Laserfiche WebLink
NEW UST INSTALLATION INSPECTION RECORD <br /> VFACILITY <br /> ITY NAME: ADDRESS: /�-�� Awl)f/s <br /> IDX TANKX ULX S/ TANK MODEL/MATERIAL: <br /> PRODUCT: R.E.H.S: �. <br /> ITY. It'g2j I l%i'� <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 EQUIPMENT INSPECTED <br /> DATE <br /> �) y I ( /. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25797) <br /> I / v, <br /> �]9 qf, I /� I 2. UST INSTALLATION PLANS APPROVED <br /> ( /7 INITIAL INSPECTIONS <br /> 1 3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br /> Ei4j <br /> vVACUUM: SOAP: PSI: HRS/MIN: BRINE(LIOUID ANNULAR): OTHER: <br /> I4. PRIMARY TANK TEST: PSI: HRS/MIN: <br /> 5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (API/PEI) <br /> PIPING INSPECTIONS <br /> d1'�I vll V 1 /rl 6• <br /> PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) (CCR 2636 (e)) <br /> 1 �, 1 7. SECONDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: OTHER: (CCR 2636 (ell <br /> 1d a. LAKE TEST ON ALL SUMPS (24 HR. MINIMUM) HRS: (CCR 2635 (a) (4)) <br /> 9, UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br /> PEI <br /> Y (CCR 2635 (b) (1) (C)) <br /> 1 1 110. OVERSPILL PERFORMANCE TEST <br /> Ir� I11. ALL PIPING AND FITTINGS CORROSION PROTECTED (CQ 2 ' (b7) <br /> V l [�c) (CCR 2636 (c)(1)) <br /> K 2 l 1 I I12. PIPING SLOPES TO COLLECTION SUMP <br /> FINAL INSPECTION <br /> y. I q 113. PERFORMANCE TEST FOR "ALL" MONITORING PROBES (CCR 2632 (c) (2)) <br /> 70�7J(9 R I v I.� I14• PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (c) (2)) <br /> em <br /> PERFORMANCE TEST OF LINE LEAK DETECTION (OCR 2643 (c) (1)) <br /> 4 116. PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF 2636 (9)) <br /> V/,111 117• BALL FLOAT VALVES INSTALLED <br /> (CCR 2655 (b) (2)) <br /> ltg. OVERFILL PROTECTION INSTALLED/APPROVED <br /> 119. TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) API <br /> 120. TANK INTEGRITY TEST (PASSING HARD COPY) (CCR 2635 (a) (5)) <br /> / 1 ✓ 121, MONITORING PLAN, RESPONSE PUN AND LOG BOOK ON SITE (CCR 2632 (d)) <br /> • 122, "C^ FORM COMPLETED AND SUBMITTED (CCR 26.35 (d)) <br /> V 123MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (CCR 2630-2636) <br /> /� 124. ALL CONDITIONS MET; FACILITY PERM 3T ISSUED <br /> (H+S CODE 75284) <br /> COMMENTS: <br /> E423-.006 9/95 T <br />