Chandos - Enviso - BLR-F-019

• Document No.

• Job # / Site Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Instructions:

• This form is to be completed for each fuel storage tank on site.
  

• This form does not apply to tidy tanks in vehicles.

• Tidy tanks are not allowed on the ground due to Fire Code Regulations.

• Form is completed within the first week the tank arrives on site.

• Completed inspection reports are to be forwarded to City Representative and Steve Reynolds.

1 - All Tanks ? Complete All Items Below

• 1.1 - For fuel dispensing tanks, a refueling procedure is in place?

  Acceptable

  Action Required

• 1.2 - Refueling procedure requires employees to be present in the immediate area during the refueling proces?

  Acceptable

  Action Required

• 1.3 - Are monthly documented fuel tank inspections are completed?

  Acceptable

  Action Required

• 1.4 - Is there One meter separation between fuel tanks?

  Correct

  Action Required

  N/A

• 1.5 - Are fire extinguishers are readily available?

  Acceptable

  Action Required

• 1.6 - Are propane cylinders are stored away from fuel storage tanks and containers?

  Correct

  Action Required

  N/A

• 1.7 - Label on fuel tank indicates content, TDG labels are acceptable?

  Acceptable

  Action Required

• 1.8 - ?Non-Smoking & Turn off Sources of Ignition? signage in the area?

  Acceptable

  Action Required

• 1.9 - Adequate spill kit is fully stocked and readily available?

  Acceptable

  Action Required

• 1.10 - Tanks greater than 2500 liters are registered with the Petroleum Tank Management Association of Alberta (PTMAA).

  Correct

  Action Required

  N/A

• 1.11 - Tank is located in an area, where in the event of a release the spill does not readily enter a storm drain or water way?

  Acceptable

  Action Required

• 1.12 - Tank has physical barrier or other means in place to prevent accidental contact?

  Correct

  Action Required

  N/A

• 1.13 - Has the fire department been notified of the fuel tanks on site?

  Yes

  Action Required

2 - Doubled Wall Tanks

• 2.1 - Monthly inspections document checking the space between the tank?s inner and outer walls for inner wall leakage?

  Acceptable

  Action Required

3 - Single Walled Tanks

• 3.1 - Single walled fuel tanks have secondary containment?

  Acceptable

  Action Required

• 3.2 - Volume of the secondary containment is 110% of the fuel tank?s total volume?

  Acceptable

  Action Required

• 3.3 - Secondary containment is in good condition?

  Acceptable

  Action Required

• 3.4 - Secondary containment is free from other material? (ie rain water, equipment)

  Acceptable

  Action Required

• 3.5 - Secondary containment is constructed of non-combustible material? (not wood or plastic)

  Acceptable

  Action Required

Inspection Comments:

• Add media

  Media

• Add drawing

  Drawing

Action Items:

• 1) Action Required:

• Date Required:

  Date

• Person Responsible:

  Sign

• Date Completed:

  Date

• 2) Action Required:

• Date Required:

  Date

• Person Responsible:

  Sign

• Date Completed:

  Date

• 3) Action Required:

• Date Required:

  Date

• Person Responsible:

  Sign

• Date Completed:

  Date

• 4) Action Required:

• Date Required:

  Date

• Person Responsible:

  Sign

• Date Completed:

  Date