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Tank Assessment Page Tank Name/marking: <br /> Tank age:191(g)(3)/192(k)(3) <br /> Remaining service life:191(g)(10)/192(k)(11) <br /> Tank Construction: <br /> Shape: <br /> Orientation: 191(g)(1)/192(k)(1) <br /> Location (above/below ground): <br /> Material of construction: 191(g)(2)(A)/192(k)(2)(A) <br /> Thickness and method used to determine: 191(g)(2)(B)/192(k)(2)(B) <br /> Lining material & thickness (if applicable): <br /> Corrosion Protection equipment: 191(g)(5)/192(k)(5) <br /> Structural support: <br /> Other identifying features: <br /> Piping and ancillary equipment (pumps): 191(g)(2)(C&D)/192(k)(2)(C&D) <br /> Piping Material of Construction: <br /> Piping Diameter: <br /> Pump location(s): <br /> Pump type(s)/capacities: <br /> Material Storage: <br /> Material and characteristics: 191(g)(7)/192(k)(8) <br /> Specific Gravity: <br /> Operating Capacity: <br /> Chemical compatibility findings: The materials identified above are compatible <br /> for contact with or proximity to the equipment, tank or tank system in this <br /> assessment. Initials: <br /> Visual Inspection: 191(g)(8)/192(k)(9) <br /> Tank parameters at time of inspection (empty, etc.): <br /> Acute visual evidence of leaks: <br /> Condition of interior surface: <br /> Condition of exterior surface: <br /> Condition of nozzles, flanges, fittings at tank: <br /> Condition of piping: <br /> Visual Inspection findings: A visual inspection of the tank and its affiliated <br /> pumps, piping and ancillary equipment did not reveal signs of leaks, corrosion, <br /> weld cracks or breaks, or scrapes in protective coating which may cause a <br /> release from the tank system. A description of all discrepancies noted during the <br /> visual inspection is included with this report. Initials: <br /> Company Name Tank/Tank System identification <br />