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AST SPob1 ANNUAL INSPECTION <br /> Item Task Status <br /> 1 5.3.4 Scterroid vaives Cycle power to valve and confirmed operation. (Electrical r Yes r-No N/A <br /> solenoids can be verified by listening to the plunger opening <br /> and closing. If no audible confirmation,the valve should be <br /> Inspected for the presence and operation of the plunger)(enter I <br /> manufacturer and model number in Comments if available) <br /> 5.3.5 fire and shear valves a. Manually cycle the valve and confirmed components are l�Yes �`No N/A <br /> moving freely and that the valve handle or lever has clearance <br /> to allow valve to close completely.(enter manufacturer and <br /> model number in Comments if available) <br /> b.Valves must not be wired in open position. l-Yes l-No TV N/A <br /> c. Make sure fusible element is in place and correctly I- Yes No ro-N/A <br /> positioned. <br /> I d. Be sure test ports are sealed with plug after testing is l~Yes r-No 1✓N/A <br /> complete and no temporary test fixture or component remains i <br /> connecied to valve. <br /> Comments: <br /> 5.4 lntersti'tia€ ieak detection Check condition of equipment, including: <br /> equipment a Make: ,Model: <br /> a The window is clean and clear in sight leak gauges. r-Yes i"No W N/A <br /> a The wire connections of electronic gauges for tightness and ..es No WN/A <br /> corrosion. 1 <br /> Activ,3te the test button, if applicable. <br /> i T-Yes :r"No WO N/A <br /> !5.5 SpdB?l wntainment boxes I a. Confirmed SB is free of corrosion, damage, or wear that j Tr Yes I-No W N/A <br /> on fill pipe has compromised the ability of the unit to perform spill <br /> f I containment functions(enter manufacturer and model number <br /> in Comments if available) I <br /> J b. Confirmed connections to the AST are tight, and all bolts, I r Yes r-No r N/A <br /> nuts, washers are in good condition- j <br /> c. Confirmed drain valves are operational. T-Yes r No I✓NIA <br /> 5.6 Strainer i a. Confirmed that the strainer is clean and in good condition. 7 Yes l-No 1✓N/A <br /> (enter m@nufacturer and model number in Comments if I <br /> availabl€) <br /> Cb. Confirmed strainer basket, cap, bolts and gasket seal are 7 Yes l-No W, N/A <br /> _ in good condition. <br /> 5.7 F te.r a. Confirmed that the filter is in good condition and is within 7 Yes r No jv N/A <br /> the manufacturer's expected service life. Replace, if <br /> necessary,Make:,Model: 9 <br /> b. Confirmed no leaks or decreased fuel flow. r Yes r-No fJ N/A <br /> 5.8 +=iarre armstors Inspected for proper operation per manufacturer's instructions i 7 Yes r No W N/A <br /> and no corrosion or blockage of air passages.(enter <br /> 1 manufacturer and model number in Comments if available) <br /> 5.9 Leak deteetor for Have been or were tested per manufacturer's instructions and [-Yes F No iv N/A <br /> {submersible pump systems authority having jurisdiction (AHJ)and verify leak detectors are <br /> suited and property installed for above ground use. <br /> Make: Model: I <br /> ( 5.10 Liquid Revel equipment a. Make: Krueger,Model:T,ype H <br /> b. Has equipment been tested to ensure proper operation? j 1�Yes 7 No r NIA <br /> c. Does equipment operate as required? r Yes J No t"NIA <br /> d. Does the equipment perform per manufacturer's W,Yes T-No i"N/A <br /> instructions? <br /> M-, 67032W SEFT MBER 2016 <br />