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STI SP001 Monthiv Ins ection Checklist <br /> General Inspection Information: <br /> Inspection Date: / Prior Inspection Date: <br /> Retain until date: <br /> Inspector Name(print): ` <br /> � � c <br /> 7iUe: <br /> Inspector's Signature <br /> Tank(s)inspected ID --7 <br /> Regulatory facility name and ID number(if applicable) 64 G 4//t/ ILA A-rz r,VI4-- <br /> Inspection Guidance: <br /> ➢ This checklist is intended as a model. locally developed checklists are acceptable as long as they are substantially equivalent(as applicable). Inspections of multi <br /> tanks may be captured on one form as long as the tanks are substantially the same. <br /> ➢ For equipment not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. p e <br /> ➢ The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure.This visual inspection does not require a Certified <br /> Inspector. It shall be performed by an owner's inspector per paragraph 4.1.2 of the standard. <br /> Y Upon discovery of water in the primary tank,secondary containment area,interstice,or spill container, remove promptly or take other corrective <br /> for regulated products or other contaminants and dispose of properly. <br /> Non-conforming items im ortant o tank or containment inte ri require evaluation by an engineer experienced in AST design,a Certified Inspector, or atank Inspect the liquid <br /> manufacturer who will determine the corrective action.Note the non-conformance and corresponding corrective action in the comment section. <br /> ➢ Retain the completed checklists for at least 36 months. <br /> ➢ After severe weather(snow, ice,wind storms)or maintenance(such as coating)that could affect the operation of critical components(normal and <br /> emergency vents,valves),an inspection of these components is required as soon as the equipment is safely accessible after the event <br /> 1TBN <br /> STATUS COMMENTS/DATE CORRECTED <br /> Tank and Piping <br /> Is tank exterior(roof,shell,heads,bottom,connections,fittings,valves,etc_)free of visible <br /> 1 leaks? <br /> Note.K No" identify tank and descd/be teak and actions taken. es o No <br /> 2 Is the tank liquid level gauge legible and in good working condition? <br /> ❑ Yes ❑ N /A <br /> 3 Is the area around the tank(concrete surfaces,ground,containment,etc.)free of visible <br /> V_ <br /> of leakage? <br /> es ❑ No <br /> Monthly Checklist <br /> Page 100 3 <br />