Laserfiche WebLink
NEW UST INSTALLATION IHSPECI'ION RECORD <br />AGILITY NAME: QC���` �(J ( Z(n ADDRESS: <br />°ACILITY ID# TANKS ULS TANK ACGEL/MATERIAL: <br />:APACITY: i 'z, U ©O PRODUCT: Ll <br />INITIAL INSPECTIONS <br />4 y14� I N �I 3. <br />A <br />I <br />VACUUM: SOAP: PSI: HRS/MIN: 3RSHE(LICUIB ANNU OTHER: <br />2JS I 4. <br />? <br />A <br />ALL TANKS TO SE INSTALLED AND TESTED IN ACCORDANCE <br />(CO2 2635 (a) (4)) <br />P <br />I <br />WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />JO. <br />_ ( <br />R <br />T <br />,o _ 6 ✓ �4p� 11. <br />ALL PIPING AND=ITTINGS CORROSION PROTECTED <br />0 <br />I <br />SLOPES D CDLLr! i ION SUMP <br />(= 2636 (c) C i) ) <br />V <br />A <br />✓ <br />E <br />L <br />(CGT 2635 (b) (2)) <br />D <br />s <br />TANK ACCESS PORTS 3R000HT TD GRADE (LOCXE')s AND WATERTIGHT) <br />API <br />(20. <br />ITEM OR EQUIPMENT INSPEC,r � <br />DATE <br />i()- 6 <br />✓ I �21. <br />ADNITCRING PUN, RESPONSE PUN AND LOG 3OOK ON SITE <br />Zaz (d) ) <br />✓I �22. <br />1. UST PUNS SUBMITTED/ Fw5 PAID (H+S =OE 25ZB7) <br />(CCR 2635 (d) ) <br />6I ✓ I 23. <br />MONITORING AE-jHCD FOR ALL TANKS AND PIPING APPROVED <br />2. UST INSTALLATION PUNS APPROVED <br />INITIAL INSPECTIONS <br />4 y14� I N �I 3. <br />INSPECTION AND TEST OF SECONDARY CONTAINMENT: <br />(cam 2636 (e)) <br />VACUUM: SOAP: PSI: HRS/MIN: 3RSHE(LICUIB ANNU OTHER: <br />2JS I 4. <br />PRIMARY TANK TEST. PSI: 5 �'' HRS/MIN: 3 a h,ti <br />5. <br />TANK APPROPRIATELY PLACED WITH APPROVE] 3AWILL (APT/PEI) <br />PIPING INSPECTICHS <br />ID - / I ✓ I <br />PRIMARY PIPING TEST (MINIMUM 4O PSI/3D AIN) �o 19,3! 13 p M,4 -v, <br />(cam 2636 (e)) <br />4 I If 17. <br />SE=UDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: 3C) OTHER: <br />(CCR 2636 (e)) <br />p--16 -76 K4 8. <br />LAKE icST ON ALL SUNPS (24 HR. AIHIMUM) HRS: <br />(CO2 2635 (a) (4)) <br />II 19. <br />UNUSED TANK OMINGS SEALS) AND CORROSION PROTECTED <br />PEI <br />JO. <br />_ ( <br />OVEZSPILL PStFCRMANC -EST <br />(CO2 22535 (b) C1) (C)) <br />,o _ 6 ✓ �4p� 11. <br />ALL PIPING AND=ITTINGS CORROSION PROTECTED <br />(CLZ Z636 (b)) <br />V/1 K 12PTPtNG <br />SLOPES D CDLLr! i ION SUMP <br />(= 2636 (c) C i) ) <br />FINAL INSPECTION <br />yl6l <br />✓ I 13. <br />PERFORMANCE TEST FOR "ALL" AOIITORING PROSES <br /><C Z63Z (c) (2)) <br />14. <br />PERFCRXUC EST OF CONTINUOUS ACNITORING SYSTel (PANEL) <br />CCGZ 2632 (c) (2)) <br />0 <br />I <br />( 15. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />CCS 2643 Cc) (1)) <br />16. <br />PSRFCRXANCZ TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF <br />CGL2 Z636 (S)) <br />✓ <br />( 17. <br />BALL FLOAT VALVES INSTALLED <br />✓ <br />I04�18. <br />OYE.RFILL PROTECTION INSTALLa/APPROVED <br />(CGT 2635 (b) (2)) <br />,�19. <br />TANK ACCESS PORTS 3R000HT TD GRADE (LOCXE')s AND WATERTIGHT) <br />API <br />(20. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />2535 (a) (5)) <br />i()- 6 <br />✓ I �21. <br />ADNITCRING PUN, RESPONSE PUN AND LOG 3OOK ON SITE <br />Zaz (d) ) <br />✓I �22. <br />FORM CCMPLE E0 AND SUBMITTED <br />(CCR 2635 (d) ) <br />6I ✓ I 23. <br />MONITORING AE-jHCD FOR ALL TANKS AND PIPING APPROVED <br />(c:z 2630-25.36) <br />1 I I24. <br />ALL =901TIONS MET; FACILITY PERMIT ISSUED <br />CN+S Coe 252B4) <br />=MMENTS: <br />=H23-Qa6 9/95 T <br />