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OOM& nda Cont to nmenr M <br />�s. <br />4 <br />Rig "01 <br />. r <br />• •. .1#M. IIWMMMIRIMM <br />Secondary Containment• • • <br />material,(breaches, foreign <br />Secondary Containment <br />Wrain Valve Locked? Z4111111i <br />.ii . - il�lll� <br />• <br />i 0 <br />_v_ <br />_ �a <br />ncillary Equipment: Piping ! Piping <br />Good <br />Connections (leaks, corrosion, supports) ------------ <br />Other <br />{{�� <br />"SHIMMMEW • qT.E <br />3ltd 7 F53fx <br />si ri %Tr(�, z ,, 1_ <br />.,v_,.�,.. <br />:hF?#44k _i <br />Install anti -siphon valves where the liquid level in a tank <br />Anti Siphon Valve installed? No <br />is at a higher elevation than the supply piping or <br />dispensing unit. <br />Anti Siphon Valve Manufacturer <br />N/A <br />Anti Siphon Valve Model <br />N/A <br />Is the Anti Siphon Valve Operational And <br />N/A <br />Properly Sized? <br />Fire Valve <br />Installed? <br />Yes <br />Fire Valve Manufacturer <br />Morrison Brothers <br />— <br />Fire Valve Valve Model <br />Number <br />3 <br />-------------- <br />Is the Fire Valve Operational? <br />Yes <br />- _ --- <br />Otherkh <br />- <br />3 - q< „. <br />MU <br />y Y„ <br />§�F�Sr 11 S<;. <br />_,. <J�a'#I% KL: <br />-_ <br />:._ .x {�a`}k'g A--":* <br />Normal Vent Manufacturer <br />Unknown <br />k2 <br />Normal Vent Size <br />211 <br />Normal Vent ModelUnknown <br />- --- <br />Normal Vent Condition <br />Good <br />--__._._------------_-- <br />Normal Vent Properly Sized? <br />Yes <br />0 <br />