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NEU UST INSTALLATION INSPECTION RECORD <br />FACILITY NAME c I r !r r ADDRESS: <br />FACILITY ID* O �g3 TANKS ® UL! TANK ACCELlMATERiAL: S�tv <br />CAPACITY: L&000 PROOUCT: <br />fiTiWFPIFi�I��ti'Eli <br />R, <br />-A <br />I <br />2536 (e)) <br />` <br />VACWM:® SOAP: PSI: H I 3RINE(LIQUIII ANNULAR}; Gnat: <br />N <br />ALL TANKS TO SE INSTALL® AND TESTED IN A <br />PRIMARY TANK TEST: PSI: as/HIM: <br />P <br />t <br />'WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />R <br />T <br />PEI <br />O <br />I <br />CCGt2633 ChD (1) (C)) <br />V <br />A <br />CCCt Z636 (b)) <br />?. <br />E <br />L <br />(C 2536 (c)(1)) <br />D <br />S <br />I20. TANK INTE{6tITY TEST (PASSING HARD COPY) (CCR 2635 (a) (5)) <br />ITE+N OR EQUIPMENT CNSPEChTED <br />GATE <br />1 <br />1 <br />I ZZ. ac" FORM COMPLETED AND SCMITTED <Cwt 2635 (d) ) <br />1 1 123_ MOMITORING XETRW FOR ALL TANKS AND PIPING APPROVED M30-2536) <br />I <br />1. UST PLANS SUiiMITTED/ FEES PAID CN+S =OE 25287) <br />1 <br />12. UST INSTALLATION PLANS APPROVED <br />fiTiWFPIFi�I��ti'Eli <br />R, <br />✓ 16-r+ 3. <br />INSPECTION AND TEST OF SECONDARY 03UTAI _ MUDAY: <br />2536 (e)) <br />` <br />VACWM:® SOAP: PSI: H I 3RINE(LIQUIII ANNULAR}; Gnat: <br />SECONDARY PIPING CONTAINMENTTEST' PSI: IN: d _ <br /><Cwt 2536 (e)) <br />PRIMARY TANK TEST: PSI: as/HIM: <br />1 a_ <br />5. <br />TANK APPROPRIATELY PLACED WITH APPW40 3AWILL (API/PEI) <br />PIPING IINSPECTI <br />FINAL INSPECTION <br />6_ <br />PRIMARY PtPtNG TEST (MINIMUM 40 P4im MIN) <br />2536 (e)) <br />` <br />I_ <br />SECONDARY PIPING CONTAINMENTTEST' PSI: IN: d _ <br /><Cwt 2536 (e)) <br />1 a_ <br />LAKE TEST ON ALL SUMPS (24 HR_ '"NIMUM) HRS: <br />C= 26M (a) (4) ) <br />9. <br />UXJSED TANK OPENINGS SEALED AND =ROSION <br />PEI <br />1 1 (10. <br />OVERSPILL PERFORMANCE TEST <br />CCGt2633 ChD (1) (C)) <br />I11. <br />ALL PIPING Aim FITTINGS C=tCSION PROTECTED <br />CCCt Z636 (b)) <br />?. <br />r/ 19112. <br />PIPING SLOES TO COLLECTION SUMP <br />(C 2536 (c)(1)) <br />FINAL INSPECTION <br />CCHMENTS: <br />E.423-006 9/95 7 <br />V <br />) <br />113. PERFORKPACE TEST FOR "ALL" AGNITORING PROBES Z632 (6) (2) ) <br />AA <br />I <br />14, PERFORMANCE TEST Of CONTI MONITORING SYSM.(PAMM) <LCt202 (a) (2)) <br />II <br />15_ PaFovo= TEST OF LINE LEAK DETECTION (CGI 2543 Cc) (1)) <br />1 S <br />116. PERFORMANCE TEST OF A nWATIC PUMP SYSTEM SHUT -QEF CCwt 26,36 (4) ) <br />I1 <br />J <br />17. BALL FLOAT VALVES INSTALUD <br />ta. OVERFILL ON INSTALLS/ (Cwt 205 (b) (23) <br />?. <br />I ✓1 <br />SI19. <br />TANK ACCESS PORTS BRWGNT TO GRACE (UXXM AMC HATERTIGNT) API <br />1 <br />I20. TANK INTE{6tITY TEST (PASSING HARD COPY) (CCR 2635 (a) (5)) <br />(21. MONITORING PLAN, RESPONSE PLAN AND LOG 3OOK ON SITE CCwt 2632 (d)) <br />1 <br />1 <br />I ZZ. ac" FORM COMPLETED AND SCMITTED <Cwt 2635 (d) ) <br />1 1 123_ MOMITORING XETRW FOR ALL TANKS AND PIPING APPROVED M30-2536) <br />I 1Z4. ALL CCXDITTONNS NET; FACILITY PERMIT ISSUED (H+4 =E 25284) <br />CCHMENTS: <br />E.423-006 9/95 7 <br />