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AST SP001 ANNUAL INSPECTION <br /> item Task Status <br /> 1� <br /> 5.11 Overfill cquipment a. Follow manufacturers instructions and regulatory Yes !`No W N/A <br /> requirements for inspection and functionality verification. <br /> b. Confirm device is suited for above ground use by the r Yes No N/A <br /> manutacturer.Make. Model.- <br /> Comments: <br /> 6.0 Insulated Tanks <br /> 6.1� insulator Insulation is free of: <br /> • Missing sections 7Yes i No rN/A <br /> • Areas of moisture r Yes r No W N/A <br /> • Mold F Yes 7 No IW N/A <br /> ® Damage I r Y c s 7 No P-1 N/A <br /> 6.2'Insulat;ion cover or jacket Inspected and confirmed that insulation cover or jacket is free ! r Yes r No Id N/A <br /> of damage that will allow water intrusion. <br /> Comments: <br /> I _ <br /> 7.0. Miscellaneous �y <br /> 7.1 Electrical Wring and Are they in good condition? r Yes �`No w N/A <br /> :boxes <br /> T.2 Labels and tags • No Smoking ry Yes No r N/A <br /> • NFPA Placards tv Yes r No N/A <br /> • Capacity Yes No N/A <br /> • Contents rv"Yes r No N/A <br /> _ • Fill Procedures <br /> • Emergency Contacts r Yes r No 1'N/A <br /> Yes r No r N/A <br /> Comments: <br /> Additional Comments: <br /> 'Ari: 61,01206 SEP i EMBER 2016 <br />