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Z 0018d <br />RECEIVED <br />BULK PETROLEUM ABOVEGROUND TANK INSPECTION CHECKLIST AUG 0 2 2013 <br />Tank:6j �ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />Inspector :� 4.A); c (-c:f- Signatt -�c� �W---Date:V/—T <br />1. Is the lank systettr free of visual signs <br />of damage <br />(cracks, dents, corrosion or leakage): <br />u. Tank exterior -including small <br />cracks in <br />concrete exterior or rusting on <br />steel <br />compotlentO <br />b. Piping, hoses. valves, titting or <br />connections? <br />2. Is the secondary containment free of <br />vivual signs <br />of damugc (cracks, dents, corrosion or <br />fM.:ikilbl•) <br />- <br />3. is equipment timctinnin>; properly: <br />a. Pumps valves. connections <br />4. Is tank urea clean and (tee of trach <br />J <br />u <br />F <br />c <br />—M <br />a <br />A <br />P <br />M <br />n <br />J <br />u <br />.I <br />U <br />O <br />N <br />0 <br />DYear: <br />en <br />5, is tank dearly and legibly9--t' <br />b <br />r <br />r <br />Y <br />n <br />1 <br />si ned/labcled: <br />v <br />cU <br />r <br />c <br />i <br />e <br />y <br />ffAS <br />e <br />om mr <br />AiElire spillcontrol supplies Prevent <br />m,d —11 dcked'? <br />h <br />bY <br />r <br />e. <br />e <br />Y <br />r <br />r <br />1. Is the lank systettr free of visual signs <br />of damage <br />(cracks, dents, corrosion or leakage): <br />u. Tank exterior -including small <br />cracks in <br />concrete exterior or rusting on <br />steel <br />compotlentO <br />b. Piping, hoses. valves, titting or <br />connections? <br />2. Is the secondary containment free of <br />vivual signs <br />of damugc (cracks, dents, corrosion or <br />fM.:ikilbl•) <br />- <br />3. is equipment timctinnin>; properly: <br />a. Pumps valves. connections <br />4. Is tank urea clean and (tee of trach <br />and debris? <br />5, is tank dearly and legibly9--t' <br />si ned/labcled: <br />6. Is thevatrdalisnt/building <br />locked')/• <br />AiElire spillcontrol supplies Prevent <br />m,d —11 dcked'? <br />WH OV -01. £I./ZO/SO <br />