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• • UNDERGROUND TANK INSPECTION RECORD • <br /> NEW TANK INSTALLATION <br /> SITE NAME <br /> .ADDRESS INSPECTOR'S NAME <br /> CITY ZIP <br /> CONTRACTOR: NAME <br /> PHONE <br /> OWNER: NAME <br /> PHONE <br /> DIS INSPECTOR'S <br /> DATE PPROVED PPROVED INITIALS <br /> ITEM OR EQUIPMENT INSPECTED <br /> 1. Fees paid <br /> io�a�86 <br /> . Plans Approved <br /> INITIAL INSPECTION <br /> 1. UL numbers tank size <br /> Tank tested upon delivery [Holiday (plasteet) or air at 5 PSI (FRP)I <br /> . Visual inspection of secondary containment. <br /> Tank appropriately placed with approved backfitl. <br /> IPING STAGE INSPECTION <br /> , PeAu 5;P"I ft ou yl� a r I �� f (,L,) 14 �4 <br /> pi o <br /> test f piping. [Primar and Secondar G� <br /> e in Y Y (NEPA )) <br /> 2. Ball float valves installed. <br /> 3. Overfill protection installed, describe: <br /> 4. Unused tank opening seated and cathodically protected. <br /> 5. Visual inspection of secondary coairrent on iping. <br /> P J , <br /> Monitoring ports in place and brought,to grade. (l9ckable weathe .,roof covers) <br /> 7. Fill and vent piping brought to grade. ij <br /> 8. Product line leak detector in place. (Hard wired) <br /> 9. Approved tank leak monitoring device installed. <br /> 10. All galvanized piping and fittings properly wrapped. <br /> 11. Pressure decay test on complete tank and product delivery system. <br /> INAL INSPECTION <br /> 1. Precision test successfully completed and hard copies received. (NFPA 329) <br /> 2. Spilt protection at fill pipe. <br /> 3. Performance test of overfill protection system. <br /> 4. Performance test of product line leak detector. (Hard wired) <br /> 5. Performance test of continuous monitoring system(s) on tank (s) <br /> 6. Permit to operate application complete. <br /> 7. Acceptable recordkeeping system. <br /> Comments: <br /> EH 23 006 10/89 <br />