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Northwest Pipe Spill Prevention, Control, and Countermeasure (SPCC) Plan 52 <br /> Company Tracy Plant <br /> Appendix G Monthly Visual Inspections <br /> U01Tat west Pipe <br /> Company <br /> Title: Periodic Visual Oil Storage Inspection Form <br /> Fad I ity Name: I nspect m Conduced By: Date: <br /> Period io nspectians of bulk ail storage containers&oil-fil led operational equ ipme,nt with>55 gallon capacity shat!consider the fDllawing items: <br /> 1. Inspect outside Df the Storage container far signs of deterioration or discharge-Ensure labels are n place and legible- <br /> 2. Visually inspect seams,gaskets-pipng,pumps,valves,rivets,andfor baits where applicable. <br /> 3. Inspect secondary Dontaihrnent structures for sylns of deterioration,d iso arge,or accumulation Df of in the containment area- <br /> 4a.Is the secondarycontanrnentFREE ofanyliquidacc ullation.ITVFmowed.arrargePair"todemaaedaWmnagedprop -DONtDTDfRW.A'rheeni%not <br /> mse m me mew may be 4WW ora-RE WMI14 as boas Ox. a dopa by a sPYASor 3W axamanw on M Tarn ar W itrenman nom sW mym WWPWW <br /> reTAeteta�Sl <br /> 4b.If applicable.Manager must sign here if We Plan to fain water acu mulation to ground. <br /> 5. Describe any issues that need attention,identified during the inspection.Nate the release of any accumulated rainwater here. <br /> d. Mote the date when the corrective action was completed. <br /> Id Gal Items I.Z S t>�. 4b. 5-Issues Ii-Corrective <br /> Aoceptable? carte ^+• •"•: : Rctian date <br /> Eksel AST MOM ❑Y ON ❑Y❑N <br /> Casorne AST 363 Y H Y N <br /> Aubxriatic transrnsr" Y LJH LjY LJN <br /> Iltid AST <br /> Hr talc Ort AST Y H Y N <br /> t�hos <br /> Mo r Cd AST 5[U ❑Y❑4 ❑Y❑N <br /> U c ttLPW tka <br /> McbileRefwier 22m Y 711 LJY LJN <br /> 1' <br /> Diesel emergency ❑Y❑H ❑Y❑N <br /> enet3tor <br /> Page 1 of d <br /> Master Tempi"Form revised 04;111''2012 <br /> Site-Specfio Template Revised 03109,4020 <br />