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STI SP-001 AST Annual Inspection Checklist <br /> General Inspection Information: <br /> Inspection Date: ,/U 23 Prior Inspection Date: !i 2/ Retain until date: <br /> Inspector Name(print): A N` e �a`�'E' Title:--D <br /> Inspector's Signature: iv T 2 <br /> Tank(s) inspected ID 1— '-3, (LD <br /> Regulatory facility name and ID number(i applicable) '' l <br /> Inspection Guidance: <br /> r This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent(as applicable). <br /> For equipment not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. <br /> :- 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 /> Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the <br /> environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. <br /> In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper <br /> operation (40 CFR 112.8(c)(8)(v)). <br /> i- 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 /> r Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. <br /> Note: If a change has occurred to the tank system or containment that may affect the SPCC plan,the condition should be evaluated against the current plan <br /> requirement by a Professional Engineer knowledgeable in SPCC development and implementation. <br /> ITEM STATUS COMMENTS/DATE CORRECTED <br /> Tank Foundation/Supports <br /> 1 Free of tank settlement or foundation washout? 2<Yes ❑No <br /> 2 Concrete pad or ring wall free of cracking and Yes []No F]N/A <br /> spalling? <br /> Annual Checklist Page 1 of 4 <br />