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.............. <br /> STI SP001 Annual Inspection Checklist <br /> General Inspection Information: <br /> Inspection Date: Prior Inspection Date: Retain until date: <br /> Inspector Name(print): Title: <br /> Inspector's Signature: <br /> Tank(s)inspected ID <br /> Regulatory facility name and ID number(if applicable) <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). <br /> • For equipment not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. <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 /> ➢ Remove promptly standing water or liquid discovered in the primary tank,secondary containment area,interstice,or spill container. Before discharge to the <br /> environment,inspect the liquid for regulated products or other contaminants and disposed of it properly. <br /> 9 In order to comply with EPA SPCC(Spill Prevention, Control and Countermeasure)rules,a facility should regularly test liquid level sensing devices to ensure proper <br /> operation(40 CFR 112.8(c)(8)(v)). <br /> ➢ Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design,a Certified Inspector,ora tank <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 /> ➢ Complete this checklist on an annual basis,supplemental to the owner monthly-performed inspection checklists. <br /> ➢ Note:If a change has occurred to the tank system or containment that may affect the SPCC plan,the condition should be evaluated against the current plan <br /> requirement by a Professional Engineer knowledgeable in SPCC development and implementation. <br /> __F_ <br /> ITEMSTATUS COMMENTS lDATE CORRECTED <br /> Tank Foundation/Supports <br /> 1 Free of tank settlement or foundation washout? ❑Yes ❑No <br /> 2 Concrete pad or ring wall free of cracking and ❑Yes ❑NO ❑N A <br /> spalling? <br /> Annual Checklist Page 1 of 4 <br />