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IVCYV U.` IIVJ I ALL A 1 IUN JNbPtl: I SUN Fir )HU <br /> .ITY NAME: ADDRESS: <br /> 9y <br /> :EPSP TANKil ULf TANK MODEL/MATERIAL: <br /> CAPACITY: /0PRODUCT:(� �/ <br /> /\ � f�� R.E.H.S: <br /> A I <br /> P N ALL TANKS TO BE INSTALLED AND TESTED 1N ACCORDANCE <br />' P I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br /> R T <br /> 0 1 <br /> V A <br /> E L <br /> D S <br /> DATE <br /> ITEM OR EQUIPMENT INSPECTED <br /> 1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (8) <br /> UST INSTALLATION PLANS APPROVID p����� 1�F� (CCR 2635 (E) (5)) <br /> INITIAL INSPECTIONS <br /> 3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br /> VACUUM: SOAP: PSI: HRS/MIM: BRINE(LIOUID ANNULAR): OTHER: <br /> 4. PRIMARY TANK TEST: PSI: HRS/MIN: <br /> 5. TANK APPROPRIATELY PLACID WITH APPROVED BACKFILL (CCR 2635 (A) (3) (4) (6)/ API/PEI) <br /> PIPING INSPECTIONS <br /> 6. PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) '. (CCR 2635 (B) (4)) <br /> 7- SECONDARY PIPING CONTAINMENT TEST PSI:Z HRS/MIN:/*f , OT R: (CCR 2635 (A) (4)) <br /> J 8. LAKE TEST ON ALL SUMPS (24 HR. MINIMUM) NRS: Z (CCR 2635 (A)) <br /> (Z� q 1/ vI 9. UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED (CCR 2635) <br /> 10. OVERSPILL PERFORMANCE TEST (CCR 2635 (A) (4)) <br /> �= 1. ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2635 (8)) <br /> FINAL INSPECTION <br /> Gj 1 12. PERFORMANCE TEST FOR -ALL- MONITORING PROBES (CCR 2632 (C) (2)) <br /> 13. PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (A) (2)) <br /> v(G{ ✓ ( 14. PERFORMANCE TEST OF LINE LEAK DETECTION <br /> (CCR 2632 (D) 2635 (e) (5)) <br /> 15. PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (CCR 2635 (8) (5)) <br /> R 116. BALL FLOAT VALVES INSTALLED (CCR 2635 (B) (6)) <br /> 17. OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635-(E) (2)) <br /> l2 1 18. TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AMD WATERTIGHT) (CCR 2631 (D) (5)) <br /> 1 19. TANK INTEGRITY TEST (PASSING HARD COPT) <br /> (CCR 2635 (A) (5)) <br /> f 7- <br /> / q 20. MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE (CCR 2632 (E) (1) (2)) <br /> ��/ ✓ ��( 21. •C• FORM COMPLETED AND SUBMITTED <br /> (CCR 2635 (E)) <br /> �� 22. MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (CCA 2641-2644) <br /> (2 3J q 23. ALL CONDITIONS MET; FACILITY PERMIT ISSUED (H+S CODE 25284 (E) (F)) <br /> COMMENTS: <br /> EH23-006 3/92 (REVISED 11\92) <br /> 8 <br />