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UNDERGROUND TANK INSPECTION RECORD <br /> NEW TANK INSTALLATION �} <br /> SITE NAME S%�Y'.C�%071/ �E�-JQ INSPECTOR/'S NAME O-akol oz- <br /> ADDRESS CITY ZIP <br /> CONTRACTOR: NAME 121-*1-1`1e, /Lc- La ale PHONE <br /> OWNER: NAME PHONE <br /> DIS INSPECTOR'S <br /> DATE ;PPROVED PPROVED INITIALS <br /> ITEM OR EQUIPMENT INSPECTED <br /> - 1. Fees paid <br /> Plans Approved <br /> ANv f6-?7[V- INITIAL INSPECTION <br /> 1. UL numbers tank size G , <br /> . Tank tested upon delivery [Holiday (plasteel) or air at 5 PSI (FRP)I <br /> / . Visual inspection of secondary containment. <br /> . Tank appropriately placed with approved backfill. <br /> (PING STAGE INSPECTION <br /> 1. Pressure test of piping. [Primary and Secondary (NFPA 30)) <br /> } 2. Ball float valves installed. <br /> 3. Overfill protection installed, describe: <br /> G� 4. Unused tank opening sealed and cathodically protected. <br /> L 5. Visual inspection of secondary contairrrient 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 /> r�J�yQ Gni 8. Product line 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 product line leak detector. (Hard wired) <br /> �/5 G 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 /> EN 23 006 10189 <br />