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STI SP001 Monthly Inspection Checklist <br /> General Inspection Information: <br /> Inspection Date: 8 1V SCJ �/ j1 Prior Inspection Date: Retain until date: <br /> Inspector Name (print): 61-Ar Coctwan Title: Z,/!P Ceril,cE �o,ncge; <br /> Inspector's Signature �/ <br /> Tank(s) inspected ID_,6/i,t rnrm -. o2k5 1., 214 J4 � 7 <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). Inspections of multiple <br /> 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. <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 owners inspector per paragraph 4.1.2 of the standard. <br /> ➢ 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, ora 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)or maintenance(such as coating)that could affect the operation of critical components (normal and <br /> emergency vents,valves),an inspection of these components is required as soon as the equipment is safely accessible after the event. <br /> ITEM STATUS COMMENTS I DATE CORRECTED <br /> Tank and Piping <br /> Is tank exterior(roof,shell,heads, bottom,connections,fittings,valves,etc.)free of visible <br /> 1 leaks? )KYes o No <br /> Note:If"No", identify tank and describe leak and actions taken- <br /> 2 Is the tank liquid level gauge legible and in good working condition? xtYeS ❑ No ❑ N/A <br /> 3 Is the area around the tank(concrete surfaces, ground,containment, etc.)free of visible KYeS ❑ No <br /> signs of leakage? <br /> Monthly Checklist Page 1 of 3 <br />