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6 Access Hatches Closed? Yes No N/ 1 All floating roof deck openings are dosed? Y Yes No �NIA) 8 Roof Sump—nas Screen Cover/Check Valve Free and Clear you No V 9 Material&debris from repairs have been removed? Y No NfA ID Robing Ladder is on els&operating correctly? Yes No 1x- I I Floating Roof supports are In conect position,pinned&secured? Yes No NIA 12 Floating roof seals&snorts are in mmect position? Yes No 13 Roof drain is clear&open on Boating m r? Yes No lA 14 Roof drain check valve is in place&operational? Yes Na NIA ❑ PROCEDURAL I OPERATIONAL CHECKS INITIALS CHECKS l All charges in the tanks Capacity or operation have been Commented&communicated ye Ne N unth all operators.control Center&Product Supply? 2 Have proper regulatory agencies been noti ed? eJ No MA E CHECKS DURING FILLING OPERATION INITIALS CHECKS 1 Tank Gauge operalronal&reporting correct level You No NIA 2 Leos Need To Se Set To Lax Leg Selling When Tank Recanes Full Yes No NIA 3 Temporarily open rod drain valve to verify leak light than close Roof Drain Leak light? Yes No NA a Walk tank perimeter to check for leaks OK? Yes No NIA e Utilize slay fig rate during insist fill unfit floating roof is floating and ail internal piping is Yes No NIA submersed by al least IS` Slaw INuglized? t- 6 Verify Boating roof is In level&seals remain in rented with shell.Roof level&seals light? Yes No ? After tank level reaches 12',verity mixers are operational by remote and manual ac iva ion. Yes No Mixers chKk col CK? Documentation for DOT Files: 1 Complete the repaircomplelian fam wNl lM Authorized lnapedals signature assorting repairs and verifying that necessary repairs have been campleted in acwldance villi API 653 standard 2 Ova lflas ur Rttordo of lrumov.,ovemeebg repairs 3 Ac-bull sketchasrdraxlms of all repair ar modificatons shut Indude location weld joint tlesails.sh¢Ii rollout(it applipble) no Ode details,noagrg mar,seal desatk rooraain IayauVdeta is eta Ifweldingisperiarmed:Well Procedure Spedfirariana WPS) Mocedure Onlifiratlan Recods IPOR).and Weider CuasiGnauon lest Reconl5(WOR) 5 Maleral lest reports mrnew maenala(MTRs forsleei Lobanalystvforme song 6 Malerial rest reports tar crew maledals(MTRs for steel lab analysis for new sand) ? NonCestroctive Exmminatan lnspaclofs Oualificaliona S Results of all h atng Padorro d(MT,Ilr,RT,VT,VST Hydro-teal,LPT,Helium Too.m-ped pressure lean,al-1 9 IR,sufts of all feuding performed LMT UT,RT,VT,VBT,Hyam-lest.LPL Helium Test,raped pressure teal,eta.) Notes: Check Performed by(Name) Data 16. 1 lliLeg Tsgn ASc. 1( -9 F .4,1k J4tc f D - -S', Page 2 oft