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• ' ( ' ( Is the primary tank free of water or has another preventative measure been taken? )(Yes o No □N/A4 NOTE: Refer to paragraphs 6. 10 and 6.11 of the standard for alternatives for Category 1 tanks. N/A is only appropriate for these alternatives. 5 For double-wall or double bottom tanks or CE-ASTs, is interstitial monitoring equipment (where applicable) in good working condition? fYes □No □N/A 6 For double-wall tanks or double bottom tanks or CE-ASTs, Is interstice free of liquid? Remove the liquid If it is found. If tank product Is found, Investigate possible leak. iYes □No □N/A Equipment on tank 7 If overfill equipment has a "test" button, does it activate the audible horn or light to confirm operation? If battery operated, replace battery If needed. )(Yes o No oN/A 8 Is overfill prevention equipment In good working conditlon?lf It Is equipped with a mechanlcal test mechanism, actuate the mechanism to confirm operation. �Yes a No □N/A 9 Is the spill container (spill bucket) empty, free of visible leaks and In good \'i'orklng condition? "'Yes o No □N/A Are piping connections to the tank (valves, fittings, pumps, etc.) free of visible leaks? �Yes □ No 10 Note: If "No", identify location and describe lea/<. ' I •. .. . Do the ladders/platforms/walkways appear to be secure with no sign of severe corrosion . 11 )(Yes o No oN/A or damage? . . , . r---- Containment (Dlkinn/lmnoundln11II.. . -•-· -- Is the containment free of excess liquid, debris, cracks, cor�osion, erosion, fire hazards and 12 )(Yes o No □N/A I other integrity issues? ..._ __ oN/A 13 Are dike drain valves closed and in good working condition? )\Yes o No . ---· 14 1·-----L Ar-e containment egress pathways clear and any gates/doors operable? )(Yes o No □N/A 15 16 17 18 Concrete Exterior AST (CE-AST) Inspect all sides for cracks In concrete. Are there any cracks In the concrete exterior larger than 1 /16"? □Yes �No- Inspect concrete exterior body of 1he tank for cleanliness, need of coating, or rusting where applicable. Tank exterior In acceptable condition? □Yes iNo Visual inspect all tank top openings including nipples, manways, tank top overfill containers, and leak detection tubes. Is the sealant between all tank top openings and concrete Intact and in good condition? iYes o No Other Conditions ·o N/A oN/A □N/A Is the system free of any other conditions that need to be addressed for continued safe operation? �Yes o No Monthly Checklist Page 2 of 3 ( . - I !I I -·. .I I I ' Ii I I I I I I - I