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UNDERGROUND TANK TNSPECTION RECORD <br /> NEW TANK INSTAL.L.ATION <br /> SITE NAME INSPECTOR'S NAME <br /> ADDRESSGam / e! rU�% C. L�L7J CIT n -'._) ZIP <br /> CONTRACTOR: NAME (��? ['�� yQ"� TELEPHONE <br /> OWNER: NAME TELEPHONE <br /> DIS- INSPECTOR'S <br /> DATE APPROVED APPROVED INITIALS rr <br /> ) ' TEl OR EQUIPMENT INSPECTED <br /> I pa id <br /> t <br /> tl = <br /> IN_IT IA1. INSPECTION <br /> 1. Tank tested upon delivery IH.lid. ;Iasteel) or air at SPSI (FRP)) <br /> 2. Visual inspection of secondary containment. <br /> 3. Tank appropriatel laced with approved backfill. <br /> 4 UL numbers and tank capacities recorded. <br /> v)F`a O✓ ''-"�PING STAGE INSPECTION <br /> ' 1. Pressu test of a>in lPrimar and Sccondar (NFPA 3O)1 <br /> 2. Ball float valves installed. <br /> 3. Overfill protection installed. descriltc: <br /> 4. Unt:sed tank openings scaled and cathodically protected. r, <br /> 5. Visual ins eclton of secondary containeent on piping. <br /> (Ixkebt• veet Mr prop <br /> n (n a e and btuu ht to rade. ewers) <br /> 7. Fill and vent piping brought to grade. <br /> B. 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 com 1CLe Lank and product delivery s sLemV <br /> I FINAL. It:SPF.CTION <br /> c E <br /> Precision Lest successiull i.Imnleted ar.d hard i..ales received.g79S <br /> 7. Spill protectinii at fill r .r. <br /> 3. Performance test of m•4-rf111 lit p or ion r.vsteo. _ <br /> 4. Prrfj.rmaoce toll of rtodur, line rc.rk dcrectot. (Hard wired) <br /> N1�?rd <br /> 5. Performance te:;t of continuous r.mrt utrt s• srrm(s) on tank(:)M rr <br /> 6. Petalt to o aerate appjjcakj,.0 (om,Icte. <br /> 7. Acceptable recordkeeping s stew. <br />