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UNDERGROUND TANK TNSPECTION RECORD <br /> NEW TANK INSTALLATION <br /> SITE NAME���)VIIVIt _ INSPECTOR'S NAME: ELL <br /> ADDRESS_ 4 (7 b ,7 �Gvy,�� _ C ITY� Zip <br /> CONTRACTOR: NAME TELEPHONE <br /> J <br /> OWNER: NAME TELEPHONE <br /> DIS- INSPECTOR'S <br /> DATE. APPROVED APPROVED INITIALS <br /> TEM OR EQUIPMENT INSPECTED <br /> Fee na td <br /> ns Annrnged <br /> lr1-? �� ✓ <br /> INITIAL INSPECTION <br /> 1, Tank tested upon deliver Hnlida lasteel) or air at SPSI FRP <br /> 2. Visual Inspection of secondary containment. <br /> 3. Tank appropriately placed with approved backfill. <br /> £- t <br /> 4. UL numbers and tank ca amities recorded-5s?" <br /> � �7 ,L <br /> PIPING STAGE INSPECTION <br /> 1. Pressure test of pitting; - JLIP <br /> 2. Ball float valves installed. <br /> 3. Uverf(ll protection in,lalled. descrihc: <br /> 4. Unused tank openings scaled and cathodicaLly protected. <br /> S. Visual inspection of secondary containment on piping. J <br /> (lockable t"ther prop <br /> 6. Hottitorinx ports In place and by-ought to jrpde. trovers <br /> 7. Fill and vent piping broulthL to xrade. <br /> 8. Product line leak detector in place. Hard wired) <br /> 9. Avvroved tank leak ■onLtorin device Installed. <br /> LO. All galvanized piping and fittings properly wrapped. Ht(�� <br /> 1. Pressure deca test on Complete tank and product deliver s atem(30P <br /> FINAL INSPECTION <br /> t . Precision test succc•ssiull c <br /> �.�■ Ictd .11,dt•d hard i.•,lCs received! <br /> 7. Spill rotectiou at. fill pol.r. <br /> 3. Performance test of nc.:rflil i(,tertiun ::vstcm. <br /> 4. Ptrfurmance test of trodu. t Itnt• Irak detectot . (Hurd wired) <br /> 1�b rd <br /> 5. Performanct te:u of c•rotlnuuu:; min.itnrinr s• stem(n) on tank(s)M trtt <br /> 6. Vetmlt to o>eratt aplication tum.lett <br /> 7. Acceptable recordkee in s etem. <br /> �arrtxr: i <br /> •6� <br /> f ' <br />