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Inspection Date: S— Retain Until Date: <br /> —Z7 Inspector Name; V 136 months from in <br /> Prior Inspection Date: 1 — 7a�s v� pectiondate) <br /> Tanks Inspected (ID#'s): !�• <br /> Inspection Guidance: <br /> p <br /> ➢ For equipment not included in this Standard follow the <br /> manufacturer recommended ins ectionitesting schedules and rocedures. <br /> ➢ The periodic AST Inspection is intended for monitoringthe external AST condition and its containment structure.Thispisualinspecfiondoes tied <br /> Inspector. It shall be performed by an owners inspector who is familiar with the site and can identify changes and develo m not aCert� <br /> of water in the primary tank, secondary containment area, interstice, or spill container, remove promptly or take Other corrective acf�on.Before <br /> ➢ Upon discovery inspect the liquid for regulated products or other contaminants and disposed of it ro erl <br /> discharge to the environment, insp <br /> ➢ (*) designates e item in anon-conformance status. This indicatesthataction is required to address a problem.p p y <br /> ➢ Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced inine the corrective AST design,a Certified inspecnk <br /> tor,or ata <br /> manufacturer who will determ is for 36 months.action. Note the non-conformance and corresponding corrective action in the comment section. <br /> )> Retain the completed ch ice, wind storms) or maintenance (such as painting)that could affect the operation of critical components <br /> ➢ In the event of severe weather (snow, <br /> (normal and emergency vents, valves), an inspection of these components is required as soon as the equipment is safely accessible afterthe event. <br /> Task <br /> Status comments <br /> Item <br /> 1.0 Tank Containmen ChecK for water, <br /> 1.1 Containment <br /> structure debris, cracks or fire ®Yes* ❑ 'No *N/A <br /> hazard ❑YeS* 59—No <br /> 1.2 Primary tank Check for water <br /> Operable and in a 'es No* I/A <br /> � Ll <br /> 1.3 Containment closed position <br /> drain valves Clear and <br /> 1.4 Pathways and gates/doors Yes Ll No* El N/A <br /> entry operable <br /> 2.0 Leak Detection Visible signs of ]Yes* k No <br /> 2.1 Tank leakage <br /> 2.2 Secondary Visible signs of <br /> Containment leakage from tank ❑Yes* No <br /> into secondary <br /> containment <br /> ❑Yes* No ❑ NIA <br /> 2.3 Surrounding soil <br /> Visible <br /> ee signs of SEpTEN <br /> 2.4 Interstice Visible signs of []Yes* No [INIA <br /> leakage <br /> AST INSPECTION STANDARD <br />