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t <br /> Model Number:__ s— /00 / <br /> ____ Sensor Type: ____Vapor____Liquid____Both. <br /> Sensor Brand: Sensor Model:___________ <br /> ____ Location(s)for sensors[Indicate location of sensor(s)with check mark]: <br /> _►''Tank: Sensor Brand:__�V�o __Sensor ModeI:IS L C f S <br /> ✓PJJ'ping: Sensor Brand:-=i NGo^� _Sensor Model: Vie—UE S <br /> ✓bispenser:Sensor Brand:__ 7;�CO^r_Sensor Model:$ ®yGS <br /> _----Other(specify):---------- Sensor Brand:____________Sensor <br /> Model: <br /> C. Monitoring and response plan submitted[Section 2632(d)(1)&(2)]. <br /> 15. ____ Any special accessories,fittings,coatings,or linings not inherent within the initial design of the 1°tank or double- <br /> wall UST. [Section 2631 (b)] <br /> ®� A A Approved by a nationally recognized independent testing organization. <br /> 'v B. Demonstration of integrity with the primary and/or secondary containment. <br /> 16. ____ Tanks subject to floatation. [Section 2635(a)(7)] <br /> A. Anchored by deadman or slab. <br /> B. Anchors to be installed as specified by manufacturer. <br /> C. Installation details provided on plans. <br /> D. Calculations provided. <br /> 17. SPILL AND OVERFILL PREVENTION S 7-1ik G, <br /> ____ Underground storage tank equipped with spill container and an overfill prevention system. (detail drawing of spill <br /> container(s)/piping sump(s)required,including tank fill and all openings). <br /> A Spill container[Section 2635(b)(1)]. <br /> /® ____ If made of metal,exterior wall protected from galvanic corrosion. <br /> Capacity:(minimum of five gallons) <br /> ____ Equipped with a drain valve which allows drainage of spill into primary container. <br /> Manufacturer:________________________ <br /> B. Overfill prevention system does not allow for manual override and meets one of the following <br /> requirements: <br /> (1) Alert transfer operator at 90%m full by restricting the flow into the tank or triggering an audible and <br /> visual alarm[Section 2635(b)(2)(A)]. <br /> ( Y( Manufacturer: Model:_---------------------- <br /> (2) <br /> ________ .(2) Restrict delivery flow to the tank 30 minutes before overfill when tank is filled at no more than <br /> 95%capacity and activates an audible alarm at least five minutes before overfill[Section <br /> 2635(b)(2)(B)]. <br /> Manufacturer: Model: _________ <br /> (3) Provide positive shut off at no more than 95%capacity[Section 2635(b)(2)(C)]. <br /> Manufacturer: Model:----------------------- <br /> (4) <br /> __________ .(4) Provide positive shut-off of flow to the tank so that the fittings on top of the tank are not exposed to <br /> 7 <br />