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UNDERGROUND TANK INSPECTION RECORD <br /> NEW TANK INSTALLATION /� <br /> SITE NAME������' SC�,,IC INSPECTOR'S NAMEC <br /> ADDRESS to L� -C C: CITY ZIP. <br /> ! <br /> CONTRACTOR: NAME _ C TELEPHONE <br /> OWNER: NAME L�� .L�JTELEPHONE <br /> DIS- ENSPECTOR'S <br /> DATE APPROVF,D APPROVSD INITIALS <br /> TEM OR EQUIPMENT INSPECTED <br /> INITIAL INSPECTION <br /> 1. Tank tested upon deliver [Holiday lastecd ur air at 5PSI (PHP)I <br /> 2. Visual inspection of secondary containment. <br /> 3. Tank appropriately placed with apprnved backfill. <br /> 4. UL numbers and tank capacities recorded. <br /> PIPING STAGE INSPECTION <br /> It (✓ C4 l� I. Pressure test of piping, {Primary and Secoudar (NFPA 3n)] <br /> 2. Ball float valves instilled. <br /> 3. Vverfill protection installed, descriikt• <br /> 4. Unused tank 0 ent—s scaled and cathodical) protected. <br /> / 5. Visual ins ection of secondar cuntainnent on i in . <br /> (lmkable ,+leather prooti <br /> r arrx to nlare and brow ht to rade. cw�rs <br /> (J 7. Pill and vent piping brought. to grade. <br /> 8. Product line leak detector in lace. (Hard wired) <br /> 9. Approved tank leak Monitoring device installed. <br /> L0. All galvanized piping and fittin s properIX wrapped. <br /> Pj <br /> 1. Pressure deco teat on com kcte tank and product deliver s stem.701 <br /> j FINAI. it:SPECTION <br /> t I . Precision test suUcssiull c++m letud and hard i,++ies received�� t <br /> 2. S ill protection at fill ++ +c. <br /> 3. Performance test of nv,rrfill a++terti++u :=vstcm. _ <br /> 4. Perf:+:manic trst ,+E Y:Y,dur, l+nr leak dui cctul. (Hard wired) <br /> tl�rJ <br /> S. Performance teM Of c„nt lnuoU:; m++ult+,r:n,' s s+,m(sl nn tank(S) <br /> 6. PCta+tt to azt;rate a licatiou crimple::. <br /> 7. <br /> Acceptable recordkee in s bter. <br /> OfTttE7i'[3: <br />