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5000 Sikorsky Street PR0541901 <br /> January 10, 2022 Program: APSA <br /> PHOTO 3: Monthly inspections are not equivalent to SP001 standard. <br /> R <br /> FUJI <br /> rgCILITY CHECKS STATION:SCK FACILITY:Tank 1 MONTfi:December YEAR:2021 <br /> NOT DAILY <br /> RECORO DgILY SUM1 14 2 3 4 5 6 ] 6 9 30 11 12 13 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 <br /> E P RESULTS ON ATA FORM 303.0113&Filter Differential Pressure on ATA 103.06(Weekly Corrected DP Should Be Rec,,dded on ATA 103.01C) <br /> � <br /> 2 GENELCONDITION OF TANK YARD S S S J � �2 5 5 5 7 S S S S+ <br /> 2 HOSE ry,FIRE&SAFETY DEFICIENCIES S S 5 S J 15 1� S 11 15 1 5 �� S 5 G 115 IS NA <br /> 3.HOSES,SWI-I—,N022LE—COUPLERS C. C (., C �, <br /> 4.ST REE C L C C C. � <br /> S FI ATIC LS,CABLES AND CLAMPS S S S S �� S rj S S S 5 S <br /> RNGUISHERS Q S S S 5 S <> S S S S S S S <br /> 6.F.""'SUMP SEPARATORS <br /> 2SPILL SUPPLIESr S IA•IXM W A W LA I MRP a \V <br /> SSS S SsS 5 � S �> s sSSSs <br /> hyt �bh 6H Cn16�NtiE Ga.C C1 <br /> IDENTIFICATION OF PERSON PERFORMING TASKS • <br /> MONTHLY CONDITION DATE SIGNATURE <br /> 1.FILTRATION(MILLIPORE)TEST -� <br /> 2.FREE WATER TEST <br /> Method Used: b <br /> 3.LOADING RACK NOZZLE SCREEN VISUAL INSPECTION 2,-143a.LOADING RACK NOZZLE SCREEN CLEANING (only �/� <br /> required for loading rocks with filter monitors) <br /> 9.SIGNS,LABELS&PLACARDS <br /> S.FLOATING SUCTIONS <br /> 6 <br /> 6.FIRE EXTINGUISHER <br /> 7.CLAYTREATERS <br /> PA <br /> REMARKS: n r.i!V <br /> ATA FORM 10 111 <br /> CONDITIONCODES: S=SATISFACTORY; C=COMMENT(REQUIRED IN REMARKS SECTION); N/U=NOTUSED; N/A=NOTP�PPLICABLE <br /> 11/2019 <br /> RETAIN ON FRE FOR 12 MONTHS <br /> Lydia Baker, SR. REHS Page 3 of 4 <br />