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TANK INSTALLATION CHECKLIST <br /> TO INSTALLER:After tank installation,deliver the Installation Manual with the completed Tank I nsta I I at!on Checklist to the tank owner.Retain a copy of <br /> each for your records. <br /> TO OWNER:After installation,retain the limited warranty,the Installation Manual and completed Tank Installation Checklist for future reference arid to <br /> facilitate any warranty claim. !� <br /> INSTALLATION DATE(S):-61-701 7 PERSON COMPLETING FORM:KEG/ 92� S 720A-1 <br /> INSTALLATION ADDRESS: J��/ /�I/}/il/ STEFJ <br /> 'PQt LY8 r 7AN #t <br /> Tank type-Single-Wall(SW),Double-Wall(DW) <br /> TankUsage(Water)-Potable Water,Water Collection N <br /> ;Tanl�lr��a�e�W�S'�ermater) Grease Interceptor Septic Industrial Waste � °5 <br /> � walEl`��1}���♦Ca^"�-^ ', " �" '`; .- -,'�� w�/t��,t�!" .�'Y��, R `i �"`� <br /> Tank Usage(Oil/Water Separator) <br /> Nominal Tank Diameter-give in feet ,/® ' /p ° <br /> Nomr al TanlsCap�q'iTy give to gallons or liters(:and nate which) p� $ - �" C 1 r(7 i <br /> If applicable,000LC#(read from tank label)-yes or no _/y3Gc -/e °t spa r� .i7�wc <br /> IM wsx�c.sKwaxx,- .. +Tx _ errxia5" -., <br /> -0 - dRM71011(SSeetrdL Nom- AT�1' aI NTANr TAf # �T A <br /> PrimarybackfillmeetsAppendixCrequirements-yesornoY5� <br /> �eeoridarybatkftll��terfal,will"b�u;3ed'.�.erst6fnba, � ;:.� Y7 � ` ° �,`.>�K �;=, <br /> Secondary backfill meets our requirements_yes or no 1y <br /> GeotexfFle wdl bo uyed yes or no c <br /> Excavation-shored or not shored <br /> Tattikes.f{Iseetraf#icla'dd�(H70or,H520), yesorno �'-$ ° '". 'i ` . � ;i „��.`' . ,�; <br /> Holecondition-dryorwet ,fie <br /> Anchoring system will be used-yes or no 'f e' <br /> If applicable,anchoring system used-deadmenoranchorslab 0kr6/Jwty <br /> ALLA1 SPEC710�NANEESTN ediand4)..' �A INS q Ag �TC4 K <br /> Shipping damage-yes or no /k/0 A16 wo <br /> Loss of vacuum yesolho <br /> Monitoring fluid visible on interior ofta<nk-yes or no 0 d <br /> Monrtonngflultlwsibleionextenoroftank yesor;n`o; A­ ZJ <br /> �equirementsmeffordouble-wafLEanksshippedundeririierstiffal - <br /> vacuum yes or no.If yes,record thevalue. ly ✓f N/� <br /> R``e2grd:ffurdafeuel�inres�T,�oirTo�3'doublew�('Iwettanks�., � ®� .::;�„ .�!!� !/ <br /> If req u i red,ta n k passed pressu re/soap test-yes or no <br /> ZCL i XEXES® IMOG1119PP 37 <br />