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NEW UST INSTALLATION INSPECTION RECORD <br /> FACILITY NAME: Pyq (f ADDRESS: t.�,7V t4-jW-e <br /> FACILITY ID# 8s TANK#-607/*lv UL# TANK MODEL/MATERIAL:'" <br /> CAPACITY: 7'v1G SPc�T 1 K y7 yr PRODUCT: /e5-iry ciZ <br /> R.E.H.S: <br /> A I <br /> P N ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br /> P I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br /> R T <br /> 0 1 <br /> V A <br /> E L <br /> D S <br /> ITEM OR EQUIPMENT INSPECTED <br /> DATE <br /> 9/ 1. UST PLANS SUBMITTED/ FEES PAID (H-S CODE 25287) <br /> 2. UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> 1q' ri 3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: j <br /> VACUUM: SOAP: PSI: HRJ(/ t Jl.� BRINE(LIQUID ANNULAR): OTHER: <br /> PRIMARY TANK EST: PSI: HRS/MIN: <br /> p i/ 5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (API/PEI) <br /> PIPING INSPECTIONS <br /> �/ lU ✓ 6. PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) (CCR 2636 (e)) <br /> �� f� ✓ 7. SECONDARY PIPING CONTAINMENT TEST PSI: We- <br /> HRS/MgL, U OTHER: (CCR 2636 (e)) <br /> ,✓ 8. LAKE TEST ON ALL SUMPS (24 HR. MINIMUM) HRS: (CCR 2635 (a) (4)) <br /> // d ( 9. UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED PEI <br /> I/ 10. OVERSPILL PERFORMANCE TEST (CCR 2635 (b) (1) (C)) <br /> II r 1. ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2636 (b)) <br /> 12. PIPING SLOPES TO COLLECTION SUMP (CCR 2636 (c)(1)) <br /> FINAL INSPECTION <br /> 'fes PERFORMANCE TEST FOR "ALL" MONITORING PROBES (CCR 2632 (c) (2)) <br /> PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (c) (2)) <br /> �e,•155. PERFORMANCE TEST OF LINE LEAK DETECTION (CCR 2643 (c) (1)) <br /> • y PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (CCR 2636 (D)) <br /> v 17. BALL FLOAT VALVES INSTALLED <br /> 1D� 14X05- OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635 (b) (2)) <br /> xjgTANK ACCESS PORTS BROUGHT TO GRADE CLOCKED AND WATERTIGHT) API <br /> XW TANK INTEGRITY TEST (PASSING HARD COPY) (CCR 2635 (a) (5)) <br /> 21. MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE (CCR 2632 (d)) <br /> A�(/' ✓ "C" FORM COMPLETED AND SUBMITTED (CCR 2635 (d)) <br /> (/ 23. MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (CCR 2630-2636) G <br /> �24. ALL CONDITIONS MET; FACILITY PERMIT ISSUED (H-S CODE 25284) �tl <br /> COMMENTS: <br /> EH23-006 9/95 <br /> 10 <br />