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•. � is � ,; � � �. (♦ "1 � <br />(Please review the important Notice section on page 2 before <br />A. Omer/Operator (please print & alga noose) <br />1. Job Site Add:tsa <br />2. Job Site Rcpresentacriz <br />B. installation Contractor <br />1. Job Site Fortran (please print & sigh name) <br />C. IastaLiation Dates) <br />D. Pipe Manufacturer <br />To Be Initialled &r. <br />E. PRE-LVSTAL.LA-MON CHECE (indicate dste verified atter each Item) Installer's Owner/Operator's <br />1. Installer shall show evidence that he/she W Fomnnan Representative <br />a. Licensed or certified by the state tmpkacntL^.g a&_ncy, or <br />b. Trained by the pipe manufacturer. <br />2. Installer has current rranufaeturtr's installation instruct!on-& <br />a. Instructions dated <br />b. Installation manual number <br />3. Pipe & fittings have UL (Underwriters' laboratories) or G'L.0 <br />(Underwriters' Laboratories of Canada) Label. <br />4. Proper tools and adhestve available per manufacturer's lmtructions. <br />S. Pipe & fittings Inspection: <br />a. Impact or puncture_ .. Cut out. See footnote (1) for repairs. <br />b. Da=w4cd tapers... Cut off and retaper. <br />c. Check bonding surfaces'for ultrwlokt weathering dc&-adaCon- <br />6. Trench <br />a. Allow for minimum of 6' bedding asatcrial. <br />b. Have required slope per owners 3pCCi8C2a0a. <br />c. Width: Allow for 4' minimum separation between <br />4= pipes and 6- minimum &oar trench wa1Ls. <br />7. Approved backfill (m native soW <br />a. Clean washed sand, or <br />b. pea gravel - 1/8' to 3/4' particle size, or <br />c. Refer to footnote (1) for other backfill materials. <br />F. L`tSTAL.LATTON PROCED9R.E.4 (indicate date verified after each It--=) <br />1. 6' of approved bedding materiel. <br />2. Dry tit system prior to adhesive bonding. See footnote (1) <br />3. Heat assist required for adhesive cuhng when <br />temperature is below 702F (2190). <br />4. Use flcdble connector or a minimum 4' straight run of FRP pipe <br />(per Apt 16 15) at FRP pipe terminations. <br />S. A minimum separation of 4- between pipe tuns. and 2 1/2' on crossovers. <br />6. Bedding/backfLU supports pipe completely on runs and erosaovers. <br />7. Minimum of 6' approved beck811 cover material or <br />more as required by bat authorities. <br />S. If surface is unpaved. a minimum of 20' of approved backfill is required. <br />G. LYSPFCV-01f AYD 3E5T11 9 (Indicate date verified after each ltesa3 <br />1. Joint inspection <br />a. Cocked Joints (misaligned tapers). See footnote (2) <br />b. Joint back-o2'See footnote (2) <br />c. Check for proper cure of adhesive bond. See adhesive kit irsstrucdons. <br />Qi 2. Test system in accordance with NFPA 30 or local <br />requirements. See footnote (3) <br />3. Secondary containment piping. See footnote (1) <br />Prepared by. Fiberglass Petroleum Tanis at Pipe Institute, One SeaGate. Suite 1001. Toledo. Ohio 43604. <br />Phone: 419-247-5412. Fax: 419-247-5421 <br />