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Inspection Data: / <br /> ANNUAL INSPECTION CHECKLIST <br /> Facility Inspector: M1k'e Tsars Inspector Title: (aW*-,da°t �elaw {U°k�cv <br /> (printed) <br /> ➢ Complete this checklist on.appual basis.The periodic AST Inspection is intended for monitoring the extemnl AST condition and its odnminnuad struotura.This visual inapeotion doe,not require a <br /> Certified Inspector.Il should be perhnmed by peonnnel who are rmni I or with the Fri and can idemi I,changes and developing problems. <br /> ➢ (1)designate,an item in a mon-conformance status and indicates action is required to address the problem.Note the Intended,pmture of the red-raboncmnee item,aM corrective action in the <br /> description. <br /> ➢ Retain compbrW checklists for at least 36 martin <br /> ➢ In order to empty watt SPA SPCC rules,a Facility net rsanded.,taetllquldlocal sensldg devices to enam proper operation(40 CPR 112.8(a S8)yd. <br /> ➢ New If a ehmnge be,occurred to We took system or containment that may effmt the SPCC pill the condition should be evaluated against the curnml plea requirement by a Pro@arm al <br /> Engineer kmowledgeable in SPCC development. <br /> Location/Inspection Item Circle One Description <br /> STORAGE TANKS <br /> The following items are operational: <br /> Vents N* <br /> Valves (anti-siphon, check,gate,fire N* <br /> Liquid level equipment N* <br /> Overfill equipment N* <br /> Tank surfaces show signs of leakage Y* <br /> Tanks are damaged Y* <br /> Bolts,rivets, or seams are damaged Y* <br /> Tank supports are deteriorated or buckled Y* <br /> Tank foundations have eroded or settled Y* <br /> Level gauges or alarms are inoperative Y* <br /> Vents are obstructed Y* <br /> Secondary containment is dams ed or stained Y* <br /> Water/product in containment area Y* <br /> Containment drainage valve iso en or is not lacked Y* <br /> PIPING <br /> Valve seals, gaskets,or other appurtenances are leaking Y* <br /> Pipelines or supports are dame ed or detericratin Y* 1 (91 <br /> Joints,valves, and other appurtenances are leaking Y* <br />