Monthly AVO Inspection

• Conducted on

  Date

• Prepared by

• Well Name

• API

• Add location
  Address

• Regulation

  OOOO

  OOOOa

  Regulation 7

• Wind Speed (MPH)

• Temperature (Degrees Fahrenheit)

• Inspection Start Time

  Date

Closed Vent System

• Are there any defects in storage tank closed vents systems that could result in air emissions including, but not limited to; visible cracks, holes or gaps in piping, loose connections, liquid leaks, or broken or missing caps or other closure devices?

  Yes

  No

  N/A

Covers

• Are there any defects in storage tank covers that could result in air emissions, including, but not limited to; visible cracks, holes or gaps in the cover, or between the cover and the separator wall; broken, cracked, or otherwise damaged seals or gaskets on closure devices; and broken or missing hatches, access covers, caps, or other closure devices?

  Yes

  No

  N/A

Bypass Devices

• If a bypass device valve is installed, is the inlet to the bypass secured in the non-diverting position using a car-seal or a lock-and-key type configuration, and is the deal or closure mechanism valve maintained in the non-diverting position and is the vent stream not being diverted through the bypass device?

  Yes

  No

  N/A

Equipment Accessibility

• Are there any parts of the closed vent, cover system, or any other well equipment that are unsafe or difficult to inspect?

  Yes

  No

  N/A

Flowlines

• Are on location, above ground flow lines free of evidence of a leak at the time of this inspection?

  Yes

  No

  N/A

• Are on location, below ground dump lines free of evidence of a leak at the time of this inspection?

  Yes

  No

  N/A

Leaks

• Leaks

Leak

• Leaking Equipemt

  Wellhead

  Tank

  Separator

  Piping

  Meter

• Leaking Component

  Select Valve Fitting Gasket Thief Hatch PRV Controller Union Weld Other

  • Valve
  • Fitting
  • Gasket
  • Thief Hatch
  • PRV
  • Controller
  • Union
  • Weld
  • Other

• Description

• Leak Repaired?

  Yes

  No

• Total Leaks Found

• Total Leaks Repaired

• Leaks Needing Workorders

• Inspection End Time

  Date

• Add signature

  Sign