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e /e <br /> IINIIERGROUND TANK 1 HSPECTtON N1a'UHIt <br /> to <br /> • NEW TANK 1 NSTALI.AT I ON T) <br /> ` <br /> .SITE NAME y O � INSPECTOR'S NAME . <br /> AbORESS ��Q (� (��► {�� �(./'Ytir CITY ZIP 4 <br /> CONTRACTOR% NAME TELEPHONE <br /> OWNER$ NAME TELEPHONE <br /> DIS- INSPECTOR'S <br /> DATE APPROVED APPROVED tHITIALS <br /> — <br /> ITEM OR EQUIPMENT INSPECTED. <br /> imtTlAl_ INSPECTION <br /> OA <br /> Tank tested ue2n deliver'l INntida lasteel) ur air a 3PSl PNP <br /> c6 ✓ � ?. Visual Inspection of secondary containment. <br /> ). (auk jpl!roprtjtelY placed with approved backfill. <br /> numbers and tack ca attties tecnrded. <br /> PIPING STAGE INSPECTION <br /> ✓' I. Pressure test of -palline. 1primaryand Secondary (NFPA 7n)i <br /> 2. Bali (lost valve$ Installed. <br /> 1. uverltll, proteciton inaalled, der.• r11pe:t2 <br /> E. Une:sed tank opeutn•s sealed and cathudicstl protected.. <br /> a . �- S. Visual Ins ecttun of secunda% cuntainmeat on ! In S'U Gs ;A ,Lar �% <br /> .' Ilo[Meb <br /> .L l• wetnor prop <br /> Z✓ 6. 1ij 1,1fc and b ou h to-grade. covors <br /> rZ.._._ 1. Pill and vent 1plptng brought to Kradt. <br /> 8. Product line leak detector In place. Hard wired) <br /> C 9* Approved tank leak monitoring; device installed. <br /> OJlU. All alv utleed piping and (Ittln s r_ Irl wrapped. <br /> Il. Pressure decayteat on complete tank and product deliver s slemf30� <br /> C If/ Neck O%L C FINAI. It••SI'ECTION <br /> I <br /> Precision test su::•rsstull .•.m•Ieted seal hoed .o.les re.elved.� S <br /> protectloot -it I I'll <br /> i. I'erlurwancc le—.1 .•1 ovrr f 111 •p•.e e.p e..q ::vee em. <br /> v L. Petl..prn•ce Iet;I of isl4ossf. 1 lour lvje Aceett••t. (Hurd wlrt•d) <br /> 1rd <br /> 5 Pcrtorwenca• teat ..f %•rut luuuu: r••upee.p lip• •sI.•m al nit tank(n)PI-16 p <br /> 6. Primp to uwrale ap lecallou eum.lele. <br /> /. A able jejacdkeepipiL •tem. <br /> aolstxfs: <br />