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W.O.# NW1-2344494 Cust Ref#: 409507 <br /> Annual Walkthrough Checklist(Contractor) <br /> ID#: ANNUAL DISPENSER CHECKLIST Date: <br /> Category Description PEI/RP900 NIA Disp 1 jSP'f tl« $srcr'? <br /> Initial Fuel Dispenser Inspection 8.5 <br /> All Dispensers All dispenser components are clean and dry 8.5.1 <br /> If dispenser sump Is present,sump Is dry 8.5.2 <br /> Fuel Dispenser Inspection 8.6 <br /> Visible piping and fittings show no signs of leaking 8.6.1 Y y <br /> Piping in good condition 8.6.2 Y Y <br /> All Dispensers Dispenser containment sump free of trash and debris 8.6.5 <br /> Any water or product removed and disposed of properly 8.6.4 I Y Y <br /> Sump free of cracks,holes,bulges,or other defects 8.6.6 Y 7 <br /> Dispensers With <br /> Sumps Penetration fittings Intact and secured 8.8.7 <br /> Piping interstitial space open to the dispenser sump or dispenser pan(open double-walled piping system only) 8 6 21 <br /> Piping interstitial space closed to the dispenser sump(closed double-walled piping system only) 8.6.22 Y Y Y <br /> Category Description PEURP900 NIA 6/b Haat 17/S NIii <br /> Initial Fuel Dispenser Inspection 8.5 ✓ ,/ <br /> All Dispensers All dispenser components are clean and dry 8.5.1 <br /> If dispenser sump is present,sump is dry 8.5.2 <br /> Fuel Dispenser Inspection 8.6 <br /> Visible piping and fittings show no signs of leaking 8.6.1 f y <br /> Piping in good condition 8.6.2 <br /> All Dispensers Dispenser containment sump free of trash and debris 8.6.5 <br /> Any water or product removed and disposed of properly 8.6.4 <br /> _ Sump free of cracks,holes,bulges,or other defects 8.6.6 ✓ L/ <br /> Dispensers With <br /> Sumps Penetration fittings intact and secured 8.6.7 <br /> Piping interstitial space open to the dispenser sump or dispenser pan(open double-walled piping system only) 8.6.21 <br /> Piping interstitial space closed to the dispenser sump(closed double-walled piping system only) 8.6.22 Y <br /> DESCRIBE ANY DEFICIENCIES HERE: 11 oc r S1 7\ 0-ad1At r-0, <br /> t` VPi <br /> Fulq1,11 /JoF SlIaw Si C k—A <br /> Adapted from PEI RP 900 Ryder Fuel Services,Version 1.0,11/2018 Page 2 of 4 - <br /> RECEIVED BY EHD: <br /> 7/27/2021 <br /> (received via Crompco Vault Portal) <br />