Laserfiche WebLink
NEW UST INSTALLATION INSPECTION RECORD <br /> FACILITY NAME: ADDRESS: <br /> FACILITY ID# TANKS ULt TANK MCOEL/MATEtIAL: <br /> CAPACITY: ) PRODUCT: <br /> A I <br /> P N ALL TANKS TO 3E INSTALLED AND TESTED IN ACCORDANCE <br /> P I n f WITH RAUUFACTURSt WRITTEN SPECIFICATIONS <br /> R TZ- <br /> 11 <br /> !J J <br /> a A Tl <br /> E L <br /> a s <br /> ITEM OR MIPMENT tNSPECTED <br /> OATS <br /> 1. UST PLANS SUBMITTED/ FEES PAID (H+S CODE 25287) <br /> 2. UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> 66s-Ml <br /> ( 3. INSPECTION AND TEST OF SECONDARY CONTAINMENT: HOLIDAY: <br /> VACUUM: SOAP: PSI: HRS/MIN: 3RIHE(LIRUID ANNULAR): OTHER: <br /> 4. PRIMARY TANK TEST: PSI: HRS/MIH: <br /> s 5. TANK APPROPRIATELY PLACED WITH APPROVED 3ACXFTLL (API/PEI) <br /> PIPING INSPEC:iONS <br /> 6. PRIMARY PIPING TEST CMINIMUM 40 PSI/30 MIN) (CC2 2636 (e)) <br /> 5 7. SECONDARY PIPING CONTAINMENT TEST PSI: i HRS/MIN: a 4THE2: (CCI 2636 (e)) <br /> I 8. LAKE TEST aN ALL SUMPS (24 HR. MINI ) HRS: ( (a) (4)) <br /> ` 19. UNUSM TANK OPENINGS SEALED AND CORROSION PROTECTED PEI <br /> I10. OVERSPILL PERFORMANCE TEST <CC2 2635 (b) (1) (C)) <br /> ' I I11. ALL PIPING ANO FITTINGS CORROSION PROTc'e.ED (CCZ 2636 (b)) <br /> D (12. PIPING SLOPES 1-0 COLLECTION SUMP (CCR 2636 (c)(1)) <br /> FINAL INSPE=':IOM <br /> IP1 13. PERFORMANCE TEST FOR "ALL" MONITORING PROSES CCC2 2632 (c) (2)) <br /> ! I 114. PERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEI (PANEL) CCC2 2632 (c) (2)) <br /> �15. PERFORMANCE TEST OF LINE LEAK DETECTION (CO2 2643 Ce) (i)) <br /> jjf16. PERFORMANCE TEST OF AUTOIATIC PUMP SYSTEM SHUT-OFF (CCZ 2636 (9)) <br /> 17. SALL FLOAT VALVES INSTALLED <br /> 18. OVERFILL PROTECTION INSTALLS/APPROVED (CCZ 26.x35 (b) (2)) <br /> (19. TANK ACCESS PORTS BROUGHT TO =ADE (LOC= AND WATERTIGHT) APT <br /> / I I20. TANK INTEGRITY TEST (PASSING HARD COPT) (CCR 2635 (a) (5)) <br /> �(21. MONITORING PLAN. ,RESPONSE PIAN AND LOA: 300K ON SITE CCC2 26332 (d)) <br /> �`� )ZZ. "C^ FORM CCMPt?TED AND SUBMITTED Ccc2 2635 (d)) <br /> �23. MONITORING MET= FOR ALL TANKS AND PIPING APPROVED CCC2 2630-2636) <br /> 24. ALL CMITIONS MET; FACILITY PERMIT ISSUED (H+S CSE 25284) <br /> COMMENTS: <br /> EH23-1306 9/95 7 <br />