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UNDERGROUND TANK INSPECTION RECORD <br /> NEN TANK INSTALLATION <br /> SITE NAME G[G// �'' cJd�s INSPECTOR'S NAME <br /> ADDRESS ��� �q /�Q� CITY �i-(')( �� ZIP <br /> CONTRACTOR: NAME �/ Q �_— PHONE <br /> OWNER: NAME PHONE <br /> DIS INSPECTOR'S <br /> DATE IPPROVED PPROVED INITIALS <br /> ITEM OR EQUIPMENT INSPECTED <br /> �7 1. Fees paid <br /> 'Icr T Plans Approved r r <br /> CL <br /> INITIAL INSPECTION <br /> 1. UL numbers tank size <br /> . Tank tested upon delivery [Holiday (plasteel) or air at 5 PSI (FRP)) <br /> 3. Visual inspection of secondary containment. <br /> Tank appropriately placed with approved backfill. <br /> z <br /> (PING STAGE INSPECTION _ _ <br /> a. ✓ 1. Pressure test of piping. (Primary and econdary (NFPA 30)) -- <br /> 2. Dell float valves installed. <br /> 3. Overfill protection installed, describe: I <br /> 4. Unused tank opening sealed and cathodically protected. <br /> 5. Visual inspection of secondary containment on piping. <br /> 6. Monitoring ports in place and brought to grade. (lockable weather proof covers) <br /> 7. Fill and vent piping brought to grade. <br /> a ko <br /> B. Product It 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 /> 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 pr uct ine t <br /> l �ak detector. Hard wired)All P C'y L <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 /> FH 23 9� <br /> 1 10. <br /> EH 23 006 /89 <br />