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APPENDIX A-3: SAMPLE FORM FOR ANNUAL STP INSPECTION CHECKLIST — Page 2 <br /> Go to www.pei.orgIRP900 for an electronic version of this form. <br /> Category I Description PIEMP990N/ATenkt Taic2 TarYc3Taica <br /> STP:In <br /> Double-Walled If not continuously monitored or inspected annually,double- ailed TEST DATE: S.B.t9 <br /> Containment sump tightness tested every 3 years <br /> Sum <br /> DESCRIBE ANY DEFICIENCIES HERE: <br /> PEI RP 900 Annual STP Inspection Checklist Page_of_ <br />