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Annual Facility Inspection Checklist <br /> This inspection record must be completed each year. If any response requires further elaboration , provide comments <br /> in Description & Comments space provided . Further description and comments , if necessary, must be provided on a <br /> separate sheet of paper and attached to this sheet. *Any item that receives 'yes" as an answer must be described <br /> and addressed immediately. <br /> Storage Tanks NIA Y** N Description & Comment <br /> Aboveground Fuel Tank No. 1 <br /> Diesel Fuel <br /> Tank surfaces show signs of leakage 9 <br /> Tank is damaged, rusted or deteriorated <br /> Bolts, rivets or seams are damaged tJ <br /> Tank supports are deteriorated or buckled is <br /> Level gauges or alarms are inoperative <br /> Vents are obstructed <br /> "Berm " is clear of debris/obstructions <br /> "Berm " is clear of petroleum product G rm t S s L' L4, k >ee�s t Z <br /> Tank shows deterioration of paint �4 <br /> Tank Signage is deteriorating l4 : <br /> Overfill Box is closed & secured ( f� <br /> Overfill Box has product present <br /> NFPA 704 Placard attached <br /> Fire Extinguisher Present & Current <br /> Drains free from evidence of product <br /> Tank Illumination Operational <br /> Emergency Vents Operational y <br /> Ground is clear of petroleum product <br /> Aboveground Fuel Tank No. 2 <br /> Diesel Fuel <br /> Tank surfaces show signs of leakage <br /> Tank is damaged, rusted or deteriorated <br /> Bolts, rivets or seams are damaged <br /> Tank supports are deteriorated or buckled <br /> Level gauges or alarms are inoperative <br /> Vents are obstructed <br /> "Berm " is clear of debris/obstructions <br /> "Berm " is clear of petroleum product <br /> Tank shows deterioration of paint <br /> Tank Signage is deteriorating <br /> Overfill Box is closed & secured <br /> Overfill Box has product present <br /> NFPA 704 Placard attached <br /> Fire Extinguisher Present & Current <br /> Drains free from evidence of product <br /> Tank Illumination Operational <br /> Emergency Vents Operational <br /> Ground is clear of petroleum product <br /> Aboveground Fuel Tank No. 3 <br /> Diesel Fuel <br /> Tank surfaces show signs of leakage <br /> Tank is damaged, rusted or deteriorated <br /> Bolts, rivets or seams are damaged <br /> Tank supports are deteriorated or buckled <br />(t <br />[€4 <br /> k <br /> E <br />