Laserfiche WebLink
NEW UST INSTALLATION INSPECTION RECRD ��^^ <br />FACILITY NAME: CJti ADDRESS: US ( J tS <br />SWEEPS# Zz3 `v 7 Z-- TANKS` S-S� c 6 "'A 25717 TANK <br />CAPACITY: �ro ®c PRODUCT: R.E.H.S: <br />INITIAL INSPECTIONS <br />3 �a <br />A <br />P <br />I <br />w <br />ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br />Begs4. <br />�� <br />P <br />I <br />WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (CCR 2635 (A) (3) (4) (6)/ API/PEI) <br />6 <br />R <br />T <br />LAKE TEST ON ALL SUMPS (24 HR. NININUM) HRS: <br />(CCR 2635 (A)) <br />% <br />0 <br />I <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />(CCR 2635) <br />]���� <br />V <br />A <br />OVERSPILL PERFORMANCE TEST <br />(CCR 2635 (A) (4)) <br />t4j.16. <br />E <br />L <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCR 2635 (B)) <br />✓ <br />D <br />S <br />OVERFILL PROTECTION INSTALLED/ <br />(CCR 2635 (E) (2)) <br />f <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />(ccR 2631 (D) (5)) <br />V1 <br />ITEM OR EQUIPMENT INSPECTED <br />19. <br />DATE <br />(CCR 2635 (A) (5)) <br />rZ 6 <br />ky <br />�'-� gs <br />✓ <br />(CCR 2632 (E) (1) (2)) <br />1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (8) <br />`® _aL <br />✓ <br />21. <br />2. UST INSTALLATION PLANS APPROVED (CCR 2635 (E) (5)) <br />INITIAL INSPECTIONS <br />3 �a <br />✓ <br />3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br />VACUUM: w SOAP: PSI: HRS/MIN:2 ® BRINE(LICUID ): OTHER: <br />Begs4. <br />�� <br />PSS: S— HRS/MIw: �3 <br />PRIMARY TANK TEST: lip <br />pl <br />SECONDARY PIPING CONTAINMENT TEST PSI: '!�- HRS/NIN:_3 (D OTHER: <br />5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (CCR 2635 (A) (3) (4) (6)/ API/PEI) <br />PIPING INSPECTIONS <br />I..vr-f6 <br />V/ <br />N 6. <br />PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) SE/ / /'r, <br />(CCR 2635 (B) (4)) <br />�� <br />✓ <br />7. <br />SECONDARY PIPING CONTAINMENT TEST PSI: '!�- HRS/NIN:_3 (D OTHER: <br />(CCR 2635 (A) (4)) <br />6 <br />V <br />A- 8. <br />LAKE TEST ON ALL SUMPS (24 HR. NININUM) HRS: <br />(CCR 2635 (A)) <br />% <br />✓ <br />9. <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />(CCR 2635) <br />]���� <br />✓ <br />10. <br />OVERSPILL PERFORMANCE TEST <br />(CCR 2635 (A) (4)) <br />t4j.16. <br />11. <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCR 2635 (B)) <br />FINAL INSPECTION <br />�' ♦ ►� <br />010._. t. <br />_E <br />Flop <br />EH23-006 3/92 <br />12. <br />PERFORMANCE TEST FOR -ALL- MONITORING M13ES <br />(CCR 2632 (C) (2)) <br />�� <br />✓ <br />13. <br />PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) <br />(CCR 2632 (A) (23) <br />3-24- 6 <br />✓ <br />14_ <br />PERFORMANCE TEST OF LIMN LEAK DETECTION <br />(CCR 2632 (D) 2635 (B) (5)) <br />C. <br />15. <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF <br />(CCR 2635 (B) (5)) <br />�- 4 <br />✓ <br />t4j.16. <br />BALL FLOAT VALVES INSTALLED <br />(CCR 2635 (B) (6)) <br />e,�0 <br />✓ <br />17. <br />OVERFILL PROTECTION INSTALLED/ <br />(CCR 2635 (E) (2)) <br />18. <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />(ccR 2631 (D) (5)) <br />V1 <br />Yq <br />19. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR 2635 (A) (5)) <br />rZ 6 <br />ky <br />20. <br />MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCR 2632 (E) (1) (2)) <br />21. <br />-C- FORM COMPLETED AND SUBMITTED <br />(CCR 2635 (E)) <br />S� <br />✓ <br />,,Q22 <br />MONITORING METHOD FOR ALL TANKS AID PIPING APPROVED <br />(CCR 2641-2644) <br />�--� <br />23. <br />ALL CONDITIONS MET; FACILITY PERMIT ISSUED <br />(H+S CODE 25284 (E) (F)) <br />�' ♦ ►� <br />010._. t. <br />_E <br />Flop <br />EH23-006 3/92 <br />