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i <br /> )rates <br /> UNDERGROUND TANK. TNSPECTION RECORD <br /> / NEW TANK INSTALLATION <br /> SITE NAME Dii /�nd�-� INSPECTOR'S NAME / ) <br /> /' c ��• !/� J <br /> ADDRESS S� <br /> l�� _CITY+ ZIP _ <br /> TELEPHONE <br /> CONTRACTOR: NAME <br /> TELEPHONE <br /> OWNER: NAME <br /> DIS- INSPECTOR'S <br /> DATEAPPROVF,D APPROVED INITIALS ITEM OR EQUIPMENT INSPECTED_ <br /> t sb ./ <br /> 1319,0 IN IT[Al. INSPECTION `�R/rV %o <br /> CAlj � 1, Tank tested u on deliver Holida lasteel) ur�lair at SPS1 RP)I <br /> 2, Visual inspection of secondar containment. <br /> 3. Tank a ro riately laced with approved backfill. (O OM <br /> 4, UL numbers and tank ca acities recorded. &a5 - <br /> t,�} � '831 3-�o,o�o -c->�.>•.D-z. �.L.•mss t��3� _ °� <br /> ,t( '� � PIPING STAGE INSPECTION <br /> rVrp I. Pressure test of ti tin . PI mar and Secondar FPA(N3tl) <br /> All $ 2. Ball float valves tnstalled. <br /> 3. Uverf111 protection installed, describe: <br /> } D 4, Unused tank o tettin's scaled and cathodically protected. <br /> 5. Visual ins ection oC secondary containment on i 1(ltxkeb e .roether prop <br /> oZ la Mot o 111 a and brought to rade. covers <br /> -779 7. Fill and vent piping hrou hl to rade. <br /> ✓ 0.O8. Product line leak detector in lace. (Hard wired) <br /> Ib �n 9. Approved tank leak atonitorin device installed. <br /> b �h 10. All galvanized piping and fitt.in s properly wrapped. % <br /> ll. Pressure deco teat on com lets tank and product deliver s aLem. <br /> I FINAL it:SPECTION <br /> Precision Lest scc,es.%(ulIy c.im tleted ai-d hard co ties. received!%S <br /> 7, <br /> -pill protectiou at. (ill "is'- <br /> l2 'l 7' 3. Performance test of overfill It ut t•r t.ltrn :•.vst em. <br /> 4. Per(u:mance tc ttC trudur, lino leak dctectot. (11ard wired)KL 6k herd <br /> 5, Per(ormenee te:a of c +ntinuuus muulttrin s stem s) on <br /> ` 6. Prlmit to operate at licatiou t-om,letc. <br /> 7. Acce table recordkee in s stem, ` <br /> /yl nty[ 11it JA141 rtL�Q-I�f-� I�`l�le 1 Gi�ill��(oL-moi Lam__L•� <br />