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Tank Installation Checklist <br />For Fiberglass Underground Tanks JAN 03 2019 <br />The tank installation checklist, these instructions, and any correspondence related to the tank my tallation must'be ) <br />retained by tank owner. This checklist will be required and must be provided to CSI when making a warranty claim,, r AAL 9 <br />Site Owner _ ['_. / f �'^ ' K ` . `!%` ' Date of Installation' 7 `� <br />Site Address <br />Street �•c City State <br />Zip . <br />Installing Contractor <br />Company Street City <br />!( State <br />Completed <br />1. Installation backfill material meets CSI specification (sieve analysis is attached). ✓ <br />Indicate which material you used: ® Pea Gravel <br />❑ Crushed Stone <br />❑ Other (CSI approval letter attached) <br />2. Backfill above tank top. <br />Indicate which material you used: Same backfill material as #1 above <br />❑ Geotextile and alternative material above tank top <br />3. Excavation and tank clearance meet requirements of Section 6. <br />4. Geotextile used to line excavation: ❑ Yes ® No <br />5. Indicate hole condition: <br />E Dry hole (Water is not anticipated to reach tank - area is not subject to flooding) <br />❑ Wet hole (Excavation may trap water - area is subject to flooding) <br />6. Anchoring performed in accordance with installation instructions: <br />Indicate which method you used IN Deadmen <br />❑ Anchor Pad <br />❑ No mechanical anchoring <br />p <br />N/A <br />7. <br />Depth of backfill under tank /c� inches <br />8. <br />All deflection measurements are recorded on reverse side. <br />9. <br />Backfill placed in 12" lifts & probed as described in Section 11. <br />10. <br />Tanks ballasted according to Section 10. <br />,jam <br />11. <br />Tank burial depth complies with the requirements of Section 8. <br />12. <br />Piping and bottom sump clearances according to Section 13. <br />✓ <br />13. <br />All piping connections are flexible connections according to Section 13. <br />✓ <br />Installation was in accordance with Tank Installation Instructions (INST. 6001). <br />Owner Representative (Print Name) Date Contractor Representative (Print Name) Date <br />Owner Representative (Signature) Date 30 Contractor Representative (Signature) Date <br />