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AST 512009 ANNUAL INSPECTION <br /> Item Task Status <br /> 3.0 Cathodic protection <br /> 3,1 Galvanic cathodic Confirm system is functional, includes the wire connections for r Yes r No F NIA <br /> protections stem galvanic systems. <br /> 3.2 Impressed current a. Inspect the operational components (power switch, meters, and r Yes r No rix NIA <br /> system alarms)- <br /> b. <br /> larms)_b. Record hour meter, ammeter and voltmeter readings, r Yes r No F/_NIA <br /> c_ Rectifier Unit: Make:,Model: <br /> Comments: <br /> 4.0 Tank$hall, Heads Roof <br /> 4.1 Coating Is the coating in good condition? P Yes r No r N/A <br /> 4.2 Steel condition Is structure free of: <br /> + Dents W Yes r No r N/A <br /> + Buckling V Yes 7 No r NIA <br /> • Bulging W Yes r No r"NIA <br /> • Corrosion 17 Yes r No r-NIA <br /> + Cracking r Yes r No r N/A <br /> 4.3 Roof slope System is free of low points and standing water. r Yes r No r NIA <br /> Comments: <br /> 5.0 Tank Equipment <br /> _ 5.1 Vents- Primary Components are moving freely and vent passageways are not <br /> obstructed for: r Yes r No r NIA <br /> + Emergency vent covers: Make: ,Model:, Diameter: r Yes r No r NIA <br /> + Normal Vent: Make: ,Model:, Diameter: ryes r No r NIA <br /> • Other moving vent components (enter manufacturer and model <br /> number in Comments if available. <br /> 5,2 Vents-Secondary Components are moving freely and vent passageways are not <br /> obstructed for: r Yes r No P NIA <br /> • Emergency vent covers:Make:,(Model:,Diameter: r Yes r No W NIA <br /> + SecondaryVent:Make:,Model:,Diameter: r-Yes r-No WN/A <br /> + Other moving vent components(enter manufacturer and model <br /> number In Comments if available. <br /> Comments: <br /> 5.3 Valves All valves are free of leaks, corrosion and damage. r Yes r No <br /> 5.3.1 Anti-siphon, check Cycle the valve open and closed and confirmed proper operation, r Yes r No 1 NIA <br /> and gate valves enter manufacturer and model number In Comments if available) <br /> 5.3.2 Pressure regulator Confirmed proper operation. (Note that there may be small, 114 inch r Yes r No W NIA <br /> valve drain plugs in the bottom of the valve that are not visible by looking <br /> from above only)(enter manufacturer and model number in <br /> Comments if available <br /> 5.3.3 Expansion relief valve Confirmed that the valve is in the proper orientation. (Note that fuel r Yes r No 17 NIA <br /> must be discharged back to the tank via a separate pipe or tubing.) <br /> inter manufacturer and model number in Comments if available)__ _ _ <br /> .- W0. 6703206 SEPTEMBER 2018 <br />