Siler City Plant - SPCC Monthly Inspection

• Conducted on

  Date

• Prepared by

• Instructions: This inspection record will be completed every month. Inspections should be performed by tank owner's designated inspector who is familiar with the storage facility operations, the type of AST and its associated components, and the characteristics of the material stored. Please mark "good" for criteria meeting expectations. If any response requires elaboration, do so in Notes space provided. Further descriptions or comments should be attached on a separate sheet of paper if necessary.

Emergency Generator AST

• Tank/container surfaces (note signs of leakage, verify proper labeling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank bolts, rivets, seams and welds (note signs of corrosion, damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Tanks condition (note any damage, rust, or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank appurtenances: Level gauge, vent, fill port cap, drain (note any damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank supports (note erosion or settling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank foundation (note any damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Level gauges or alarms condition (note if inoperative, damaged)

  Good

  Fair

  Poor

  N/A

• Notes

• Vents, O-rings, Gaskets (note if vents are obstructed or gaskets & o-rings show deterioration)

  Good

  Fair

  Poor

  N/A

• Notes

• Pipelines, hose, fittings, pumps, and supports (note if damaged or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Unloading area (note tanker containment availability, condition)

  Good

  Fair

  Poor

  N/A

• Notes

• Connections (note if required caps or blanks are not in use)

  Good

  Fair

  Poor

  N/A

• Notes

• Secondary and tanker containment (note condition, utilization, area drainage)

  Good

  Fair

  Poor

  N/A

• Notes

• Verify that spill supplies are as described in the SPCC Plan (check all if adequate)

  Good

  Fair

  Poor

  N/A

• Notes

• Interstice tank (check to ensure no product has leaked into interstice tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Water in tank (check to ensure no water is in the tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Fencing, gates, or lighting (note if non-functional)

  Good

  Fair

  Poor

  N/A

• Notes

• Site drainage (note sediment that needs removal, excessive puddling or erosion)

  Good

  Fair

  Poor

  N/A

• Notes

On-Road Diesel AST

• Tank/container surfaces (note signs of leakage, verify proper labeling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank bolts, rivets, seams and welds (note signs of corrosion, damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Tanks condition (note any damage, rust, or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank appurtenances: Level gauge, vent, fill port cap, drain (note any damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank supports (note erosion or settling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank foundation (note any damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Level gauges or alarms condition (note if inoperative, damaged)

  Good

  Fair

  Poor

  N/A

• Notes

• Vents, O-rings, Gaskets (note if vents are obstructed or gaskets & o-rings show deterioration)

  Good

  Fair

  Poor

  N/A

• Notes

• Pipelines, hose, fittings, pumps, and supports (note if damaged or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Unloading area (note tanker containment availability, condition)

  Good

  Fair

  Poor

  N/A

• Notes

• Connections (note if required caps or blanks are not in use)

  Good

  Fair

  Poor

  N/A

• Notes

• Secondary and tanker containment (note condition, utilization, area drainage)

  Good

  Fair

  Poor

  N/A

• Notes

• Verify that spill supplies are as described in the SPCC Plan (check all if adequate)

  Good

  Fair

  Poor

  N/A

• Notes

• Interstice tank (check to ensure no product has leaked into interstice tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Water in tank (check to ensure no water is in the tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Fencing, gates, or lighting (note if non-functional)

  Good

  Fair

  Poor

  N/A

• Notes

• Site drainage (note sediment that needs removal, excessive puddling or erosion)

  Good

  Fair

  Poor

  N/A

• Notes

500-Gallon Diesel AST

• Tank/container surfaces (note signs of leakage, verify proper labeling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank bolts, rivets, seams and welds (note signs of corrosion, damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Tanks condition (note any damage, rust, or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank appurtenances: Level gauge, vent, fill port cap, drain (note any damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank supports (note erosion or settling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tank foundation (note any damage)

  Good

  Fair

  Poor

  N/A

• Notes

• Level gauges or alarms condition (note if inoperative, damaged)

  Good

  Fair

  Poor

  N/A

• Notes

• Vents, O-rings, Gaskets (note if vents are obstructed or gaskets & o-rings show deterioration)

  Good

  Fair

  Poor

  N/A

• Notes

• Pipelines, hose, fittings, pumps, and supports (note if damaged or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Unloading area (note tanker containment availability, condition)

  Good

  Fair

  Poor

  N/A

• Notes

• Connections (note if required caps or blanks are not in use)

  Good

  Fair

  Poor

  N/A

• Notes

• Secondary and tanker containment (note condition, utilization, area drainage)

  Good

  Fair

  Poor

  N/A

• Notes

• Verify that spill supplies are as described in the SPCC Plan (check all if adequate)

  Good

  Fair

  Poor

  N/A

• Notes

• Interstice tank (check to ensure no product has leaked into interstice tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Water in tank (check to ensure no water is in the tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Fencing, gates, or lighting (note if non-functional)

  Good

  Fair

  Poor

  N/A

• Notes

• Site drainage (note sediment that needs removal, excessive puddling or erosion)

  Good

  Fair

  Poor

  N/A

• Notes

Used Oil Drums

• Tank/container surfaces (note signs of leakage, verify proper labeling)

  Good

  Fair

  Poor

  N/A

• Notes

• Tanks condition (note any damage, rust, or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Pipelines, hose, fittings, pumps, and supports (note if damaged or deteriorated)

  Good

  Fair

  Poor

  N/A

• Notes

• Unloading area (note tanker containment availability, condition)

  Good

  Fair

  Poor

  N/A

• Notes

• Connections (note if required caps or blanks are not in use)

  Good

  Fair

  Poor

  N/A

• Notes

• Secondary and tanker containment (note condition, utilization, area drainage)

  Good

  Fair

  Poor

  N/A

• Notes

• Verify that spill supplies are as described in the SPCC Plan (check all if adequate)

  Good

  Fair

  Poor

  N/A

• Notes

• Water in tank (check to ensure no water is in the tank)

  Good

  Fair

  Poor

  N/A

• Notes

• Fencing, gates, or lighting (note if non-functional)

  Good

  Fair

  Poor

  N/A

• Notes

• Site drainage (note sediment that needs removal, excessive puddling or erosion)

  Good

  Fair

  Poor

  N/A

• Notes

• Additional Comments

• Inspector Signature

  Sign

• Please upload the inspection log onto Intelex when completed, and keep a hard copy of the completed form on file at the facility for 3 years