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AST SP001 ANNUAL INSPECTION Item Task Status 5.3.4 Solenoid valves Cycle power to valve and confirmed operation.(Electrical r Yes r No r N/A solenoids can be verified by listening to the plunger opening and closing. If no audible confirmation,the valve should be inspected for the presence and operation of the plunger.)(enter manufacturer and model number in Comments if available 5.3.5 Fire and shear valves a.Manually cycle the valve and confirmed components are r Yes r No r N/A moving freely and that the valve handle or lever has clearance to allow valve to close completely.(enter manufacturer and model number in Comments if available) b.Valves must not be wired in open position. r Yes r No F N/A c.Make sure fusible element is in place and correctly r Yes r No r N/A positioned. d.Be sure test ports are sealed with plug after testing is r Yes r No r N/A complete and no temporary test fixture or component remains connected to valve. Comments: 5.4 Interstitial leak detection Check condition of equipment,including: equipment • Make: ,Model: • The window is clean and clear in sight leak gauges. r Yes r No A N/A • The wire connections of electronic gauges for tightness and [—Yes r No r N/A corrosion. rYes r No r N/A • Activate the test button, if applicable. 5.5 Spill containment boxes a.Confirmed SB is free of corrosion,damage, or wear that rYes r No r N/A on fill pipe has compromised the ability of the unit to perform spill containment functions(enter manufacturer and model number in Comments if available b.Confirmed connections to the AST are tight,and all bolts, r Yes r No r N/A nuts,washers are in good condition. c.Confirmed drain valves are operational. R Yes r No r N/A 5.6 Strainer a.Confined that the strainer is clean and in good condition, r Yes r No 17 N/A (enter manufacturer and model number in Comments if available b.Confirmed strainer basket,cap,bolts and gasket seal are r Yes r No r+N/A in good condition. 5.7 Filter a.Confirmed that the filter is in good condition and is within r Yes r No r N/A the manufacturers expected service life. Replace,if necessar .Make:,Model: b.Confirmed no leaks or decreased fuel flow. r Yes r No r N/A 5.8 Flame arrestors Inspected for proper operation per manufacturers instmctions r Yes r No r N/A and no corrosion or blockage of air passages.(enter manufacturer and model number in Comments if available 5.9 Leak detector for Have been or were tested per manufacturers instructions and r Yes r No r N/A submersible pump systems authority having jurisdiction(AHJ)and verify leak detectors are suited and properly installed for above ground use. Make: ,Model: 5.10 Liquid level equipment a.Make: ,Model: b. Has equipment been tested to ensure proper operation? r Yes r No 17 N/A c. Does equipment operate as required? r Yes r No R N/A d. Does the equipment perform per manufacturers r Yes r No r N/A instructions? _ WO: 6703239 SERrFMBER2016