NSU Monthly Tank Inspection Log

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Above Ground Storage Tank

• Outer tank surface checked for signs of leakage

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Tank condition is considered good (not rusting, no signs of corrosion or pitting)

  Satisfactory

  Repair or Adjustment Required

  Not Applicable

  Additional Comments Attached

• No signs of separation or swelling of tank

  Satisfactory

  Repair or Adjustment Required

  Not Applicable

  Additional Comments Attached

• Bolts, rivets, and/or seams are not damaged and appear in good condition

  Satisfactory

  Repair or Adjustment Required

  Not Applicable

  Additional Comments Attached

• No signs of excessive settlement of AST

  Satisfactory

  Repair or Adjustment Required

  Not Applicable

  Additional Comments Attached

• Level gauges and alarms are working properly (push button to test alarms)

  Satisfactory

  Repair or Adjustment Required

  Not Applicable

  Additional Comments Attached

• Vents are not obstructed

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Valves, flanges, and gaskets are free from leaks

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

Truck Loading/Unloading Area

• Fill ports are properly color-coded and labeled

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• No standing water in loading/unloading containment area

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Warning signs are posted in area

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Fill port containment does not have standing water

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Drip pans are not overflowing (or have standing water)

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Containment curbing is in good condition

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Fill port connections are capped or bank-flanged

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

Spill Prevention Equipment

• Spill prevention equipment is maintained at tank location

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Spill prevention equipment is in good condition with adequate supplies

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

Tank Pipelines

• Pipe surfaces checked for signs of leakage

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• No signs of corrosion to pipelines or pipe supports

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Buried pipelines are not exposed

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Out-of-service pipelines are capped

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Signs/barriers to protect aboveground pipes from vehicles are present

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• No leaks at valves, flanges, or other fittings

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

Secondary Containment Area

• Containment area drainage valves are closed and are locked

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Containment area does not have signs of leakage

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Containment area pumps are working properly

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• No visible oil sheen in containment area (if so, water must not be drained to ground surface)

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• No standing water in containment area

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Containment structure is free from cracks or holes

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

Security Measures

• Door to tank is in good condition

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Door is locked

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

• Available lighting system works properly

  Select Satisfactory Repair or Adjustment Required Not Applicable Additional Comments Attached

  • Satisfactory
  • Repair or Adjustment Required
  • Not Applicable
  • Additional Comments Attached

Certification of Tank Inspection

• I certify that the above inspection has been performed in a manner consistent with requirements of 6 NYCRR section 613.6,

• Add signature

  Sign

• Select date

  Date