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Site Number / Date t`v ZQ <br /> z�,B"- Mwd.chaer Bucket S aft direct buckets .FH1out a fair. buckets <br /> TaoKi 8pJ$ a bl <br /> Doue r. Db a� >�Bucket:Condition Sp1118ud*t Cleen aiW Ory Ontin Va*e <br /> wCordahamr.tT <br /> s.,. <br /> .XIA. Weil <br /> CNI,EBW,Fairfield,Franklin, is the bucket Bucket Intact and in proper <br /> DPW,PNrTrte,Sate Ute,Universal Estimated Is the spill bucket condition W=Water present Does drain valve <br /> Order bucket capacity S4xylewan or GL=Grade level dived bury? (N not,explain below to the F-Fuel present funbon properly? <br /> per tank C=No vapor bucket;dbucket;Coax system (gallons) Doublewafions) BG=Below grade comments section) D=Dent's present <br /> monitor D-No bucket,DieselNA=No bucket Yes or No CD=Clean and Dry Yes or No <br /> SWDW <br /> V=No bucket,Vapor Manifolded NA=No Bucket NA=No Bucket NA=No Bucket Yes or No (Circle all Ural apply) NA=No drain valve <br /> R a No bucket,Maser only NA=No Bucket <br /> 1 O W F D CD <br /> o <br /> Y 2 0 1 C,) l5(�(J W F D CD <br /> U <br /> 7 <br /> Vm 3 W S W F D CD f) <br /> w <br /> O 4 W F D CD <br /> cc <br /> o. <br /> 5 W F D CD <br /> J <br /> LL <br /> 6 W F D Co <br /> 1 V W F D <br /> r 2 W S Gil /(fD e 5 <br /> 3 ,5L- <br /> 4 W F D CD <br /> P <br /> a <br /> 5 W F D CD <br /> 6 W F D CD <br /> Spin B.uireL <br /> Tepk i Al"89 FID Lid RD Caps!13aaketa Adapters Hose,Fit"W Rivet <br /> Product conartlD tag present&in FRI Gd in good condition&property Riser ut good condition,so that It <br /> proper condition painted? Are fill caps 8 is safe to drop fuer) if a fin sump IS <br /> Are swivel Are de8very hose fittings in present,is he riser <br /> Order gaskets good adapters present? proper condition? comments <br /> explain Denthe grounded? <br /> Pair tank NP=Not present NR=needs to be replaced condition?io n7 commenla secticti on)) <br /> monitor NC=Not In proper condition NP=needs to be painted <br /> OK=present&proper OK=good condition&painted Yes or No Yea or No Yes or No Yes or No Yes or No <br /> co <br /> (Clyde all that apply) (Circle all that apply) Unk=Unknown NA=No fill sump <br /> ern 1 NC OK NR NP IC C lQ C <br /> 4 Vo <br /> 2 NC OK NR NP K l� Q J (r ' <br /> 1 <br /> in 3P NC OK NR NP <br /> U l04 <br /> C O 4 NP NC OK NR NP OK <br /> a <br /> 5 NP NC OK NR NP OK <br /> J <br /> 6 NP NC OK NR NP OK <br /> 1 NP NC OK NR NP K qVet/jq ,Q 5 Sok' <br /> ao 2 NC OK NR NP OK l O f v�Q } �) <br /> t C L <br /> tj 3 NR DIP <br /> m <br /> 4 NP NC OK NR NP OK <br /> o. <br /> a <br /> 5 NP NC OK NR NP OK <br /> 6 NP NG OK NR NP OK 'r_ti <br /> Commerds on any damaged/defective equipment <br /> ;T <br /> issued 12127/2017 Page 3 of 10 <br />