Appendix_B_SPRP_Form_6.pdf

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Oil Water Separator inspection/Cleaning
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Appendix B Form 6

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174th ATKW, NYANG

OHS SPRP

Final June 2017

K-19 Form 6 Oil/Water Separator Inspection Checklist

FORM 6: Oil/Water Separator Inspection Checklist

Instructions: Complete routine external visual inspection of OWSs. Notify the SPRP Lead, Base Environmental Manager, immediately if any significant deficiencies are identified.

Industry Standard Consideration: Multi-Service Oil/Water Separator Guidance Manual

Frequency: Semi-Annually

Site/Date:

Inspector:

SAT UNSAT NA CAR Comments

OWS Functioning � Presence of Free Product1 Presence of Sheen1 Presence of Fuel Odor1 Coalescer Inspection for Fouling Operation of Pump, Valve, Skimmer, etc.

Leaks from Separator or Appurtenances Operation of Pumps Determination of Solids Level OWS Free of Blockage Up/Down Stream Free of Blockage

Determination of Oil Level

AS REQUIRED

Inspection/Cleaning of Internal Chambers

Notes:

1 Inspect OWS and effluent CAR Corrective action required NA Not applicable OWS Oil/water separator SAT Satisfactory UNSAT Unsatisfactory

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