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1 ) � <br /> Appendix F-3 <br /> STI SP001 Portable Container Monthly Inspection Checklist <br /> General Inspection Information: <br /> Inspection Date: Prior Inspection Date: CAV Z., Retain until date: 2 <br /> Inspector Name(print): a 6 Title: - <br /> Inspector's Signature Q: <br /> Container(s)inspected ID blese 1 TGY1�L or,J '"QA,� 5100 T'V`k. <br /> 14 <br /> Regulatory facility name and ID number(if applicable) Nc-r CL <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 /> ➢ This periodic Inspection is intended for monitoring the external condition and its containment structure. This visual inspection does not require a <br /> 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 <br /> the non-conformance and corresponding corrective action in the comment section. <br /> ➢ Retain the completed checklists for at least 36 months. <br /> Item Area: Area: Area: Area: <br /> Portable Container Containment/Storage Area <br /> 1 Are all portable container(s)within designated Yes ONO OYes ONO ❑Yes ONO OYes ONO <br /> storage area? <br /> 2 Is the containment and storage area free of excess <br /> liquid,debris,cracks or fire hazards? ,ZYes ONO OYes ONO OYes ONO OYes ONO <br /> 3 Are drain valves closed and in good working <br /> condition? Yes 0 No ❑N/A OYes 0 No ❑N/A OYes 0 No ON/A ❑Yes 0 No ❑N/A <br /> 4 Are containment egress pathways clear and any Wes 0 No ❑N/A OYes 0 No ON/A OYes 0 No ❑N/A OYes ❑ No ON/A <br /> gates/doors operable? <br /> Container <br /> 5 Is the container free of leaks? <br /> Note:If"No" identify container and describe /Yes ❑No OYes ONO OYes ONO OYes ONO <br /> leak. <br /> s Is the container free of distortions,buckling, <br /> dentin �' <br /> or bulging?? es ONO OYes ONO OYes ONO OYes ONO <br /> Portable Container Checklist Page 1 of 2 <br />