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STI SPOO1 montnlly irn5j2UL;L1U1I ICtrf� <br /> General Inspection Information: <br /> �� 7-R,2 j Retain Until Date: (36 months from inspection date) <br /> Date: I <br /> Inspector Name: Chl a h'f � L����� <br /> Finspeotion <br /> Inspection Date: <br /> Tanks Inspected (ID#'s): 1� <br /> Inspection Guidance: <br /> ➢ For equipment not included in this St ed fordmonitoring the external AST condition deandittsecontainmeg structure.Thischedules s visualprocedures. <br /> n inspection does not require a Certified <br /> ➢ The periodic AST Inspection is intendidentify es and developing problems. <br /> Inspector. It shalt be performed by an owner's inspector who is familiar with the site and can identi chang <br /> ner, remove <br /> ➢ <br /> Upon discovery of water in the primary tank, secondary containmentareea, inter contaminants and idisposed of it <br /> roop tl yor take other corrective action.Before <br /> discharge to the environment, inspect the liquid for regulated products <br /> ➢ (*)designates an item in a non-conformance status.This indicates that action is required to address a problem. <br /> n AST design, a <br /> ed <br /> items <br /> important to tank or containment integrity require evaluation <br /> by n engin <br /> correspondingcorrectiver 'ac on the commenit'sectiopector, or a tank <br /> ➢ Non-conforming <br /> manufacturer who will determine the corrective action. Note the non con that could affect the operation of critical compone <br /> Retain the completed checklists for 36 months. aintenance (such as painting) <br /> nts <br /> ➢ <br /> ➢ In the event of severe weather(snow, ice, wind storms) or m <br /> and emergency vents, valves), an inspection of these components is required as soon as the equipment is safely accessible after the event. <br /> (normal Comments <br /> Item <br /> Task Status <br /> 1.0 Tank Containment <br /> 1.1 Containment Check for water, <br /> structureonidebris, cracks or fire ®Yes* No ❑ N/A <br /> hazard <br /> 1.2 Primary <br /> tank Check for water ❑Yes* No <br /> 1.3 Containment Operable and in a Ayes ❑ No* ❑ N/A <br /> drain valves closed position <br /> 1.4 Pathways and Clear and es ❑ No* ❑ N/A <br /> entry gates/doors <br /> operable <br /> 2.0 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* to <br /> into secondary / <br /> containment <br /> 2.3 Surrounding soil Visible signs of ❑Yes*,,g No ❑ N/A <br /> leaka e <br /> 2.4 Interstice Visible signs of ❑Yes* ❑ No YN/A _ _- <br /> leakage <br /> AST 1NSPECTfON STANDARD <br />