Laserfiche WebLink
Attachment 5 RECEIVED <br />_ OCT 232017 <br />TANK INSPECTION CHECKLIST <br />A. ..i A <br />rr� <br />vavu - V. -r <br />FACIUTY NAME: .0� r, �p l t ENVIRONMENTAL HEALTH <br />FACILITY LOCATION: 9-7 <br />.DATE OF INSPECTION: - V I <br />Surrounding Evidence of Spillage in fill and/or dispersing areas <br />Area Evidence of Spillage 'on or in soil <br />Evidence of Spillage <br />❑ Yes <br />(t No ❑ NA <br />❑ Yes t� 1 No ❑ NA <br />❑. Yes No ❑ NA <br />Electrical <br />Equipment <br />Operating controls present and in good condition <br />m Yes <br />❑ No <br />❑ NA <br />Release detection and monitoring equipment present and <br />in good operating condition <br />Yes ❑ No <br />❑ NA <br />Emergency <br />Equipment <br />Overfill prevention equipment & alarms in good condition <br />0 Yes <br />❑ No <br />O NA <br />Fire control equipment present and in good condition <br />2 Yes •O No <br />❑ NA <br />Spill control equipment present and adequate inventory <br />❑ Yes ❑ No <br />❑ NA <br />Other <br />Proper signage present <br />Yes <br />❑ No <br />❑ NA <br />Written operating instructions available <br />❑ Yes ❑ No <br />❑ NA <br />Comments or Corrective Action to be Taken: <br />Date Corrective Action Taken: <br />Inspector's Signature �—� Date Signed: (o _ <br />ri <br />Inspector's Name (print): <br />BA CC 1602. D BC -Z22 -TRACY <br />