED <br />(CCR 2635 (d)) <br />�23. <br />MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED <br />(CCR 2630-2636) <br />I24. <br />ALL CONDITIONS MET; FACILITY PERMIT ISSUED <br />(H+S CODE 25284) <br />SH23-006 9/95 T <br />