Title Page

  • Conducted on

  • Prepared by

  • Location

Oil-filled equipment/containers

  • Are any leaks observed at valves, bushings, seams, flanges or other fittings

  • What actions were taken?

  • Any signs of corrosion/deterioration on equipment/containers

  • What actions were taken?

Secondary containment

  • Is there an accumulation of oil within containment berm?

  • What actions were taken?

  • Is there an oil sheen on retained water?

  • What actions were taken?

  • Is there any surface staining observed?

  • What actions were taken?

  • Is the berm/dike in good condition

  • What actions were taken?

Security

  • Are all fences and gates intact?

  • Are all gates locked?

  • Are all security lights properly working?

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  • Signature

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