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NF4 UST INSTALLA710M INSPECTION RE=RD <br /> FACILITY NAME: y lqw ADDRESS: LD_(� S� Lote, < QCs -yam <br /> FACILITY ID# 063 <br /> TANKS UL# TANK MODEL/MATERIAL: <br /> CAPACITY: PRODUCT: <br /> A I <br /> P N ALL TANKS TO 3E INSTALLa AND TESTED IN AC=Rl3ANC <br /> P I WITH MANUFACTURER WRITTF-11 SPECIFICATIONS <br /> R T <br /> 0 I <br /> V A <br /> E L <br /> O S <br /> ITEM OR ECUIPMENT INSPECTED <br /> GATE <br /> 1. UST PLANS SUBMITTED/ FEE-S PAID (H+S =F- 25287) <br /> 2. UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> "r rA <br /> INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br /> r f VACLRJM: SOAP: PSI: HRS/MIN: 3RINE(LICUID ANNULAR): OTHER: <br /> 4. PRIMARY TANK TEST: PSI: HRS/MIN: <br /> 5, TANK APPROPRIATELY PLACED WM APPRCIVE0 3ACKFILL (APS/PEI) <br /> PIPING INSPECTIONS <br /> 6. PRIMARY PIPING TEST (MINI" 4O PSI/30 MIN) (CrR 2636 (e)) <br /> 7. SE HOARY PIPING CONTAINMENT TEST (l PSI: / HRS/MIN: OTHER: (C.''R 2636 W) <br /> /Y f LAKE ON ALL "PS (24 HR_ MINIMUM) HRS: (CCR 2635 (a) (4)) <br /> UNUSED TANK OPENINGS SEALED AND CWCISIOX PROTECTED PEI <br /> Fn VI � <br /> OVERSPILL PSifGRkANC~ TEST (CCZ 2635 (b) (1) (C)) <br /> ALL PIPING AND FITTINGS CORROSION PROTEC±rs7 (CC;Z 2636 (b)) <br /> PIPING SLOPES TO COLLECTION SUMP (CC2 2636 (c)(1)) <br /> a1 FINAL INSPECTION <br /> / ` P'ERFO.RMANCE TEST FOR "ALL" MONITORING PROBES (CGt 2532 (c) (2)) <br /> 11 I V� 4. PERFORMAHC� TEST 4F CONTINUOUS MONITORING STSTEt4 (PANEL) (cm 2&M (c) (2)) <br /> f 5t� 15. PERFCMWCE TEST OF LINE LEAK DETECTION OCCUR 2643 (c) (1)) <br /> PERFORMANCZ TEST OF AUTOMATIC PUMP 57ST€.+4 SHUT-OFF (CCR 2636 (g)) <br /> FV 17. 3ALL FLOAT VALVES INSTALLED <br /> '✓ r ✓ 8. OVERFILL PR13TECTION INSTALLED/APPROVED (CIS 2635 (b) (2)) <br /> 1 lf,o V/ TANK ACCESS PORTS BROUGHT TO GRADE (LCdCc''s? AND WATEZTIGHT) API <br /> r. . TANK INTEGRITY TEST (PASSING HARD COPY) (CCR 2635 (a) (5)) <br /> MCNITORING PLAN, RESPONSE PLAN AND LOG DOCK ON SITE (CC% 2632 (d)) <br /> 22. "C" FORM COMPLETED AND SUBMITTED p f �� (CCR 26.35 Cd)) <br /> f- I ✓ ! MONITORING METHOD FOR ALL TANKS AND PIPING APPROVE? (cm 2ASO-2636) <br /> /I 6ft ALL =UDITIONS MET; FACILITY PERMIT ISSUED (H+S CODE 252$4) <br /> CCi4MENT:: <br /> EHZ3-x106 9/4s T <br />