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0 <br />ENVIRONMENTAL f i I <br />V <br />ZFACILITY INSPECTION CHECKLIST <br />M <br />E <br />"' <br />OCT 18 r <br />FACILITY#: ADDRESS: VIR AL HE <br />D PART EDIT <br />Leak <br />Repaired <br />Tank 1MTank <br />Y OP N <br />®n -site Y/N or NA <br />Top of 45 Degree Taper <br />Enter product name <br />Submerged Pump Fittings <br />. 1 <br />i�/ <br />LESS THAN 6 inches from <br />Tank Bottom (Y/N) <br />\ j <br />`t <br />Fill/Vapor Caps presentDispenser <br />Piping <br />Overfill Valves/Fla®per <br />have proper gaskets andproperly <br />Filter Warning Signs <br />N) <br />Valves set at 95% of Tank <br />lock? (Y/N) <br />N <br />(Y or <br />Capacity (Y/N or N/A) <br />Fill or Turbine sump lids <br />Pulsar Seals <br />Ball Floats set at 90%/30 <br />minutes of Tank Capacity? <br />v <br />Hoses <br />and gaskets in place and <br />i <br />l I <br />`( <br />good condition (Y/N) <br />(Y/N or N/A) <br />Nozzles, j <br />Y"" <br />Test Boots Puffed Back in <br />Sumps (Y/N) <br />0 <br />> 5 yrs old <br />Annular sensor at the <br />(Y or N) <br />Dispenser Fittings <br />t <br />A! <br />rens 1 ays rTBSenx <br />Color Coded Properly <br />(YIN) <br />Top of 45 Degree Taper <br />Submerged Pump Fittings <br />. 1 <br />i�/ <br />LESS THAN 6 inches from <br />Tank Bottom (Y/N) <br />\ j <br />`t <br />Overfill Valves/Fla®per <br />Filter Warning Signs <br />N) <br />Valves set at 95% of Tank <br />N <br />(Y or <br />Capacity (Y/N or N/A) <br />Pulsar Seals <br />Ball Floats set at 90%/30 <br />minutes of Tank Capacity? <br />v <br />(Y or N) <br />i <br />l I <br />`( <br />(Y/N or N/A) <br />Hanging Hardware <br />> 5 yrs old <br />Annular sensor at the <br />(Y or N) <br />1 S <br />�v <br />lowest point in the annular <br />space (Y/N or N/A) <br />�� <br />y <br />(notify the operator) <br />WOR/NYC Only: <br />All sensors set for <br />positive shutdown <br />(Y or N) <br />Provide the measurements <br />Any equipment <br />of the annular sensor: <br />bypassed, disabled or out <br />For Fiberglass tanks: <br />of spec <br />(Y/N or NA) <br />Length of the riser + <br />1 t` <br />(notify the ECS) <br />1(3.14 * tank diameter)/21 <br />= <br />67 <br />Comments: <br />For steel tanks: <br />t <br />Length of the riser + <br />the diameter of the tank <br />Note: All deficiencies should be communicated to the appropriate Environmental Compliance Specialist. <br />eMaintenance Ticket# Technician: Company: <br />Updated 07/15/2014 <br />