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s <br />UNDERGROUND TANK INSPECTION RECORD <br />NEN TANK INSTALLATION <br />SITE NAME II ( INSPECTOR'S NAME <br />...ADDRESS ( J4 0 27717 / elf CITY 21P A52D4_ <br />CONTRACTOR: NAME IlJ ®IL( PHONE <br />OWNER: NAME PHONE <br />DIS INSPECTOR'S -- <br />DATE kPPROVED kPPROVEb INITIALS <br />ITEM OR EQUIPMENT INSPECTED <br />1. fees paid <br />2 „ . Plans Approved <br />Coanents: <br />EN 23 006 10/89 — -- <br />INITIAL INSPECTION <br />1. UL nurbers3IDL46 tank size ( D f boo qAL- <br />PIPING STAGE INSPECTION %Q- °� <br />Pressure test of piping. (Primary and Secondary (NFPA 30)) <br />r y <br />2. tank tested upon delivery [Holiday (plasteel) or air at 5 PSI (FRP)) <br />.�, <br />2. Ball float valves installed. <br />. Visual inspection of secondary containment. <br />2. Spill protection at fill pipe.. <br />. Tank appropriately placed with approved backfill. <br />Coanents: <br />EN 23 006 10/89 — -- <br />PIPING STAGE INSPECTION %Q- °� <br />Pressure test of piping. (Primary and Secondary (NFPA 30)) <br />r y <br />.�, <br />2. Ball float valves installed. <br />2. Spill protection at fill pipe.. <br />3. overfill protection installed, describe: 1 f <br />3. Performance test of overfill protection system., <br />'r °L <br />Unused tank opening sealed and cathodically protected. 00 UjI(%54 <br />q( <br />4. Performance test of product line teak detector. (Hard wired) <br />5. Visual Inspection of secondary containment on piping. <br />--�j <br />6. Monitoring ports In place and brought to grade. (lockable weather proof covers) <br />g <br />7. Fill and vent piping brought to grade. ? <br />f �I <br />-V/ <br />/ �✓ <br />8. Product line teak detector in place. (Hard wired) <br />{ of <br />7. Acceptable recordkeeping system. <br /><V <br />97 Approved tank teak monitoring device installed. e <br />akk� 547 <br />�( <br />10. All galvanized piping and fittings properly wrapped. <br />11 ? Pressure decay test on complete tank And product delivery system. <br />Coanents: <br />EN 23 006 10/89 — -- <br />FINAL INSPECTION <br />1. Precision test successfully completed and hard copies received. (NFPA 329) <br />2. Spill protection at fill pipe.. <br />3. Performance test of overfill protection system., <br />'r °L <br />4. Performance test of product line teak detector. (Hard wired) <br />5. Performance test of continuous monitoring system(s) on tank (s) <br />6. Permit to operate application complete. <br />7. Acceptable recordkeeping system. <br />Coanents: <br />EN 23 006 10/89 — -- <br />