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Rev. 112025 ATTACHMENT 3 — Inspections, Dike Drainage, Effluent Treatment FacilitieslSystems, and Personnel Training Logs Attachment 3.1 — SPCC Plan Monthly Inspection Checklist (based on STI SP001) Page 1 of 2 General Inspection I ormntion: Inspection Date: r / Inspector Name (print): — C t C' . t Inspector's Signature _ Tank(s) inspected or ID #s Prior Inspection Date: 3L3 h,5 Inspection Guidance: ®This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). Inspections of multiple tanks may be captured on one form as long as the tanks are substantially the same. ® For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. ® The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner's inspector per paragraph 4.1.2 of the standard. e Upon discovery of water in the primary tank, secondary containment area, interstice, or spill container, remove promptly or take other corrective action. Inspect the liquid for regulated products or other contaminants and dispose of properly. o Non -conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comment section. ® Retain the completed checklists for at least 36 months. ® After severe weather (snow, ice, wind storms) or maintenance (such as coating) that could affect the operation of critical components (normal and emerQenev ventsvalves), an inspection of these components is required as soon as the equipment is safely accessible after the event. ITEM STATUS COMMENTS/DATE CORRECTED Tank and Piping Is tank exterior (roof, shell, heads, bottom, connections, fittings, valves, etc.) free of visible leaks?es o No Note: If "No", identify tank and describe leak and actions taken Is the tank liquid level gauge legible and in good working condition? 041 o No o NA Is the area around the tank (concrete surfaces, ground, containment, etc.) t4es o No free of visible signs of leakage? Is the primary tank free of water or has another preventative measure been taken? NOTE: Refer to paragraphs 6.10 and 6.11 of the standard for No NA alternatives for Category 1 tanks. N/A is only appropriate for these t<Yes o o alternatives. For double-wall or double bottom tanks or CE-ASTs, is interstitial 'Yes monitoring equipment (where applicable) in good working condition? o No o NA For double-wall tanks or double bottom tanks or CE-ASTs, is interstice ,,rr� °Yes free of liquid'? Remove the liquid if it is found. If tank product is found, o No ❑ NA investigate possible leak. Equipment on Tank If overfill equipment has a "test" button, does it activate the audible horn ,� or light to confirm operation? If battery operated, replace battery if o Yes o No A needed. Is overfill prevention equipment in good working condition? If it is equipped with a mechanical test mechanism, actuate the mechanism toes o No o NA confirm operation. Is the spill container (spill bucket) empty, free of visible leaks and in good es o No o NA working condition? Are piping connections to the tank (valves, fittings, pumps, etc.) free of 'Yes No visible leaks? Note: If "No", identify location and describe leak. o Page 24 Facility SPCC Plan