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STI SP001 Monthly Inspection Checklist General Inspection Information: Inspection Date: 'z/!f/�f' Retain Until Date: Z�j�L Z� (36 months from inspection date) Nor Inspection Date: Inspector Name: �`v` t Gt+i w tG I �. 0L. �tZ oa v�7e t�h-�I 2- an-I r d,�rv�a�w 7 olY teaks Inspected(ID#'sj: K-� C +-� r --mr '�' t'lv'+t- tt%- Inspection Guidance: For equipment not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure.This visual inspection does not require a Certified Inspector. It shall be performed by an owner's inspector who is familiar with the site and can identify changes and developing problems. ➢ Upon discovery of water in the primary tank,secondary containment area,interstice,or spill container,remove promptly or take other corrective action.Before discharge to the environment,inspect the liquid for regulated products or other contaminants and disposed of it properly. (*)designates an item in a non-conformance status.This indicates that action is required to address a problem. ➢ Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design,a Certified Inspector,or a tank manufacturer who will determine the corrective action.Note the non-conformance and corresponding corrective action in the commint section. ➢ Retain the completed checklists for 36 months. ➢ In the event of severe weather(snow,ice,wind storms)or maintenance(such as painting)that could affect the operation of critical components(normal and emergency vents,valves),an inspection of these components is required as soon as the equipment is safely accessible after the event. Item Task Status Comments 1.0 Tank Containment Check for water, 1.1 Containment debris,cracks or fire R Yes*❑No❑N/A structure hazard 1.2 Primary tank Check for water @ Yes* ❑No 1.3 Containment Operable and in a 2 Yes❑No*❑N/A drain valves closed position 1.4 Pathways and Clear and CWes❑No*❑N/A entry gates/doors operable