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R- <br />L <br />RECEIVED <br />q5C� I 1 LiltS c �)J -fR 6C C� CCT 19 2017 <br />MONTHLY FACILITY INSPECTION CdECKLIST (Attachment B) T <br />ENVIRONMEN SAL HEALTH <br />Instructions: This inspection record will be completed every month. Plac e�i��T�t�Et�ew ;f4ropriate box <br />For each item. If any response requires elaboration, do so in the Descriptions & Comments space <br />provided. Further descriptions or comments should be attached on a separate sheet of paper if <br />necessary. <br />Yes No Descriptions & Comments <br />Tank surfaces show signs of leakage ❑ <br />Tanks are damaged, rusted or deteriorated ❑ <br />Bolts, rivets, or seams are damaged ❑ <br />Tank supports are deteriorated or buckled <br />Fank foundations have eroded or settled <br />Level gauges or alarms are inoperative <br />Vents are obstructed <br />Valve seals or gaskets are leaking <br />Pipelines or supports are damaged or deteriorated <br />Buried pipelines are exposed <br />Loading/unloading area is damaged or deteriorated <br />Connections are not capped or blank -flanged <br />Secondary containment is damaged or stained <br />Dike drainage valves are open <br />fencing, gates, or lighting is non-functional <br />Signature: <br />�� v <br />■ <br />■ r <br />❑ ,0 <br />■ <br />❑ ❑ Al <br />Date: 4 " G� -/ LZ_ --- <br />Tracy Truck and auto Stop <br />