SFLC-ESD-25_Tank_and_Void_Assessment_Form.pdf

SFLC-ESD-25 TANK AND VOID ASSESSMENT

FORM

GENERAL DATA Note: Use SFLC-ESD-29 for Compartments other than Tanks & Voids.

Inspector’s Name: Organization: Contact Info:

Cutter Name: Cutter Class: Hull:

Tank: Service: Tank Area: Gallons:

Solid Balast: Access Compt: Date: Assessment Reason:

ACCESS DATA

Manhole and cover condition: Tank Penetration Condition:

VENT OVERFLOW DATA

Present: Yes No Check Valve Installed: Yes No Check Valve Operates Properly: Yes No

LADDER DATA

NR of Ladder(s) Present: Yes No Ladder Damaged: Yes No Ladder Material:

TANK LEVEL INDICATOR (TLI) DATA

TLI Present in Tank: Yes No TLI Damaged: Yes No TLI Type:

SOUNDING TUBE DATA

Sounding Tube Present in Tank: Yes No Sounding Tube Damaged: Yes No Striker Plate Damaged (>50%): Yes No

CATHODIC PROTECTION DATA

Cathodic Protection in Tank: Yes No Total Zincs: Number of Zincs > 50% Depleted:

1-6 Cleanliness & Housekeeping Clean to light layer or residue 1-2 (G) Comments:

Loose accumulation scale 3-4 (Y) Impending residue and sediments 5-6 (R)

% 1-6 Coating Systems

All Painted Surfaces 1-2 (G) Comments:

3-4 (Y) 5-6 (R)

% 1-6 Structural

Corrosion 1-2 (G) Comments:

Pitting & Grooving 1-2 (G) Comments:

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SFLC-ESD-25 TANK AND VOID ASSESSMENT

SHEET

Structural Integrity Data Estimated Total Linear Feet of Structure Requiring Repair: Estimated Total Square Feet of Plating Requiring Repair:

Cracks/ Fractures Present: Yes No Buckling/Deflections/ Distortions Present: Yes No Holes Present: Yes No Material Wastage Present: Yes No All Welds Intact: Yes No Structural Evaluation Recommended: Yes No

PHOTOGRAPHS

Pictures Taken (enter quantity):

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Additional Comments:

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