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This publication is copyrighted and intended for the sole use of Gary Reeves-09/16/2019 <br /> STI SP001 Annual Inspection Checklist <br /> General Ins p Aion Information: <br /> Inspection De Prior Inspection Date: Retain until date: <br /> Inspector Nar (print): Title: <br /> Inspector's Si atu re: <br /> Tank(s)inspE :!d ID <br /> Regulatory fa <br /> ,ty name and ID number(if applicable) <br /> Inspection :,jidance: <br /> ➢ This checl :t is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent(as applicable). <br /> ➢ For equips :,it not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. <br /> ➢ The perio( :,AST Inspection is intended for monitoring the external AST condition and its containment structure.This visual inspection does not require a Certified <br /> Inspector. :3hall be performed by an owner's inspector per paragraph 4.1.2 of the standard. <br /> ➢ Remove p :nptly standing water or liquid discovered in the primary tank,secondary containment area, interstice, or spill container. Before discharge to the <br /> environme inspect the liquid for regulated products or other contaminants and disposed of it properly. <br /> ➢ In order tc ::amply with EPA SPCC(Spill Prevention, Control and Countermeasure)rules, a facility should regularly test liquid level sensing devices to ensure proper <br /> operation,,, CFR 112.8(c)(8)(v)). <br /> ➢ Non-confc :iing items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank <br /> manufact :r who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comment section. <br /> ➢ Retain thea :)mpleted checklists for at least 36 months. <br /> ➢ Complete ::s checklist on an annual basis,supplemental to the owner monthly-performed inspection checklists. <br /> ➢ Note:If a :iange has occurred to the tank system or containment that may affect the SPCC plan,the condition should be evaluated against the current plan <br /> requirern t by a Professional Engineer knowledgeable in SPCC development and implementation. <br /> ITEM STATUS COMMENTS/DATE CORRECTED <br /> Tank Foundation/Supports <br /> 1 Fre )f tank settlement or foundation washout? []Yes El No <br /> 2 Co ',ete pad or ring wall free of cracking and EJYes E]No EIN/A <br /> spa Ig? <br /> F <br /> : I <br /> Annual_` heclklist Page 1 of 4 <br />