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General Inspection Information: <br /> Inspection Date: 4/C J—Z3 Retain Until Date: [ (�—�-ZG (36 months from inspermu ON <br /> Prior Inspection Date: Inspector Name: V �V <br /> st: Tanks Inspected(ID#'s): <br /> nE <br /> U; Inspection Guidance: <br /> 3 i ➢ For equipment not included in this Standard,follow the manufacturer recommended inspection/testing schedules and procedures. <br />'S )> 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 who is familiar with the site and can identify changes and developing problems. <br /> N ➢ Upon discovery of water in the primary tank,secondary containment area, interstice, or spill container, remove promptly or take other corrective action.Before <br />( discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. <br /> ➢ (*)designates an item in a non-conformance status.This indicates that action is required to address a problem. <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 /> r 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 36 months. <br /> I ➢ In the event of severe weather(snow, ice,wind storms) or maintenance(such as painting)that could affect the operation of critical components <br /> i (normal and emergency vents,valves), an inspection of these components is required as soon as the equipment is safely accessible after the event. <br /> Item Task Status Comments <br /> 1.0 Tank Containment <br /> 1.1 Containment Check for water, <br /> structure debris, cracks or fire ®Yes* El No { N/A <br /> hazard <br /> 1.2 Primary tank Check for water [:]Yes* �Nc <br /> 1.3 Containment Operable and in a Yes ❑ No* �llA <br /> drain valves closed position <br /> 1.4 Pathways and Clear and Yes ❑ No* El N/A <br /> entry gates/doors <br /> 2operable <br /> .0 Leak Detection <br /> 2.1 Tank Visible signs of ❑Yes* '<No <br /> leakage <br /> 2.2 Secondary Visible signs of <br /> Containment leakage from tank ❑Yes* �X No <br /> into secondary <br /> containment <br /> 2.3 Surrounding soil Visible signs of ❑Yes* No ❑ N/A <br /> -leakage <br /> 2.41nterstice Visible signs of ❑Yes* No ❑ N/A <br /> leakage SEPTEMBER <br /> AST INSPECTION STANDARD <br /> •1 <br />