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XERXES ® TANASTAL,ATION CHECKLISI0 <br /> CORPORATION Fiberglass Underground Storage Tanks <br /> Single-Wall(SWT), Double-Wall.(DWT}, Multioompar)ment(MCT)and OI[Mater Separators(OWS) . <br /> Complete this checklist,and keep h with copies of any written authorizations for variations and/or devlations received from Xerxes. <br /> • Date of Installation Ca -2 to ^D3 Tank Size and Capacity _ /O,UDD <br /> Tank Type SWT DWT MONITORING-FLUID DRY M6T OWS (Circle those that apply.) UL Number 2610 3 <br /> • Site Owner 7- 45leue.J rnlc, a�t"Ok I qn <br /> • Site Address yG43 S, 51,41e (2�. 99 S�ac� n n t , .Z10 <br /> • installing Contractorlr- Arier .e 140nJsvfPou, a/`jo xa.�r i, s agW6 Ab,-s5ell A?1J >lAilkl�' &W <br /> I OnSiteSupervisorYYJv���t�er,. <br /> PREINSTALLATION1. Verified by: <br /> A. Visual Inspection:No evidence of damage(holes,cracks,gouges)In tank.(Document any damage found.)..................................... <br /> B. Monhoring-Fluid Tanks: 1.Check and record monitoring-fluid level in reservoir. .............................................................................. <br /> 2.Check for monitoring fluid inside and outside of tank............................................................................... <br /> C. Physical Test: Preinstallation air/soap test completed in accordance with installation instructions....................................................... — E916— <br /> D. Backfill Material: (Indicate which type.) 1.Pea gravel or crushed stone as specified by XERXES......................................... <br /> 2.Other(Requires spec approval by XERXES-describe.)................................. <br /> E. Excavation: Hole dimensions are correct per installation Instructions for appropriate conditions......................................................... <br /> F. Internal Diameter Measurement: The idemaldhirlardthetank•sm and doarrertiedCNN InIsn'dDiatrelerinSection 4below).... <br /> G. GeotexUle Utilized: (Indicate one.)6es) 2.No.......................................................................................................................... <br /> H. Hole Condition: (Indicate one.) 1.Dry hole(Water is not anticipated to reach tank-area is not subject to flooding.)................ <br /> 2.Wet hole(Excavation may trap water-area is subject to flooding.)...................................... <br /> I. Traffic Loads: (Indicate one.) 1.Traffic bads anticipated.......................................................................................................... 1_ <br /> 2.No traffic loads anticipated.................................................................:................................... <br /> J. Anchoring: Performed in accordance with installation instructions. 1. ad 2.Full slab................................................... <br /> 1� K. Fittings and Other Metal Components: Coated to protect against corrosion...................................................................................... <br /> 2. DURING INSTALLATIONVerified by: <br /> A. Backfill-material bed is level and is a minimum of 12 inches deep,over native soll or slab,before setting tank.........._........... <br /> B. Tank Spacing: Tanks are spaced correctly from each other and from excavation according to instructions......................................... <br /> C. Visual Inspection: No evidence of damage is found after setting in hole............:....................................................................-.......... <br /> . <br /> D. Hold-down Straps: Positioned and secured according to installation instructions.(See SECTION 6.4.of Installation Manual.)......... <br /> E. Backfill Compacted: Material has been tamped and/or compacted to fill all voids around tank........................................................... <br /> F. Tank is properly ballasted during backfilling: (wet-hole installation only)......................................................................................... <br /> G. Tank(s)are buried at proper depth to conform to appropriate conditions: (wet,dry,bafflc or no traffic)....................................... <br /> 3. POSTINSTALLATION Verified by: <br /> A. Physical Test: Air/soap test is completed according to installation instructions.................................................................................... <br /> li Intemal Dfame&MeasutementTheitenddameterdtinetartismeasuredaiddoauneriled(FnallntandDiamebrnSedan4balwr)............. 6Lm <br /> C. Monitoring-Fluid Tanks: 1.Check and record monitoring-fluid level in the reservoirA//_ (inches)......................................... <br /> 2.Check for monitoring fluid Inside tank...................................................................................................... <br /> D. Installation Manual: Deliver Installation Manual and Operating Guidelines to owner. .....:................................................................... <br /> 4. DEFLECTION <br /> All tanks must be measured to determine vertical deflection. Follow deflection-measurement instructions(Section 14)In the Installation Manual. An <br /> Initial intemal-diameter measurement is taken and recorded as a point of reference. Subsequent internal-diameter measurements show tank deflection and <br /> can be compared to the table below. Take each measurement from Ute same filling using the same procedure. <br /> External Tank <br /> INTERNAL-DIAMETER MEASUREMENTS „ END CENTER <br /> Diameter 4 6 6 10 12 Initial Internal Diameter(before backfilling) <br /> (Ft) Final Internal Diameter(after backfilling) "' am:r <br /> Allowable Initial Internal Diameter minus <br /> Deflection 112 314 1-1/4 1.1/2 1.3/4 Finallnte is a r= e j <br /> (In.) n Mark the location where inlemal-0diameter <br /> Verified by: measurements were taken. <br /> 27 <br />