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NEW UST INSTALLATION INSPECTION RECORD jok <br /> FACILITY NAME: ADDRESS: <br /> 17ofly <br /> FACILITY ID#,a 3 r + L TANK# UL Ltd 69?TANK MODEL/MATERIAL: <br /> CAPACITY: d �+ PRODUCT: _ '�! R.E.H_S: <br /> A [ <br /> P N ALL TANKS TO BE INSTALLED AND TESTED IN ACCORDANCE <br /> A I WITH MANUFACTURER WRITTEN SPECIFICATIONS <br /> 0 I �d�a(p <br /> V A <br /> E L <br /> D S <br /> ITEM OR EQUIPMENT INSPECTED <br /> OATS <br /> 1, UST PLANS SUBMITTED/ FEES PAID (H*S CODE 25287) <br /> UST INSTALLATION PLANS APPROVED <br /> INITIAL INSPECTIONS <br /> INSPECTION AND TEST OF SECONDARY CONTAINMENT: Idr1't SOLI AY: <br /> VACUUM: SOAP: PSI: HRS/MIN: BRINE(LIRUID ANNULAR): OTHER: <br /> PRIMARY TANK TEST: r]f[L15,51�A-tQ—PSI: L15 � 1 HRS/MIN: <br /> TANK APPROPRIATELY PLACED WITH APPROVED BACKFILL (API/PEI) <br /> 17 ff4 <br /> PIPING INSPECTIONS <br /> PRIMARY PIPING TEST (MINIMUM 40 PSII30 MIN) CCCR 2636 Ce)) <br /> SECONDARY PIPING CONTAINMENT TEST PSI: HRSIMIN: OTHER: (CCR 2636 (e)) <br /> LAKE TEST ON ALL SUMPS C24 HR. MINIMUM) HRS: CCCR 2635 (a) (4)) <br /> UNUSED TANK OPENINGS SEALED AND CORROSION PROTECTED PEI <br /> r �I OVERSPILL PERFORMANCE TEST (CCR 2635 (b) (1) CC)) <br /> +11. ALL PIPING AND FITTINGS CORROSION PROTECTED (CCR 2636 (b)) <br /> 12. PIPING SLOPES TO COLLECTION SUMP (CCR 2636 (c)(1)) <br /> FINAL INSPECTION <br /> PERFORMANCE TEST FOR "ALL" MONITORING PROBES CCCR 2632 Cc) C2)) <br /> JPERFORMANCE TEST OF CONTINUOUS MONITORING SYSTEM (PANEL) (CCR 2632 (c) (2)) <br /> 15. PERFORMANCE TEST OF LINE LEAK DETECTION (CCR 2643 (c) (1)) <br /> 6- PERFORMANCE TEST OF AUTOMATIC PUMP SYSTEM SHUT-OFF (CCR 2636 (g)) <br /> 1 , 17. BALL FLOAT VALVES INSTALLED <br /> L� OVERFILL PROTECTION INSTALLED/APPROVED (CCR 2635 (b) (2)) <br /> TANK ACCESS PORTS BROUGHT TO GRADE CLOCKED AND WATERTIGHT) APT <br /> J TANK INTEGRITY TEST (PASSING HARD COPY) (CCR 2635 (a) (5)) <br /> i <br /> i 21. 40NITORIHG PLAN, RESPONSE PLAN AND LOG 300K ON SITE (CCR 2632 (d)) <br /> "C" FORM COMPLETED AND SUBMITTED (CCR 2635 (d)) <br /> 23. MONITORING METHOD FOR ALL TANKS AND PIPING APPROVED (CCR 2630-2636) <br /> 124. ALL CONDITIONS MET; FACILITY PERMIT ISSUED CH+S CODE 25284) <br /> COMMENTS: <br /> EH23-006 9/95 <br /> 10 <br />