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Owner of Tank: ACT -100e Label No. <br />Location of Tank: Date: <br />CiiECK() <br />CHECK( ) <br />HANDLING <br />When anchoring with a concrete hold down pad, <br />The handling equipment is of adequate size and <br />a minimum 6 inch (152.4 mm) layer of pea <br />capacity to lift and lower the tank without dragging <br />over the concrete pad dimensions to separate <br />or dropping. <br />tank from pad <br />The repair of any damaged laminate areas has been <br />When deadman anchors or bold down pads are used, <br />made in accordance with installation instructions. <br />hold down straps have been separated &am the tank <br />instructions. <br />by an inert insulating dielectric material at least <br />Prior to storage, the tank has been chocked with <br />1 inch (25.4 mm) wider than the steel hold <br />wood blocks or tires. <br />down straps. <br />EXCAVATION <br />Tank is electrically isolated from the hold <br />When no anchoring is required, the site has been <br />down strap. <br />excavatcd deep enough to enable 1 foot of clean <br />sand or gravel to act as bedding material between <br />BACKFILL <br />native soil and tank. <br />Homogenous backfiIl consisting of clean sand, - <br />(reference PEI/RP 100). <br />pea gravel or i/8 crushed stone has been used. <br />Burial depths meet minimum code requiretnents <br />BackM has been placed along sides of tank to ensure <br />(such as NFPA 30). .�_ <br />full support along the tank's bottom quadrant. <br />TESTING <br />PIPE CONNECTIONS <br />'The tank has been air -tested at 5 prig ( kPa) while <br />Nonconductive piping used. <br />applying soap solution onto weld seams and <br />fittings to check or leaks. <br />Metallic piping used. <br />OR <br />on a double wall tank, a vacuum test has been <br />Dielectric bushings or flanges installed. <br />performed in accordance with the fabricator's <br />instructions. <br />All local and state testing requirements have <br />Signature and Title of Installing Foreman and/or Project` <br />been performed, <br />Engineer <br />ANCHORING <br />Not applicable to this site. <br />Deadman anchors used. <br />Concrete pad. <br />Installing Contractor <br />Soil and pavement overburden will hold down tank <br />(reference PEI/RP 100). <br />570 Oakwood frond i <br />lskc Zurich IL 60047 <br />Phone: 847.438-8265 <br />Fax: 847-4384766 <br />Note: This ekeekllst Includes certain key steps In the proper <br />InstetlAtion of the ACT -100 -VT- tank &aad Is intended only as as aid to <br />Wk laWlers who are kaowledgeable and experitneed In <br />underground tank installation. Compliance herewith does not <br />aeceatarUy meet the requirements of Q applicable federal, state, and <br />I*W lows, rc=ulsdon® Aad ordlaaaees coneernin` tank Installation. <br />