Monthly leak and security inspection 1.1

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

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

  Yes

  No

• What actions were taken?

• Any signs of corrosion/deterioration on equipment/containers

  Yes

  No

• What actions were taken?

• Are the break away device dates past todays date?

  Yes

  No

• What actions were taken?

• Is there an accumulation of oil within containment berm?

  Yes

  No

• What actions were taken?

• Is there an oil sheen on retained water?

  Yes

  No

• What actions were taken?

• Is there any surface staining observed?

  Yes

  No

• What actions were taken?

• Is the berm/dike in good condition

  Yes

  No

• What actions were taken?

• Are all fences and gates intact?

  Yes

  No

• Are all gates locked?

  Yes

  No

• Are all security lights properly working?

  Yes

  No

Warehouse emergency and exit lights lights.

• North light: indicator light is on, and is free of damage or obstruction?

  Yes

  No

• East light: indicator light is on, and is free of damage or obstruction?

  Yes

  No

• South light: indicator light is on, and is free of damage or obstruction?

  Yes

  No

Office emergency and exit lights lights.

• Board Room light: indicator light is on, and is free of damage or obstruction?

  Yes

  No

• Back Hallway light: indicator light is on, and is free of damage or obstruction?

  Yes

  No

• IT office light : indicator light is on, and is free of damage or obstruction?

  Yes

  No

• Is it January? Time for the yearly light test.

  Yes

  No

• Test all warehouse lights, did they come on?

  Yes

  No

• Test all office lights, did they come on?

  Yes

  No

• Signature

  Sign