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1 1 i Appendix F-3 STI SP001 Portable Container Monthly Inspection Checklist General Inspection Information: Inspection Date:_AWIZ, LI Prior Inspection Date: May ay 7' Retain until date: 2_ Inspector Name(print): I? Title: 4!;W inspectors Signature(): Container(s)inspected ID MRACIr 6-` d f Q%S Regulatory facility name and ID number(if applicable) tAty L G. Inspection Guidance: ➢ This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent(as applicable). ➢ This periodic Inspection is intended for monitoring the external condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner's inspector who is familiar with the site and can identify changes and developing problems. Note the non-conformance and corresponding corrective action in the comment section. ➢ Retain the completed checklists for at least 36 months. Item Area: Area: Area: Area: Portable Container Containment/Storage Area FAre all portable container(s)within designated yes ONo ❑Yes ONo ❑Yes ONo ❑Yes ONo i stora a area? 2 Is the containment and storage area free of excess liquid,debris,cracks or fire hazards? ;?Yes ONo ❑Yes ONo ❑Yes ONo ❑Yes ONo 3 Are drain valves closed and in good working condition? DYes 0 No ❑N/A DYes ❑ No ON/A ❑Yes ❑ No ON/A DYes ❑ No ❑N/A 4 Are containment egress pathways clear and any �S'es ❑ No ON/A ❑Yes ❑ No ON/A ❑Yes ❑ No ON/A DYes 0 No ON/A gates/doors operable? Container 5 Is the container free of leaks? Note: If"No" identify container and describe 21"(es ONo DYes ONo DYes ONo DYes ONo leak. 6 Is the container free of distortions, buckling, 'Yes ONo DYes ONo DYes ONo ❑Yes El No denting or bulging? Portable Container Checklist Page 1 of 2