A21._Attachment_4_-_Annual_Checklist.pdf

Rep-tank_checklist For Official Use Only

Page: 1

Date Printed:

Real Property ID:

Installation/GSU:

Unit/Organization:

Finding Status:

Assessor Duty Phone:

Conclusion:

Tank ID:

Installation Date:

Designation:

Owner:

Location:

Model:

Checklist Name: ANNUAL ORGANIZATIONAL TANK ASSESSMENT

Perform Date:

Assessor:

Status:

Assessment Comments:

TANK CONTAINMENT

TANK FOUNDATION AND SUPPORTS

TANK AND APPURTENANCES

Are containment drain valves in working order and closed?

Is there evidence of tank settlement, foundation washout, or foundation cracking?

Is there any cracking, spalling or severe corrosion of tank supports and/or saddles?

Is the Normal Vent clear and free of obstructions?

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Are there water accumulations, debris, vegetation, cracks, fire hazards or holes observed in the tank containment?

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Are ladders, platforms, handrails, stairs secure with no indication of severe corrosion and/or damage?

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TANK COMPLIANCE ASSESSMENT CHECKLIST

Contents:

Serial #:

Volume (gallons):

Page: 2

Date Printed:

Tank ID:

TANK AND APPURTENANCES

CORROSION CONTROL

Is vent located five feet or more from adjacent buildings?

For class I fuels (ie MOGAS, AVGAS), are normal vents located at least 12 feet above grade?

Are there emergency vents for the primary tank?

Is the primary tank emergency vent operable (vent cover can be lifted by hand)?

Are there emergency vents for the secondary tank if a double wall tank?

Is the secondary tank emergency vent operable (vent cover can be lifted by hand)?

Is emergency vent operable (vent cover can be lifted by hand)?

Are all valves in working order?

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TANK COMPLIANCE ASSESSMENT CHECKLIST

Real Property ID:

Page: 3

Date Printed:

Tank ID:

CORROSION CONTROL

LEVEL AND OVERFILL PREVENTION

Is there any evidence of paint coating failure or severe corrosion of tank and piping surfaces?

Is there cathodic protection for underground metallic piping?

Is cathodic protection working and being checked regularly?

Has the tank level indicating device been tested and is it in working order?

Is tank level gauge viewable from the filling point?

Is the High Level Alarm present and in working order?

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Is there evidence of corrosion at pipestand and piping interfaces (undercutting of pipe) including underside of piping?

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Has the overflow shutoff mechanism (shut off valve or float valve) been tested and is it in working order?

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Page: 4

Date Printed:

Tank ID:

LEVEL AND OVERFILL PREVENTION

ELECTRICAL WIRING AND EQUIPMENT

TANK SITE

ADDITIONAL

Are anti-siphon valves operable (if present)?

Is the tank grounded?

Are grounding straps secure and in good order?

Are wiring, wiring conduit, junction boxes in good condition?

Are electrical components in classified conduit and enclosures as required?

Are traffic bollards and/or protection from vehicle traffic in place where required?

Have all other Local, State, or Federal requirements checklist(s) been accomplished, if required, and documents uploaded to this tank record?

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Provide appropriate reference to record in comments.

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