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NEW UST IN&LUTION INSPECTION RECOR^ <br /> FACILITY NAME: a, � ' /_� ne -i•7-/I ADDRESS: <br /> f�� 7 <br /> SLEEPs2 L A �' , �' TANKS &o '1 <br /> UL2TANK MODELMATERIAL: <br /> 1-Z- <br /> CAPACITY: a.� ��C ,y PRODUCT: '1?ter R.E.H.S: <br /> A I <br /> P N ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <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 ECJIPMEMT INSPECTED <br /> DATE <br /> 1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (8) <br /> y� ;t 2. UST INSTALLATION PLANS APPROVED (CCR 2635 (E) (5)) <br /> INITIAL INSPECTIONS <br /> 3. INSPECTION AND TEST OF SECONDARY CCONTAINENT: HOLIDAY: - <br /> VACOLM: SOAP: PSI: HRSMIN: -� BRINE(LIOUID ANNULAR): OTHER: <br /> PRIMARY TANK TEST- PSI:PSI: J. J HRS/MIM: 1 <br /> 5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (CCA 2635 (A) (3) (4) (6)/ API/PEI) <br /> PIPING INSPECTIONS <br /> n T � <br /> 6. PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) �� / 5 j h (fa 2635 (8) (4)) <br /> S�oSJ' 7. SECONDARY PIPING CONTAINMENT TEST PSI -� HRSMIN: �j OTHER: (CCR 2635 (A) (4)) <br /> •o/SSJ-�j _ N 8. LAKE TEST ON ALL SUMPS (24 HR. MINIMU ) HRS: ,9, (CCR 2635 (A)) <br /> 9. UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED (CCR 2635) <br /> � 0. OVERSPILL PERFCR)UMCE TEST (CCR 2635 (A) (4)) <br /> S ,1La'3 -Y� ✓ 1-I 11• ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2635 (8)) <br /> FINAL INSPECTION <br /> 2. PERFORMANCE TEST FOR 'ALL' MONITORING PROBES (CCR 2632 (C) (2)) <br /> b � 3 3. PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (A) (2)) <br /> PERFORMANCE TEST OF LINE LEAK DETECTION (CCR 2632 (D) 2635 (B) (5)) <br /> PERFORMANCE TEST OF AUTOMATIC PIMP SYSTEM SHUT-OFF (CCR 2635 (8) (5)) <br /> 6. BALL FLOAT VALVES INSTALLED CCCR Z635 (B) (6)) <br /> 0' I/ f 7. OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635 (E) (2)) <br /> _411- ✓ 18. TANK ACCESS PORTS BROUGIiT TO GRADE (LOCKED AMD WATERTIGHT) (CCR 2631 (D) (5)) <br /> 19. TANK INTEGRITY TEST (PASSING HARD COPY) J LS - 3��'JS5 (CCR 2635 (A) (5)) <br /> 20. MONITORING PWM, RESPONSE PLANOG BOOL ON SIT ) (CCR 2632 (E) (1) (2)) <br /> 21. •C` FORM COMPLETED AND SUBMITTED (CCR 2635 (E)) <br /> !� ✓ 4' MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (CCA 2641-2644) <br /> 23. ALL CONDITIONS MET; FACILITY PERMIT ISSUED (H+S CODE 25284 (E) (F)) <br /> COMMENTS: <br /> EH23-006 3/92 <br />