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If"No" is indicated on any of the above questions, please provide explanation: (Attach additional sheet if <br /> required.) <br /> Signature dz Title of Foreman/Project Engineer <br /> Installation Contractor <br /> checklist includes certain key steps in the proper installation of the GLASTEEL II jacketed steel <br /> NOTE: This c as an aid to tank installers who are knowledgeable and <br /> underground storage tank and is intended only ]dance herewith does not necessarily meet the <br /> experienced in undergr�cable federal, sinstallate and local laws, regulations and ordinances concerning tank <br /> requirements of all app <br /> installation. <br /> ny Glasteel Ile Installation Precision Test <br /> Modern Welding Compa <br /> I, "Interstitial Tightness Test Method <br /> 000 gallon tanks and smaller and 2 hours for larger tanks.1. The initial vacuum for the test shall be a minimum of <br /> mercury. <br /> 2. Test period shall be a mirumum of 1 hour for 10, <br /> drain the test period indicate the inner and outer tanks e ug <br /> 3, Vacuum decreases of less than S mercury g the test period shall require further investigation. <br /> 4. A vacuum decrease of more than 5' mercury during purchased further investigation is required. This <br /> S. Contact the repro,be required <br /> from which mp eL don of anY investigation. tightness testing of <br /> precision test Wwas <br /> ill be required apo n (EPA)requirements for <br /> 6. This test procedure meets wall tants In dry tectioatiA <br /> empty underground double <br /> CertiflcatiOn of Results to the vendor's operating instructions. <br /> I certify the methods described in the attached Alternate EPA Test Procedures <br /> that the interstitial monitor was tested under the conditions In according the evaluation. <br /> I also certify that the evaluation was performed using <br /> of interstitial Monitors, and that the results presented above are those obtained during <br /> K Wilcox Associates Inc. <br /> H.Kendall Wilcox,President <br /> (orsanization perfotmins evaluation) <br /> (prnteJ nomc) 64055 <br /> aLSL <br /> I In nden Mo. <br /> . I W- (city. Utz,zip) <br /> (yiglature) <br /> 816-795=7997 <br /> ril 21 1994 (phone number) <br /> (date) <br /> NG <br /> THIS COMPLETED CHECKLIST MUST 13TA RETURNED <br /> yRgS FABRICATED CTHE <br /> ATED ORMTIATE�WARRANTY.COMPANY,INC <br /> SUBSIDIARY FROM WHICH THE <br /> 1385-4400 Modern Wdd�B Company of lowo,Inc. <br /> SUBSIDIARIES: Corporate Office (270) 28181 .pleasant Road <br /> Modern <br /> Wddlnt comp-q of Owcnat+orn,Inc. Burlin&WM laws 52601 <br /> 319-754-6577 <br /> 1450 EParrish Ave 319.754-8428(Fax) <br /> Outnsboto.KetrtudCY 42303 Ntodorn Welding CoorPa ny of CallEornla.Ino. <br /> 270,683-5323 4141 N.Brawley Ave. <br /> 1410.6945245(Fo ) p�TorOhio.Ina. Frano,Caliromia 93722 <br /> 209.275-9353 <br /> 72 Waldo sued 209-275-4391(Fax) <br /> Nawatic Ohio 43055 Modern Welding C*mPany of Georgia,Inc- <br /> 740-344-9425 300 Prep Phinips Dr. <br /> 740-3446018(Fax) of Florida,Im. AupLU,Gwrtia 30901 <br /> Modern Welding(`only 706-722-3411 <br /> Ailaits <br /> 3 <br /> Orlando,Floyda 32806 ModernW�ECoOpmy of Tesa%lne. <br /> 4o7-843.1270 200 N.Main Str0d <br /> 407-423-8187(Fax) Inc. Rhoma,Texas 76078 <br /> Modern Weldlnt:Compm ofTesas, 817-636-2215 <br /> 715 Sakowitz Strcd 817.636-7,680(Fax) <br /> Heston.Texas 77010 <br /> 713-6754211 <br /> 713.673 63(Fax) <br /> File:Gtasteei It ctw% st, 611989 mvVCa® <br />