02_TL_4.5b_Gen_tank_insp_Form_372.xlsx
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Table 1
MONTHLY ABOVEGROUND STORAGE TANK INSPECTION FORM
Prescribing Directive: Fort McCoy Pamphlet 420-28
| Date | ||||||||||||||
| General Tank Condition | Pipe / Hose / Nozzle | Secondary Containment (Double Walled or Single Walled with Vault) | Leak Detection System (if applicable) | Other observations or corrective measures taken | ||||||||||
| Location | Inspected by | Liquid | ||||||||||||
| Level | 1. Any signs of leaks? | 2. Any rusting or pitting? | 3. Normal or emergency vents missing or nonfunctioning? | 4. Covers and caps missing or open? | 5. Any signs of leaks? | 6. Any rusting, pitting, or excessive | ||||||||
| wear? | 7. Any visible damage? | 8. Any water or debris present? | 9. Any visible POL? | 10. Alarming? | ||||||||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | Y / N | |||||
| NOTE: 1. Make sure to inspect all around the tank, piping, and secondary containment. |
2. See page two (2) if you answered YES to any of the above questions.
3. Maintain a copy for three (3) years.
| FORT MCCOY FORM 372 OCT 2013 |
| Previous versions of this form are obsolete |
| PE v1.00 |
| MONTHLY ABOVEGROUND STORAGE TANK INSPECTION FORM |
Prescribing Directive: Fort McCoy Pamphlet 420-28
| CORRECTIVE ACTIONS TO BE TAKEN IF YOU ANSWERED YES TO ANY OF THE QUESTIONS ON PAGE ONE | |
| 1. | Contain leaked material with spill pads or by other appropriate means. If greater than a gallon is spilled call 911 if in the Cantonment area or call Range Control (388 |
-4848) if outside the Cantonment area. If less than a gallon clean up and dispose of material properly. If possible fix the leak or submit a work order to get the leak fixed also notify DPW Environmental (2-6501) of the leak.
| 2. | If individual rust or pit marks are larger than a quarter or several marks cover an area larger than your hand submit a work order to repair the corrosion. Also notify DPW Environmental (2-6501) of the tank condition and corrective measures taken. |
| 3. | All tanks are required to have two vents for the primary tank and two vents for the secondary tank (if double walled). If the tank does not have the appropriate vent system submit a work order and also notify DPW Environmental (2-6501) of the corrective measures taken. |
| 4. | The fill cap should remain closed and secured when not in use. If a cap is missing a purchase request or work order should be submitted to obtain a new cap. |
| 5. | Contain leaked material with spill pads or by other appropriate means. If greater than a gallon is spilled call 911 if in the Cantonment area or call Range Control (388 |
-4848) if outside the Cantonment area. If less than a gallon clean up and dispose of material properly. If possible fix the leak or submit a work order to get the leak fixed also notify DPW Environmental (2-6501) of the leak.
| 6. | If rust or pit marks are larger than a quarter or several marks cover an area larger than your hand submit a work order. Also notify DPW Environmental (2-6501) of the tank condition and corrective measures taken. |
| 7. | Cracks in the secondary containment may reduce the ability of the structure to contain any leaks or spills. Contact DPW Environmental (2-6501) to determine if corrective actions are necessary. |
| 8a. (Single Walled) | The secondary containment should be free of debris and water to maximize the containment capacity. Remove any debris that has collected in the containment area. If water is present check if there is a POL odor or sheen on the water. Contact DPW Environmental (2-6501) if a sheen or odor is present. If there is no sheen or odor follow the instruction on Fort McCoy Form 374 prior to discharging the water. |
| 8b. |
(Double
| Walled) | Contact DPW Environmental (2-6501). | |
| 9. | If POL is present place oil absorbent or other means to contain the POL. If greater than a gallon is released call 911 if in the Cantonment area or call Range Control (388- |
4848) if outside the Cantonment area. If less than a gallon clean up and dispose of material properly. Determine where the POL came from and address condition as necessary notify DPW Environmental (2-6501) of any corrective measures that are taken.
| 10. | If the system is equipped with a leak detection system and the alarm is sounding; determine the reason for the alarm and notify DPW Environmental (2-6501) of any corrective measures that are taken. |
| Page 2 | |
| FORT MCCOY FORM 372 OCT 2013 | |
| Previous versions of this form are obsolete | |
| PE v1.00 |
File details come from the government source that posted it. Updated .