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ANNUAL INSPECTION — CHECKLIST <br /> Page 1/2 <br /> Instructions: The annual inspection is a review of all oil storage tanks and containment areas identified in <br /> Table 1 -Summary of Oil Storage Secondary Containment, of the SPCC Plan. Use this Form, and Table 1,to <br /> document the inspection and any deficiencies found. If any deficiencies are noted during the inspection, or if <br /> any corrective actions are taken, provide comments or details in the space provided below.Annual inspection <br /> of tanks is in addition to monthly inspection; it does not replace it.Complete monthly inspection and document <br /> as well. <br /> Inspection Form <br /> Inspection Date: Facility Name/Address: <br /> Inspection Completed By: Table 1, Secondary Containment, attached <br /> Date: Yes=Satisfactory <br /> Time: No= Repair,Adjust, or Corrective Action Required <br /> Facility Name: NA= Not Applicable <br /> Inspector: Additional space for comments/notes provided at end of report <br /> Attendee (s): <br /> Aboveground Storage Tanks- Including 55-Gallon Drums and Larger <br /> Bolts, rivets and seams are free of damaged and deterioration <br /> Tank foundation and supports are intact <br /> Liquid level gauges and alarms working properly <br /> Vents not obstructed <br /> Valves,flanges and gaskets are free from leaks <br /> Tank and ground surfaces checked for signs of leakage <br /> Conduct annual leak tests (Next tests due ) <br /> Other: <br /> Pipes <br /> Buried pipelines not exposed <br /> Out-of-service pipes capped <br /> Signs/barriers to protect pipelines from vehicles in place <br /> No leaks at valves,flanges or other fittings <br /> No signs of corrosion damage to pipelines or supports <br /> Other: <br /> Truck- Loading/Unloading Areas <br /> Warning signs posted <br /> No leaks in hoses <br /> Drip pans not overflowing <br /> Drip pans emptied nightly <br /> Catch basins free of contamination <br /> Containment curbing or trenches intact <br /> Connections capped or blank-flanged <br /> Secondary containment area for off-loading truck is adequate <br />