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<br />Annual Checklist Page 1 of 4 <br />STI SP001 Annual Inspection Checklist <br /> <br />General Inspection Information: <br /> <br />Inspection Date: __________________ <br /> <br />Prior Inspection Date: _________________ <br /> <br />Retain until date: __________________ <br /> <br /> <br />Inspector Name (print):________________________________________________________________ <br /> <br /> <br />Title: _____________________________ <br /> <br /> <br /> <br />Inspector’s Signature: __________________________________________________________________ <br /> <br />Tank(s) inspected ID ___________________________________________________________________ <br /> <br />Regulatory facility name and ID number (if applicable) __________________________________________________________________ <br /> <br /> <br />Inspection Guidance: <br /> <br /> This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). <br /> For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. <br /> The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified <br />Inspector. It shall be performed by an owner’s inspector per paragraph 4.1.2 of the standard. <br /> Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the <br />environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. <br /> In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper <br />operation (40 CFR 112.8(c)(8)(v)). <br /> Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank <br />manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comment section. <br /> Retain the completed checklists for at least 36 months. <br /> Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. <br /> Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan <br />requirement by a Professional Engineer knowledgeable in SPCC development and implementation. <br /> <br />ITEM STATUS COMMENTS / DATE CORRECTED <br />Tank Foundation/Supports <br />1 Free of tank settlement or foundation washout? □Yes □No <br />2 Concrete pad or ring wall free of cracking and <br />spalling? □Yes □No □N/A