Laserfiche WebLink
NEW UST ;TALLATION INSPECTION A <br />FACILITY NAME.TA <br />/ADDRESS_ <br />�-Syy <br />StS► l.' ?TAME`� tJl3 TURK <br />J f <br />CAPACITY:( ( fPRODUCT: <br />TERIAL: <br />11 INITIAL. INSPECTIONS <br />A <br />I <br />VACUUM: SOMA: PSI: NRSIMIN: / SRINE(LIOUID ANWILAR): OTHER: <br />PRIMARY PIPING TEST (MINIMUM 40 PSI= MIA) <br />P <br />NALL <br />TANKS TO BE INSTALLED AND TESTED IN ACCINRDANCE <br />P <br />I <br />WITH MANUFACTURER WRITTEN SPECIFICATIONS <br />HR S/MIN: h e- OTHER: <br />R <br />T <br />t <br />- <br />O <br />I <br />HRS: <br />(CCR 2635 CA)) <br />V <br />A <br />7PT9. <br />(CCR 2635 (E) (2)) <br />E <br />L <br />U <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />D <br />S <br />OVERSPILL PERFORMANCE TEST <br />19. <br />CCCR 2635 (A) (4)) <br />(CCR 2635 (A) CS)) <br />ITEM OR EQUIPMENT INSPECTED <br />DATE <br />1. <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCL 2632 (E) Cl) C2)) <br />!'�4�1i <br />✓ <br />/ <br />1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287, CCR 2635 (D) (13) <br />(CCR 2635 (E)) <br />Z2. <br />MONITORING 14ETHCD FOR ALL TANKS AND PIPING APPROVED <br />(CCR 2641-2644) <br />2. UST INSTALLATION PIANS APPROVED (CCR 2635 CE) 63) <br />11 INITIAL. INSPECTIONS <br />PIPING INSPECTIONS <br />If <br />pp <br />3. INSPECTION AND TETT OF SECONDARY CONTAINMEIT:�,,1c <br />VACUUM: SOMA: PSI: NRSIMIN: / SRINE(LIOUID ANWILAR): OTHER: <br />PRIMARY PIPING TEST (MINIMUM 40 PSI= MIA) <br />F)� -�;�Ur rww- <br />4. PRIMARY TANK TEST:, � �, PSI: ��/-. HRS/MIN:,�_`r <br />lDo <br />5. TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (CCR 2635 (A) (3) (4) C6)/ API/PEI) <br />PIPING INSPECTIONS <br />If <br />pp <br />f 12. <br />13. <br />6. <br />PRIMARY PIPING TEST (MINIMUM 40 PSI= MIA) <br />F)� -�;�Ur rww- <br />(CCR 2635 (8) (4)) <br />�lV <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />✓ W7. <br />SECONDARY PIPING CONTAINMENT TEST PSI . <br />HR S/MIN: h e- OTHER: <br />(CCR 2635 (A) (4)) <br />(CCR 2635 (B) CS)) <br />t <br />- <br />8. <br />LAKE TEST ON ALL SUMPS C74 BR_ MINIMUM) <br />HRS: <br />(CCR 2635 CA)) <br />17. <br />7PT9. <br />(CCR 2635 (E) (2)) <br />UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED <br />(CCR 2635) <br />U <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />(CC2 2631 (D) (5)) <br />10. <br />OVERSPILL PERFORMANCE TEST <br />19. <br />CCCR 2635 (A) (4)) <br />(CCR 2635 (A) CS)) <br />0 <br />V <br />1. <br />ALL PIPING AND FITTINGS CORROSION PROTECTED <br />(CCL 2632 (E) Cl) C2)) <br />(CCR 2635 (B)) <br />l/ FINAL INSPECTION <br />I� <br />I <br />f 12. <br />13. <br />PERFORMANCE TEST FOR 'ALL• MONITORING PROBES <br />PERFORMANCE TEST OF CONTINLICUS MONITORING SYSTEM (PANEL) <br />(Ctrl 2632 (C) (2)) <br />CCCR 2632 (A) (2)) <br />14. <br />PERFORMANCE TEST OF LINE LEAK DETECTION <br />(CCR 2632 (D) 2635 (8) (5)) <br />/'05. <br />PERFORMANCE TEST OF AUTOMATIC PIMP SYSTEM SHUT-OFF <br />(CCR 2635 (B) CS)) <br />t <br />16. <br />BALL. FLOAT VALVES INSTALLED <br />(CCR 2635 (8) (6)) <br />17. <br />OVERFILL PROTECTION INSTALLED/APPROVED <br />(CCR 2635 (E) (2)) <br />1 <br />18. <br />TANK ACCESS PORTS BROUGHT TO GRADE (LOCKED AND WATERTIGHT) <br />(CC2 2631 (D) (5)) <br />19. <br />TANK INTEGRITY TEST (PASSING HARD COPY) <br />(CCR 2635 (A) CS)) <br />20. <br />MONITORING PLAX, RESPONSE PLAN AND LOG BOOK ON SITE <br />(CCL 2632 (E) Cl) C2)) <br />2 <br />1. <br />-C- FORM COMPLETED AND SUBMITTED <br />(CCR 2635 (E)) <br />Z2. <br />MONITORING 14ETHCD FOR ALL TANKS AND PIPING APPROVED <br />(CCR 2641-2644) <br />ALL CONDITIONS MET; FACILITY PERMIT ISSUED <br />(H+S CODE 25284 (E) (F)) <br />CCWENTS: <br />::H23--006 3/92 (REVISED 11\92) <br />I <br />