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<br />Pipiac ~..: Swina Joints ? ExpIOlfoll-Pr~fPump ? Explosion-Proof Switc}: ? <br /> .-...... ---- NO YES vC'C' <br />COCT'OIi_ Pldlcdcn: ,"- UUICI'{ DieJea:nc; UnionllsoJation BU3hings: <br />I/A N/A <br />Di....1aD DiJJ*lliag to Property Line; ])i1tAllc! fi-om Dispensina to B\1ildll~i: <br />40'- - 75' m;n;m"m <br /> <br />DISPENSING EQUIPMENT & PIPING <br /> <br />ABOVEGROUND TANK INSTALLATION <br /> <br />DIESEL <br /> <br /> <br />Diameter. <br /> <br />Capacity ofTla1k: <br />8 000 <br />HorizDaf.IINenlca1 Mount: <br />HORIZONTAL <br /> <br />Tank CoasIrUctioll~ <br />C <br /> <br />Product: <br /> <br />S\lf'POrtlFounc1&tion Constr\lctlon, <br />CONCRETE SUPORT LEGS/Precast slab oundation <br /> <br /> <br />9" H <br /> <br />Rqul. Veat-Nlke; <br />12' above <br />CorlltrUCdOll of Dike: <br />COIMII.. T T <br /> <br /> <br />S~ PSI; Emel'Jency Relief Valve Make: <br /> <br />:2" 0 ens t X morri son bros 5 <br /> <br />Dramase of Rainwater Provided? [mpclVious Ground Surface Material: <br />N/A ASPHALT <br /> <br /> <br />AJI,1IM sulluit1e4 must show at lout the followine information on plot plan. Give measurement! trom tanks and <br />di.-s . J'I'OI*'Y Una, buildillgs, driveways II1d sllrlicc WIt8rS. <br /> <br />Y. N. Y. No <br />0 0 ProI*tY lines () () Vent pipe te:rmmatlOn type <br />0 () BuildiJIl (s) () () VCltt pipe size <br />() () Taak.ize 0 () Piping layout <br />() () Product In 1IDk () () Location of dispensers <br />() () Tank bury d~ () () WaterwlYs I <br />() () COQCJCe tbicknas over tAnk () () Dispenser protection <br />() () TIak fill opening () () Sips: No Smoking - Shut Off Motor- <br /> Minimum I,e for scl!-servc 16 )I"S <br />() () Driv.,..ys () () 20BC minim"" rite cxtinauishcr <br />() () Em<<pnc)' controls 0 () Sclf-serve attendant location <br />() () .... dIItccIion () () Tank location and clearances <br />() 0 OvdlJ proMCtiOl'l () () Backfl1l type <br />() () Spill pr.....cion () 0 Anchoring <br /> <br />PERMIT DE CALCULATIONS <br /> <br />I. Fmr awbt value of iDstaIlation $ S 1(77 S-- <br />la. Permit Fee (based Oft current building code) S <br />1 b. Plan check fee $ <br /> <br />2. State surcharge $ <br />3. TOTAL PERMIT nE for instaUation (add la, 1b and 2) $ <br />