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STI SP001 Annual Inspection Checklist <br /> General Inspection Information: <br /> Inspection Date: a iS - ?in 2�1 Prior Inspection Date: Retain until date: <br /> Inspector Name(print):_ Title: Fr-- , 4—t IN <br /> Inspector's Signature: �1 <br /> Tank(s) inspected ID A?r- kks_r-' <br /> Regulatory facility name and ID number(if applicable) <br /> inspection Guidance: <br /> ➢ 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 shal I be performed by an owners 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 /> ➢ Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector,ora tank <br /> anufactur_er-who will-determine-he-corrective-action-dote-the-non-copformanceand-corr�esponding-cor-r-eetive-actisn4n4he-comment section. <br /> ➢ Retain the completed checklists for at least 36 months. <br /> ➢ Complete this checklist or 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 /> I TEM STATUS COM M EN TS/DATE CO RRECTED <br /> Tank Foundation/Supports <br /> 1 Free of tank settlement or foundation washout? `* es ❑No <br /> 2 Concrete pad or ring wall free of cracking and (es ❑No ❑N/A <br /> spalling? <br /> Annual Checklist Page 1 of 4 <br />