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.1� <br /> STI SP-001 AST Monthly Inspection Checklist <br /> I General Inspection Information: <br /> "r <br /> Inspection Date: VC Z <br /> t'_f9 <br /> Prior Inspection Date: '>t Z Z Retain until date: <br /> E Inspector Name(print): Title: <br /> i Inspector's Signature f <br /> F Tank(s)inspected ID <br /> I <br /> 4.4 <br /> iFy+ Regulatory facility name and ID number(if applicable) <br /> q'20k" <br /> r Inspection Guidance: ' <br /> �, ➢ This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent(as applicable).Inspections of multiple r 9' <br /> a� r; tanks may be captured on one form as long as the tanks are substantially the same. <br /> ➢ For equipment not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. r a; <br />�` y ➢ The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure.This visual inspection does not require a Certified <br /> Inspector. It shall be performed by an owner's inspector per paragraph 4.1.2 of the standard. <br /> .._ t ➢ Upon discovery of water in the primary tank,secondary containment area,interstice,or spill container,remove promptly or take other corrective action.Inspect the liquid <br /> for regulated products or other contaminants and dispose of properly. <br /> ➢ Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design,a Certified Inspector,or a tank <br /> manufacturer who will determine the corrective action.Note the non-conformance and corresponding corrective action in the comment section. <br /> ➢ Retain the completed checklists for at least 36 months. <br /> ➢ After severe weather(snow,ice,wind storms) that could affect the operation of critical components(normal and <br /> ms)or maintenance(such as coatily accessible after the event. <br /> emergency vents,valves),an inspection of these components is required as soon as the equipment is safe <br /> STATUS COMMENTS I DATE CORRECTED <br /> ITEM <br /> u <br /> Tank and Piping <br /> Is tank exterior(roof,shell,heads,bottom,connections,fittings,valves,etc.)free of visible AeS o NO <br /> leaks? <br /> Note:If"No", identify tank and describe leak and actions taken. <br /> z`�es ❑N?' ❑N/A <br /> good working condition? <br />(t � ' 2 Is the tank liquid level gauge legible and in g <br /> a= , _ es ❑No <br /> Is the area around the tank(concrete surfaces,ground,containment,etc.)free of visible <br /> i tYrrlr 5,t' 4,: S signs of leakage? <br /> A,6 <br /> Page 1 of 3 <br /> Monthly Checklist <br />