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Attachment 5 OCT 2 3 2017 TANK INSPECTION CHECKLIST Page 3 of 4 FACILITY NAME: ii,4zt�, �6t Li !iEPARTI1/iEN LOCATION ON FACILITY: Jr'7�/� DATE OF INSPECTION: . Z . / Aboveground Tank Petroleum* level in tank ❑ Yes ❑ No ❑ NA Appropriate appurtenances are properly configured ❑ Yes ❑ No ❑ NA Normal vent(s) and riser(s) present at proper elevation and in good operating condition 0. Yes ❑ No '❑ NA Emergency vent(s) present and in good operating condition ❑ Yes ❑ No ❑ NA Overfill protection present and in good operating condition (e.g., spill container to catch any spills during tank filling), and locked when not in use ❑ Yes ❑ No ❑ NA Spill protection controls present and in good operating condition (e.g., reservoirs, catchment basins for use during tank filling and vehicle fueling) ❑ Yes ❑ No ❑ NA Vapor recovery equipment present and in good operating condition ❑ Yes ❑ No 0 NA Tank hose nozzles secured and locked when not in use ❑ Yes ❑ No Z NA Corrosion protection controls present and in good condition (e.g., paint, cathodic protection, etc.) ❑ Yes JZ No ❑ NA Evidence of corrosion on tank, supports, piping, pumps, valves, vents, etc. Z Yes ❑ No ❑ NA Holes and/or cracks present in tank ❑ Yes .© No ❑ NA Evidence of leakage from tank ❑ Yes Z No ❑ NA Evidence of leakage from valves, vents, fittings, piping and other appurtenances ❑ Yes Z No ❑ NA Evidence of spillage on tank foundation ❑ Yes Z No ❑ NA Secondary Containment Drain closed ,Q Yes ❑ No ❑ NA Free of debris (e.g., rainwater, snowmelt, dirt, leaves,) trash, stored materials, etc.) -n Yes ❑ No ❑ NA Free of leakage (excluding rainwater or snowmelt) - C� Yes ❑ No ❑ NA Visual leafs in containment drain ❑ Yes 2 No ❑ NA Signs of cracks in containment walls ❑ Yes IYNo ❑ NA Signs'of cracks in. containment floor ❑ Yes No C3 NA Evidence of leakage or spillage L6 ❑ Yes No ❑ NA. h BACC 1602.DBC-Z22-TRACY ALTH