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Annual Checklist Page 3 of 4 <br />Are all valves free of leaks, corrosion and other <br />damage? Follow manufacturers' instructions for <br />regular maintenance of these items. Check the <br />following and verify (as applicable): <br />❑ Anti -siphon valve <br />❑Yes ❑No ❑N/A <br />16 <br />❑ Check valve <br />❑Yes ❑No ❑N/A <br />❑ Gate valve <br />❑Yes ❑No ❑N/A <br />❑ Pressure regulator valve <br />❑Yes ❑No E3 N/A <br />❑ Expansion relief valve <br />❑ Solenoid valve <br />❑Yes ❑No El N/A <br />❑ Fire valve <br />❑Yes ❑No ❑N/A <br />❑ Shear valve <br />❑Yes ❑ No ❑ N/A <br />17 <br />Are strainers and filters clean and in good condition? <br />❑Yes ❑ No ❑ N/A <br />Insulated Tanks <br />Free of missing insulation? <br />❑Yes []No ❑ N/A <br />18 <br />Insulation free of visible signs of damage? <br />Insulation adequately protected from water intrusion? <br />19 <br />Insulation free of noticeable areas of moisture? <br />❑Yes ❑ No ❑ N/A <br />20 <br />Insulation free of mold? <br />❑Yes ❑ NO ❑ N/A <br />21 <br />Free of visible signs of coating failure? <br />❑Yes ❑ NO ❑ N/A <br />Tank/ Piping Release Detection <br />22 <br />Is inventory control being performed and documented <br />❑Yes ❑ NO ❑ N/A <br />if required? <br />23 <br />Is release detection being performed and documented <br />❑ Yes ❑ No ❑ N/A <br />if required? <br />Other Equipment <br />24 <br />Are electrical wiring and boxes in good condition? <br />❑Yes ❑ NO ❑ N/A <br />Has the cathodic protection system on <br />❑Yes ❑ NO ❑ N/A <br />25 <br />the tank been tested as required by <br />the designing engineer? <br />Annual Checklist Page 3 of 4 <br />