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NEW US" STALLATION INSPECTION RE{' 7 <br /> FACILITY HANE: LDv� S (-es ADDRESS: 15)o�ck_-T v CD_j <br /> SLEEPS: TAN= CJ UL.f �3 3,4_:35TAMK MCDEL/MATERIAL: Mukryi <br /> CAPACITY: -1120,D2212 PRODUCT:r R.E.H_S: <br /> A I <br /> P M ALL TANKS TO BE INSTALLED AND TESTED IN AC�DAMCE <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 l <br /> l p Alod I I 1- UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (8) <br /> 2_ UST INSTALLATION PLANS APPROVED (CCR 2635 (E) (5)) <br /> INITIAL INSPECTIONS <br /> Z DII 3_ INSPECTION AND TEST OF SECONDARY CONTAINMENT:vn c HOIIDAT: <br /> VACLLN: ,G SOAP: PSI: HRS/KIM: ` �r BRINECLIOUID ANNULAR): OTHER: <br /> L� I f 4. PRIMARY TANK TEST: PSI: HRS/MIN: <br /> 4 221D1 5. TAMK APPROPRIATELY V UNPLACED WITH APPROVED BACZFILL (CCR 2635 (A) (3) (4) (6)/ API/PEI) <br /> PIPING INSPECTIONS <br /> r;' I V15 <br /> I 6. PRIMARY PIPING TEST (MIMI" 4D PSI/30 MIM) Q 1 4r�ry-L L4,-� (C= 26,35 (8) (4)) <br /> 7- SECONDARY PIPING CONTAINMENT TEST PSI:i) C 1 HRS/1IIM: 111 `,FHER: (C� 2635 (A) (4)) <br /> �1l ( ✓ ( B. LAKE TEST ON ALL SUMOS (24 HR. MIMI") I HRS: (C= 26:5 CA)) <br /> 61DII v' 19. UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED 2635) <br /> 2 D� I ✓ 10. OVERSPILL PERFORMANCE TEST ((= 2635 (A) (4)) <br /> cJ' 2(I ( I ✓ 11. ALL PIPING AND FITTINGS CORROSION PROTECTED (CO2 2635 (8)) <br /> _1 FINAL INSPECTION <br /> 12- PERFORMANCE TEST FOR 'ALL' MONITORING PROBES (CCR 26.32 (C) (2)) <br /> gD 17 PERFORKANCE TEST OF CONTINUOUS MONITORING STSTEM (PAMNEL) (c= 2632 (A) (2)) <br /> g 2 lo L// 14. PERFORMANCE TEST OF LIME LEAK DETEL710M (CCR 2632 (D) 2635 (8) (5)) <br /> 15_ PERFORMANCE TEST OF AUTOMATIC PUMP STSTEM SHUT-OFF (CSR 2635 (8) (5)) <br /> 16. HALL FLOAT VALVES INSTALLED (CO2 26-35 (B) (6)) <br /> _/"17- OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635 CEJ (2)) <br /> /z �I V/- I 18_ TANK Ar "IrSS PORTS BROUGHT TO GRADE (LOCXED AM WATERTIGHT) (C= 2631 (D) (5)) <br /> 8 ✓ TANK INTEGRITY TEST (PASSING HARD COPT) (CO2 2635 (A) (5)) <br /> V : 20. MONITORING PLAIN, RESPONSE PLAN AND LOG BOOK ON SITE (CCR 2632 (E) (1) (2)) <br /> I O I ✓ <br /> 21- 'C' FORM COMPLETED AMD SUBMITTED (C= 2635 (E)) <br /> 22. MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (c�R 2641-z64») <br /> ✓ 23. ALL CONDITIONS MET; FACILITY PQRMIT ISSUED ()++S CODE 25284 (E) (F)) <br /> 0 0 <br /> COMMEVTS� <br /> H23-006 3/92 (REVISED 11\92) <br /> s <br />