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MONTHLY ABOVEGROUND STORAGE TANK SYSTEM INSPECTION CHECKLIST <br /> Facility[D# Facility Name/Address Qualified Person Signature Date <br /> 7-11 erg 2 l tc' >' ,- <br /> Contact <br /> If any problem is found,contact: Hertz Facil"sty Manager Information: <br /> DESCRIPTIOhf TANK <br /> �d (Answer all questions with: Y,N,or NIA) r1S f <br /> MANxOWN <br /> �- Are all tank surfaces(and paint)in good condition and free from corrosion? <br /> 1 Condition of Tanks Is the concrete pad or dike in good condition? t c� <br /> Does tank have adequate vehicle protection? Y <br /> 2 Tank Gauges Is the tank gauge accurate and working properly? <br /> 3 Tank Ladder or Stairs is the tank ladder or stairs in good condition? <br /> i' <br /> 4 Secondary Containment Is the secondary containment area dry? (Visual inspection,check leak gauge,or t, <br /> Areas print out the sensor status re ortand attach to this form.) <br /> Is the tank area clean with no evidence of any leaks or spills? <br /> Leaks (Wipe areas clean. <br /> g Ventsl Are the primary and emergency vents unrestricted and working property? <br /> 7 Fine Extinguishers Are fire extinguishers present,visible and in good working condition? <br /> Does the tank have all proper signage (i.e_, Hazard Diamond,product, v <br /> g Signage gallonage, dl delivert instructions and tank number? 1 <br /> w <br /> VOW <br /> Is the fill cover or door present, not broken or damaged? ly <br /> 7 Fill Covers or Doors <br /> mWER W- - <br /> Is the fill cover identified by color code and!stated on the correct tank? <br /> 4/ t <br /> 2 Spill Containment Areas is the spill bucket free of dirt, trash,water or product? <br /> Spill Buckets)Verify that there are no cracks,bulges or holes in spill containment? Y <br /> 3 Fill Pipes Is the fill cap in good condition and seals tightly with no obstructions inside? y <br /> 4DrSQEQSEi ►R <br /> 1 Inside Dispenser Cabinets is the dispenser cabinet area free of leaks?(Open cabinet on larger units.) ` <br /> 2 Shear Valve/Impact valves Is the hose equipped with a shear valve? t <br /> 3 Breakaways Is the hose equipped with a breakavray? L <br /> 4 Hoses and Nozzles Are the hoses and nozzles in good condition with no leaks? ` <br /> Used Oil Is the pump equipped with a shut-off device or alarm that can be heard in the <br /> Evacuation Pumps collection area? <br /> 2 Used Oil Is the Used Oil collection area clean,free of spills with no open buckets of oil? <br /> Collection Area <br /> 3 Lube Oil Pumps Is the Lube Oil pump working properly and free of leaks? <br /> 1111 t16 <br /> 7.3 Hertz Ill AST Inspection Form Page 1 of 2 <br />