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0 NEST LOST INSTALLATION INSPECTION RECD <br /> 1 <br /> f It-------- <br /> ADDRESS: qo <br /> FACILITY NAME: L / TANK l 7ELI ATERIAL- <br /> TANK)t UL# <br /> FACILITY IDA it.c'.A.3: <br /> PRODUCT. <br /> CAPACITY: <br /> A I ALL TANKS TO 3E INSTALLED AND TESTED IN AC CCROANC E <br /> P N uITH MANUFACTURE.@ WRITTEN SPECIFICATIONS <br /> ? I <br /> R T <br /> 4 I <br /> V A <br /> E L <br /> 6 S <br /> ITEM OR EQUIPMENT INSPECTS <br /> DATE (H+s CSE 252$7) <br /> UST ?TANS sum iTTFJ7/ FE`S PAID <br /> UST INSaALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> HCLIDAY: <br /> IHSPEC-4IC}9 AND TEST OF SECONDARY CONTAINMENT= OTHER' <br /> !� 3RINE(LICUID ANNULAR): <br /> ' <br /> ,. ) VAC,n)M: <br /> SOAP: PSI. HRSlMIH: <br /> 4. PRIMAR7 TANK TEST: <br /> PSI, NRSlMIN: <br /> } (APIIPEI} <br /> TANK APPR[7PRIATELT PLACED 11TTH APPROVp 3AC7;FILL <br /> I i PiPIHG IHSPEC�IONS <br /> (CcR 2636 Cel) <br /> 1Z'Z1'6� I I 6- PRIMARY PIPING TEST WINIMUM 4n P51130 MIN) <br /> HRSlMIN: OTHER- <br /> 7. <br /> 2536 (e)) <br /> T, 5£C~NDAR'f PIPING CONTAINMENT TEST PSI: ! (Ca 26. 5 (a7 (477 <br /> 1✓ pS (24 HR. AINI}R.IM) HRS:J � �y� i c�r fill ALL SUN <br /> PEI <br /> " �' 7`I ✓ (/ , UNUSED TANK OPENINGS SEALED AND CvRROSION 7ROTtCTE3 (= 5 (b) (l) (C)) <br /> iJ L OVERSPILL PERFORMAHC'—E TEST (C(2 2636 (b)) <br /> Vf 1. ,ALL PIPING AND FITTINGS =RROSICN PROTEC FD (C.� 2636 (c)(1)} <br /> � PIPING SLOPES TO Cn-LECTIO9 SUMP <br /> FINAL iNSP£CTIOH <br /> (Ca 2.632 (a) (2)) <br /> - � ` V/` I y7 PERFORMANCE TEST FOR "ALL" MONITORING PROSES <br /> 1(jl (CCR 2632 (c) C2)} <br /> } / 4. PERFORMANCE TEST OF mNTINUOUS MONITORING SYSTEM (PANEL) (CCR 2643 (c) (1)) <br /> 15. PERFORM"(= TEST OF LINE LEAK OETECION (� 2636 (9)) <br /> } PERFORMANCE TEST OF AUTOKATIC PUMP S75TEM SHUT-40FF <br /> 17. 3ALL FLOAT VALVES INSTALLED (CSR 2635 (b) (2)) <br /> J 1 g aVERFILL PROTECTION INSTALLED/APPROVED <br /> 1� 'UI I AND slATEitTIGHT) APT <br /> ,r Jb 4 / I tiD TANK ACCESS PORTS 3ROUGHT TO GRADE CL{XXED <br /> (CCR 2635 (a) (5)) <br /> TANK INTEGRITY TEST (PASSING HARD COPY) (CCS 2632 (d)) <br /> MONITORING PLAN, RESPONSE PLAN AND LOG 30OK ON SITE (CCZ Z635 (d)) <br /> P <br /> �22. � FORM <br /> CoMPLETED AND SUBMITTED <br /> MONITORING MET FOR ALL TANKS AND PIPING APPROVF37 <br /> (Ctat 7,6.30-2636} <br /> fH+S CME 252647 <br /> II=T; FACILITY PERMI7 ISSUE <br /> 24. ALL CZWITIOMS ISSUED <br /> CCIMENTd. <br /> cu»t]OA 9/45 7 <br />