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MONTHLY FACILITY INSPE <br />Instructions: This Inspection rec <br />for each item. If ai iy response re <br />provided. Further lescriptions o <br />necessary. <br />Tank surfaces show signs of le, <br />Tanks are damagec, rusted or d <br />Bolts, rivets, or se ms are dam, <br />REGI <br />OCT 13 2017 <br />:TION CHECKLIST (Attachment BYWRONMENTALHEALTH <br />PERMIT/SERMES <br />Mrd will be completed every month. Place an X in the appropriate box <br />[uires elaboration, do so in the Descriptions & Comments space <br />comments should be attached on a separate sheet of paper if <br />Yes No Descriptions & Comments <br />ige ❑ <br />;riorated ❑ <br />:d ❑ I� <br />Tank supports are <br />deterioratedbuckled <br />Secondary containi <br />❑ <br />l <br />are open <br />Tank foundations <br />ave eroded o <br />settled <br />❑ <br />Level gauges or alrd <br />s are <br />Vents are obstruct <br />Valve seals or gash ets are lea <br />Pipelines or suppoits are darn <br />Buried pipelines aexposed <br />LoadinWunloadin area is da <br />Connections are nc <br />t capped or <br />Secondary containi <br />nent is darr, <br />Dike drainage valves <br />are open <br />Fencing, gates, or I <br />fighting is n <br />Signature: <br />'il acy TRIch anti Auto $row <br />ative <br />❑ <br />C, <br />I or deteriorated <br />❑ <br />fZ1 <br />Cl <br />;d or deteriorated <br />❑ <br />Cd' <br />mk-flanged <br />❑ <br />�r <br />,d or stained <br />❑ <br />❑ <br />functional <br />❑ <br />❑ <br />Date: 1 L <br />'il acy TRIch anti Auto $row <br />