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Tank Specific Information TANK NUMBER <br /> 1 2 3 4 5 <br /> 14.Underwriter Laboratories label or tank serial number. 24 122 19(0 2q 12,2.1 1,?- <br /> 15.Tanktype.* <br /> (Indicate SW,DW,SW-OW5,or DW-OWS for each tank) <br /> 16.Interstitial Monitor type.** <br /> (Indicate HYDRO,DRY,VAC or PRIES for each tank) y�y� tr0 <br /> 17.Tank capacity. / Select one: %Gallons ❑ Liters <br /> (Indicate unit of measurement and record the capacities for each tank) 2— 000 12,000 10,W <br /> 18.Tank free of visual damage. <br /> (Document damage found and attach to this form) <br /> 19.Monitoring fluid visible on inner or outer tank wall. <br /> (Indicate Yes or No for each tank) a — <br /> 20.Pre-Installation air/soap test performed without leaks. <br /> Indicate which test in Section D you used per tank: <br /> 21.Hydrostatically monitored tanks: <br /> Indicate Yes or N/A for each step completed per tank: <br /> •Sensor sits on tank top <br /> •Check and record monitor;ng-fluid level in reservoir <br /> •Annular space vented <br /> 22.Vacuum monitored tanks: record vacuum date <br /> record vacuum level <br /> * SW=Single Wall Tank• DW=Double-Wall Tank • SW-OWS=SW Oil/Water Separator• DW-OWS=DW Oil/Water Separator <br /> **HYDRO=Hydrostatic • DRY=Dry interstice space with probe •VAC=Vacuum • PRIES=Positive Air Pressure <br /> ' • Measurement instructions are found in Section 11 of Tank Installation Instructions. <br /> g 11 u } <br /> 1)First Vertical Diameter Measurement(Section 11,Figure 11-1) 12 �►w J %rr <br /> J/ " 2S s�1, I?"�- V 11 <br /> 2)Second Vertical Diameter Measurement(Section 11,Figure 11-21 12_ J <br /> 3f Il <br /> 3)Third Vertical Diameter Measurement(Section 11,Figure 11-6) 1 Uo l r 1 Y J vo It <br /> Measurement A-Tank deflection with backfill at tank top <br /> (subtract Measurement 3 from Measurement 1 above) <br /> Refer to Table 11-1 for max.deflection values. <br /> 4)Fourth Vertical Diameter Measurement(Section 11,Figure 11-7) <br /> +� r r /I I II <br /> 5)Fifth Vertical Diameter Measurement(Section 11,Figure 11-8) 32 32 J 1 ,2, <br /> 6)Calculate the final vertical diameter measurement y a`�'I �"�/ N <br /> (subtract Measurement 5 from Measurement 4 above) - 2, 2 <br /> Measurement B-Tank deflection at subgrade l/ <br /> (subtract Calculated Value(6)from Measurement 1 above) 3A ?/fU 11 <br /> Refer to Table 11-1 for max.deflection values. / — <br /> TABLE 11-1 <br /> • Tank Diameter Maximum Deflection <br /> If Measurement A or Measurement B exceeds the values shown inTable I-1, 4' 1/2" (12mm) <br /> immediately contact Tank Technical Support priorto proceeding with the 6' 3/4" (19mm) <br /> installation. 8' 11/4" (31 mm) <br /> CSITankTechnical Support:(800)537-4730 10, 11h" (38mm) <br /> 12' 13/4 (44mm) <br /> 31 <br />