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STI SP001 Portable Container Monthly Inspection Checklist General Inspection Information: Inspection Date: 10-.10-211 Prior Inspection Date: i 2 r Retain until date: 0 Inspector Name (print): �2�"7 C& Title: c lr G,21' !h 5-6� Inspector's Signature: Container(s)inspected ID Drums Regulatory facility name and ID number(if applicable) Dart Container,Lodi _ CD CD Inspection Guidance, <' M ➢ This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent(as applicable). Q ➢ 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. pp Item Area:TpV -If Area: $ ,eODM Area: Area: iV' BOL,k R oD M OttT-S log- O< Portable Container Containment/Storage Area iV I Are all portable container(s)within designated stora a area? rdYes [I No /Yes ❑ No /Yes ❑ No Yes ❑ No 2 Is the containment and storage area free of excess liquid,debris, cracks or fire hazards? R(Yes ❑ No ?f Yes ❑ No plYes ❑ No XYes ❑ No 3 Are drain valves closed and in good working Yes ❑ No ❑ NIA Yes ❑ No ❑ NIA Yes ❑ No ❑ NIA condition? p Yes ❑ No ❑ NIA 4 Are containment egress pathways clear and any gates/doors operable? /Yes ❑ No ❑ NIA JdYes ❑ No ❑ NIA /Yes O No ❑ NIA JWYes ❑ No ❑ NIA Container 5 Is the container free of leaks? Note:if No", identify container and describe ;(Yes ❑ No /Yes ❑ No Yes ❑No VYes [] No leak. s is the container free of distortions,buckling, 41dentin Or bul in ? Yes ❑ No /YesElNo Rf Yes El Yes Q No Portable Container Checklist Page 1 of 2