Laserfiche WebLink
NEW UST INSTALLATION INSPECTION RECORD i <br />AGILITY <br />NAME: tici.tC -(a <br />ADDRESS: q31,5_ 3f,5_ <br />�� C <br />ACILITY <br />ID# 1 TANK# <br />UL# <br />TANK MODEL/MATERIAL: <br />:APACITY: <br />PRODUCT: <br />2 Q <br />R.E.H.S: <br />INITIAL INSPECTIONS <br />A <br />I <br />VACUUM: SOAP: PSI: HRS/MIN: BRINE(LIQUID ANNULAR): OTHER: <br />P <br />N ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br />2636 <br />P <br />I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />R <br />T <br />7. <br />0 <br />1 <br />2636 <br />V <br />A <br />E <br />L <br />8. <br />D <br />S <br />2635 <br />(a) <br />ITEM OR EQUIPMENT INSPECTED <br />DATE <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (� �e <br />K <br />Qu (C R <br />9. <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287) <br />L °f <br />UST INSTALLATION PLANS APPROVED <br />INITIAL INSPECTIONS <br />PIPING INSPECTIONS <br />tld <br />3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br />VACUUM: SOAP: PSI: HRS/MIN: BRINE(LIQUID ANNULAR): OTHER: <br />PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) Ll ?j F <br />4. PRIMARY TANK TEST: PSI: HRS/MIN: <br />2636 <br />5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (API/PEI) <br />PIPING INSPECTIONS <br />FINAL INSPECTION <br />tld <br />6. <br />PRIMARY PIPING TEST (MINIMUM 40 PSI/30 MIN) Ll ?j F <br />(CCR <br />2636 <br />(e)) <br />4. <br />7. <br />SECONDARY PIPING CONTAINMENT TEST PSI: HRS/MIN: OTHER: <br />(CCR <br />2636 <br />(e)) <br />rsi <br />5. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />8. <br />LAKE TEST ON ALL SUMPS (24 HR. MINIMUM) HRS: <br />(CCR <br />2635 <br />(a) <br />(4)) <br />16. <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (� �e <br />K <br />Qu (C R <br />9. <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />PEI <br />17. <br />BALL FLOAT VALVES INSTALLED <br />0. <br />OVERSPILL PERFORMANCE TEST <br />(CCR <br />2635 <br />(b) <br />(1) (C)) <br />(CCR <br />2635 <br />(b) (2)) <br />11. <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCR <br />2636 <br />(b)) <br />API <br />yP <br />2. <br />PIPING SLOPES TO COLLECTION SUMP <br />(CCR <br />2636 <br />(c)(1)) <br />FINAL INSPECTION <br />COMMENTS: <br />EH23-006 7/97 <br />10 <br />tld <br />13. <br />PERFORMANCE TEST FOR "ALL" MONITORING PROBES <br />(CCR <br />2632 <br />(c) (2)) <br />4. <br />PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) <br />(CCR <br />2632 <br />(c) (2)) <br />.a� <br />L <br />5. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR <br />2643 <br />(c) (1)) <br />�..1 <br />16. <br />PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (� �e <br />K <br />Qu (C R <br />2636 <br />(g)) <br />17. <br />BALL FLOAT VALVES INSTALLED <br />18. <br />OVERFILL PROTECTION INSTALLED/APPROVED <br />(CCR <br />2635 <br />(b) (2)) <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />API <br />20. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR <br />2635 <br />(a) (5)) <br />0\ <br />3� <br />1. <br />MONITORING PLAN, RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCR <br />2632 <br />(d)) <br />X11-0( <br />2. <br />"C" FORM COMPLETED AND SUBMITTED <br />(CCR <br />2635 <br />(d)) <br />�3. <br />MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED <br />(CCR <br />2630-2636) <br />24. <br />ALL CONDITIONS MET; FACILITY PERMIT ISSUED <br />(H+S <br />CODE <br />25284) <br />COMMENTS: <br />EH23-006 7/97 <br />10 <br />