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UNDERGROUND TANK INSPECTION RECORD <br />NEW TANK INSTALLATION <br />SITE NAME aH f orrolJ S <br />,,,ADDRESS <br />CONTRACTOR: NAME _ <br />OWNER: H/lME Fy�'�` /� �a • % 7i -- PHONE �0 % ` Y' 2 3— S,2G <br />!. C r - 0 r11. 1 u c- 4 -.. 7 4t: t c.. 1 <br />INSPECTOR'S NAME Gi 6c7 i G Z::� <br />CITY A ZIP <br />PHONE <br />Comments: <br />EH 23 006 10/89 <br />L: <br />INSPECTOR'S <br />INITIAL INSPECTION <br />1. UL numbers tank size <br />DATE <br />kPPROVED <br />PPROVED INITIALS <br />2. Batt float valves installed. <br />ITEM OR EQUIPMENT INSPECTED <br />3. Overfill protection installed, describe: <br />1. Fees paid <br />P. Ptens Approved <br />4. Performance test of product line leak detector. (Hard wired) <br />Comments: <br />EH 23 006 10/89 <br />INITIAL INSPECTION <br />1. UL numbers tank size <br />. Tank tested upon delivery [Holiday (plasteel) or air at S PSI (FRP)] <br />Visual inspection of secondary containment. <br />Tank appropriately placed with approved backfitl. <br />Comments: <br />EH 23 006 10/89 <br />(PING STAGE INSPECTION <br />1. Pressure test of piping. [Primary and Secondary (NFPA 30)] <br />2. Batt float valves installed. <br />3. Overfill protection installed, describe: <br />4. Performance test of product line leak detector. (Hard wired) <br />4. Unused tank opening seated and cathodicaliy protected. <br />5. Performance test of continuous monitoring system(s) on tank (s) <br />5. Visual inspection of secondary containment on piping. <br />b. Permit to operate application complete. <br />b. Monitoring ports in place and brought to grade. (lockable weather proof covers) <br />Acceptable recordkeeping system. <br />7. Fill and vent piping brought to grade. <br />8. Product line leak detector in ptace. (Hard wired) <br />9. Approved tank leak monitoring device instalted. <br />10. Alt galvanized piping and fittings property wrapped. <br />11. Pressure decay test on complete tank and product delivery system. <br />Comments: <br />EH 23 006 10/89 <br />FINAL INSPECTION <br />1. Precision test successfully completed and hard copies received. (NFPA 329) <br />2. spill 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 />b. Permit to operate application complete. <br />LJ7. <br />Acceptable recordkeeping system. <br />Comments: <br />EH 23 006 10/89 <br />