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MONTHLY FACILITY INSF <br />Instructions: This nspection i <br />for each item. If ai Ly response <br />provided. Further lescription., <br />necessary. <br />'�j R EEC F ! VD <br />l -v T ?.Oil <br />EN'VIR014P: N7AL HEALTH <br />PERMIT/SERVICES <br />CA <br />TION CHECKLIST (Attachment B) <br />rd will be completed every month. Place an X in the appropriate box <br />uires elaboration, do so 'in the Descriptions & Comments space <br />comments should be attached on a separate sheet of paper if <br />Yes No Descriptions & Comments <br />Tank surfaces shoN t signs of lea age ❑ <br />Tanks are damaged, rusted or dei eriorated ❑ <br />s <br />Bolts, rivets, or seams are damag ed ❑ <br />Tank supports are 4 leteriorated o buckled ❑ <br />Tank foundations I iave eroded 01 settled ❑ <br />Level gauges or alarms are inoperative ❑ - <br />Vents are obstructc d ❑ El <br />i <br />Valve seals or gaslets; are leaking ❑ Q <br />Pipelines or suppo ts are damagc d or deteriorated ❑ m <br />Buried pipelines exposed ❑ <br />Loading/unloading area is dama ed or deteriorated ❑ ,® <br />Connections are ric t capped orb k -flanged ❑ In <br />Secondary contain ent is dams ed or stained ❑ <br />Dike drainage va1v 5s are open ❑ <br />Fencing, gates, or -ghting is no functional ❑ ❑ <br />-r-�-� <br />Signature: Date: <br />