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AST SPO0I ANNUAL INSPECTION <br /> Item Task Status <br /> 5.11 Overfill equipment a. Follow manufacturers instructions and regulatory r Yes r No r N/A <br /> requirements for inspection and functionality verification. <br /> b.Confirm device is suited for above ground use by the r Yes r No r N/A <br /> manufacturer.Make: ,Model: <br /> Comments: <br /> 6.0 Insulated Tanks <br /> 6.1 Insulation Insulation is free of: <br /> • Missing sections r Yes r No r+N/A <br /> • Areas of moisture r Yes r No F N/A <br /> • Mold r Yes r No r N/A <br /> • Damage f Yes r No r N/A <br /> 6.2 Insulation cover or jacket Inspected and confirmed that insulation cover orjacket is free r Yes r No r N/A <br /> of damage that will allow water intrusion. <br /> Comments: <br /> 7.0 Miscellaneous <br /> 7.1 Electrical wiring and Are they in good condition? r Yes r No r N/A <br /> boxes <br /> 7.2 Labels and tags • No Smoking 71 Yes r No r N/A <br /> • NFPA Placards f71 Yes r No r N/A <br /> • Capacity r Yes r No r N/A <br /> • Contents A Yes r No r N/A <br /> • Fill Procedures <br /> • Emergency Contacts r Yes r No r N/A <br /> r Yes r No r N/A <br /> Comments: <br /> Additional Comments: <br /> M 6703239 SEPTFMB 2016 <br />