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AST SPOO1 ANNUAL INSPECTION <br /> Item Task Status <br /> 5.11 Overfill equipment a. Follow manufacturers instructions and regulatory r Yes r No P NIA <br /> -requirements for inspection and functionality verification. <br /> b. Confirm device is suited for above ground use by the r Yes r No r,07 NIA <br /> manufacturer.Make: ,Model: <br /> Comments: <br /> 6.0 Insulated Tanks <br /> 6.1 Insul2tion Insulation is free of, <br /> + Missing sections rYes r"No r NIA <br /> + Areas of moisture r'Yes r No P-1 NIA <br /> • Mold [—Yes r No P NIA <br /> Damage <br /> r—Yes f No f-1 NIA <br /> 6.2 Insulation cover or jacket Inspected and confirmed that insulation cover or jacket is free r`Yes r No P NIA F <br /> of damage that will allow water intrusion. <br /> Comments: j <br /> i <br /> 7.0 Miscellaneous <br /> 7.1 Electrical wiring and Are they in good condition? r-Yes r-No W NIA <br /> boxes <br /> 7.2 Labels and tags • No Smoking W Yes r No r NIA <br /> • NFPA Placards W Yes r-No r-N/A <br /> • Capacity 17Yes r-No N/A <br /> • Contents 17 Yes r No N/A <br /> • Fill Procedures <br /> • Emergency Contacts r Yes r No W NIA <br /> Yes r No r NIA <br /> Comments: <br /> Additional Comments: <br /> M, 6703206 SEPTEMBER 2016 <br />