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Attachment 5 <br />TANK INSPECTION CHECKLIST <br />R E��IVED <br />OCT '�3Z017 <br />Page 1 of 4 <br />FACIUTY NAME: `" n , y,,ENVIRE) <br />FACILITY LOCATION: , - <br />MEW= <br />,3TME <br />6-7 <br />DATE OF INSPECTION: fQ - r l <br />INSPECTED BY: Qualified Tank Inspector (STI certified)? <br />Authorized Inspector (API certified)? <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />NON-FACIUTY INSPECTOR: ❑ Yes P No if yes, from: <br />INSPECTION TYPE? ❑ Daily ,el Weekly ❑ Monthly ❑ Quarterly ❑ Annual ❑ Ten. (10) year <br />Note: If Monthly, Quarterly, Annual or Ten (10) year, must do Tank Integrity Testing per Attachment 6 <br />1.0 Records of•petroleum discharge from secondary containment? <br />❑ Yes ❑ No 14 NA <br />1.1 Records of storm water discharge from secondary containment? <br />❑ Yes ❑ No �ff NA <br />1'.2 Records of leak sensor checks? <br />❑ Yes ❑ No ❑ NA <br />1.3 Records kept? Inspection: ❑ Yes ❑ No ❑ NA Discharge: ❑ Yes ❑ No ❑ NA <br />2.0 Type of petroleum container? m Tank ❑ Drum ❑ Other Container: <br />2.1 Age of tank? v ! ,G���� <br />2.2 . Type of tank? ❑ Rivetted Steel (Welded Steel ❑ Other: <br />2.3 Number of tank compartments? 2f One (1) ?Two (2) A <br />it <br />2.4 Capacity of each tank compartment? . Primary: g cov <br />Secondary: '6®2-0 1 Z <br />2.5 Content of tank compartments? Primary: <br />. <br />Secondary: P'rd�&- <br />2.6 is all associated piping aboveground? <br />❑ Yes CEJ 'No ❑ NA <br />2.7 Bottom of the tank visible for inspection?] <br />Yes ❑. No <br />2.8 How is small leak in tank bottom detected? <br />3.0 Is there secondary containment?LJ <br />Yes ❑ No ❑ NA <br />3.1 Type of secondary containment? ❑ Earth berm ❑ Concrete Curb ❑ Steel Pan <br />❑ Concrete Vault (ConVault) B Double wall ❑ Other: <br />3.2 Secondary containment area paved? <br />❑ Yes 0 No ❑ NA <br />3.3 Secondary containment drainage pipe capped? <br />Q( Yes ❑ No ❑ NA <br />3.3 Secondary containment drainage, valve(s)? <br />If yes, are the valve(s): Closed? ❑ Yes lZf No Locked? ❑ Yes <br />❑ Yes Z No O NA <br />❑ No <br />3.4 Secondary containment for the associated piping?... --� <br />m Yes ❑ No ❑ NA <br />3.5 Loading/offloading areas paved and designed` to contai d1s7-1 <br />❑ Yes [� No ❑ NA <br />3.6 Interstitial monitor for leakage in double wall tank? <br />Ct Yes ❑ No ❑ NA <br />BACC1602. DBC -Z22 -TRACY <br />AEALTH <br />T <br />—Je�-A- <br />