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ecklist <br /> Ta <br /> nkInstallatia o ndTanks <br /> Under. <br /> for F��r`31ass n checklist,these instr <br /> The tank indall•,tlo Wil��tiO4 <br /> ret„ncItylankowner This checklist <br /> teGtland anY correspondence related to hen makingtalwarrra ty camust bm• <br /> and must be provided to CSI w <br /> C'0p tc' <br /> LDate of It+stallatlon <br /> 9 5o Street Zi / <br /> State P <br /> c�,Wdrru � i <br /> cMtrsctor tea”`on,panY � I State � P <br /> M,.LatM^9 Stree-tL5 L1iCLiS--f <br /> 0 <br /> Completed N/A <br /> II materi %fcotton al meets CSI SP — <br /> 1, Instal►anon bacicfi (sieve analysis isattached)- <br /> Ir,sczte which material you used: ❑ Pea Gravel <br /> Crushed Stone <br /> ❑ Other(CSI approval letter attached) <br /> 2. Bates above tank top. <br /> Inzica:=which material you used: Same backfill material as#1 above <br /> ❑ Geotextile and alternative material above tank top <br /> 3. Exoratioft and tank clearance meet requirements of Section 6. <br /> a. Geotertiie used to line excavation: 56Yes ❑ No <br /> i. Indiic3te hole condition: <br /> D-y hole(Water is not anticipated to reach tank-area is not subject to flooding) <br /> We hole(Excavation may trap water-area is subject to flooding) <br /> & And,oring performed in accordance with installation instructions: <br /> irr,-,,a,E r,R,ich method you used Deadmen <br /> ❑ Anchor Pad <br /> O No mechanical anchoring <br /> �• Depth of backfill under tank 1QL inches <br /> 8. All defection measurements are recorded on reverse side. <br /> 9• Backfill Placed in 12"lifts&probed as described in Section 11. <br /> 10• Tanks ballasted according to Section 10- <br /> 11. Tank burial depth complies with the requirroments of Section 9. G�(o <br /> 12. Pipin9 <br /> and bottom sump clearances accordin'to Section 13. <br /> 13• All piping connections are flexible connions according to Section 13. <br /> VIM <br /> Installatlon was In accordanco with Tank Installation Instructions(INST.6001). <br /> ate <br /> oW DAF ContractcfRepresentative(Pr Name) Date <br /> p <br /> ner Representative(Print Name) <br /> nor a�rnr�Rrnra<cMatiw lCinnaturol f)�b. <br /> 'Unn.e.e•..a.�..n rCl..n ar•..nl <br />