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S ...3'P001 Monthly Inspection Checkl.111. <br />Inspection Date: 7 I LX I Retain Until Date_ c -r / 1'G <br />6(36 months from inspection date) <br />Prior Inspection Date: Z Inspector Name: �j 0"", AYE 0 <br />Tanks Inspected (ID Ws): AST -8, AST -9 (Building 120) <br />inspection uwoance: <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 <br />does not require a Certified Inspector. it shall be performed by an owner's inspector who is familiar with the site and can identify changes <br />and developing problems. <br />➢ Upon discovery of water in the primary tank, secondary containment area, interstice, or spill container, remove promptly or take other <br />corrective action. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it <br />properly. <br />> (*) designates an item in a non-conformance status. This Indicates that action is required to address a problem. <br />^r Non -conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified <br />Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective <br />action in the comment section. <br />➢ Retain the completed checklists for 36 months. <br />In the event of severe weather (snow, ice, wind storms) or maintenance (such as painting) that could affect the operation of critical <br />components (normal and emergency vents, valves), an inspection of these components is required as soon as the equipment is safely <br />accessible after the event. <br />Item Task status comments <br />1.0 Tank Containment <br />1.1 Containment structure <br />Check for water, debris, cracks or fire hazard <br />Yes* -.4\10 N/A <br />1.2 Primary tank <br />Check for water <br />Yes*�.QVo <br />1.3 Containment drain valves <br />Operable and in a closed position <br />Yes No*,;�V/A <br />1.4 Pathways and entry <br />Clear and gates/doors operable <br />des _No* N/A <br />2.0 Leak Detection <br />2.1 Tank <br />Visible signs of leakage <br />'Yes"K1Vo <br />2.2 Secondary Containment <br />Visible signs of leakage from tank into secondary <br />containment <br />-Yes* No �.t/A <br />2.3 Surrounding soil <br />Visible signs of leakage <br />-,Yes* -'No'-A/A <br />2.4 Interstice <br />Visible signs of leakage <br />Yes*KjVo -N/A <br />3.0 Tank Equipment <br />3.1 Valves <br />a. Check for leaks. <br />.'Yes* Zo N/A <br />b. Tank drain valves must be kept locked. <br />-Yes* No>)/A <br />3.2 Spill containment boxes on fill <br />pipe <br />a. Inspect for debris, residue, and water in the box <br />and remove. <br />Yes%iNo 'JN/A <br />b. Drain valves must be operable and closed. <br />Yes* No -4/A <br />3.3 Liquid level equipment <br />a. Both visual and mechanical devices must be <br />inspected for physical damage. <br />es No* -'N/A <br />b. Check that the device is easily readable <br />Yes _No* -`N/A <br />3.4 overfill equipment <br />a. If equipped with a "test" button, activate the <br />audible horn or light to confirm operation. This <br />could be battery powered. Replace the battery if <br />needed <br />Yes No*-,,�d/A <br />b. If overfill valve is equipped with a mechanical test <br />mechanism, actuate the mechanism to confirm <br />operation. <br />Yes No* A/A <br />3.5 Piping connections <br />Check for leaks, corrosion and damage <br />Yes*-Ao <br />4.0 Tank Attachments and Appurtenances <br />4.1 Ladder and platform structure <br />Secure with no sign of severe corrosion or damage? <br />® Not Applicable <br />5.0 Other Conditions <br />5.1 Are there other conditions that should be addressed for continued safe operation or <br />that may affect the site spill prevention plan? <br />Yes'Ao <br />