36C26218Q0225-004.pdf

VA Greater Los Angeles Healthcare System Revision 11/20/2017

SPCC MONTHLY PHYSICAL INSPECTION LOGSHEET

Location _______ Bldg # ______ Date Inspected ______________

Tank ID # ______ Tank Type (please check) AST _____, AST with Berm____, Transformer ________

Inspection Checklist Tank Observations:

Inspect valves & piping for evidence of leakage.

Inspect metal surface of tank & supports for corrosion

Check for leaks at base of tank

Check secondary containment (berms) if present for leaks, cracks, etc.

Is berm drain valve in closed position?

Containment cleaned & pumped (as needed basis).

Tank secured / locked? Y/N

Are tanks labelled correctly?

Is spill equipment present/accessible?

Check that tank vents are clear of obstruction & operational

If spill or leak has occurred when was VA notified and to whom was notice given?

SOP accessible for drainage of containment?

SOP accessible for proper filling & withdrawal procedures if applicable?

Comments:

Inspected By:

SPCC ANNUAL REQUIREMENTS

Test fuel gauge (once per year)

Conduct employee training (at least once per year)

Date(s)