SPCC Annual Field Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Facility Name:

• Inspection Date:

  Date

• Inspected By:

Valves

• Are there any liquid leaks?

  Yes

  No

  N/A

• Are there any signs of misting?

  Yes

  No

  N/A

Flanges

• Are there any liquid leaks?

  Yes

  No

  N/A

• Are there any signs of misting?

  Yes

  No

  N/A

Pumps

• Are there any liquid leaks?

  Yes

  No

  N/A

• Are there any signs of misting?

  Yes

  No

  N/A

Dump Lever Arms

• Are there any liquid leaks?

  Yes

  No

  N/A

• Are there any signs of misting?

  Yes

  No

  N/A

• Are there any signs of misting?

  Yes

  No

  N/A

Tanks

• Do the tank surfaces show signs of leakage?

  Yes

  No

  N/A

• Is there any staining on the ground?

  Yes

  No

  N/A

• Are there holes in the tanks? (Including pinholes)

  Yes

  No

  N/A

• Are the tanks damaged, rusted, or deteriorated?

  Yes

  No

  N/A

• Are any of the bolts, rivets, or seams damaged?

  Yes

  No

  N/A

• Are level gauges or alarms inoperative?

  Yes

  No

  N/A

• Are any signs or labels missing on tanks?

  Yes

  No

  N/A

• Have any tank supports deteriorated or buckled?

  Yes

  No

  N/A

• Have the tank foundations eroded or settled?

  Yes

  No

  N/A

Secondary Containment

• Is the secondary containment damaged or not adequate?

  Yes

  No

  N/A

• Is the drainage valve open or broken?

  Yes

  No

  N/A

• Is there trash or vegetation inside the containment?

  Yes

  No

  N/A

• Is there any staining inside or outside the containment?

  Yes

  No

  N/A

Hatches

• Are there stains around any of the hatches?

  Yes

  No

  N/A

• Are any hatches open or partly open?

  Yes

  No

  N/A

• Gaskets not properly sealing or showing signs of deterioration?

  Yes

  No

  N/A

• Are there visible gas emissions?

  Yes

  No

  N/A

Relief Valves & Vents

• Are there any leaks?

  Yes

  No

  N/A

• Are there any visible gas emissions?

  Yes

  No

  N/A

• Vents are obstructed?

  Yes

  No

  N/A

Separator(s)

• Does shell condition show signs of:<br>Pitting, Rust or Deterioration<br>

  Yes

  No

  N/A

• Gaskets not properly sealing or showing signs of deterioration?

  Yes

  No

  N/A

• Does the equipment show signs of leakage?

  Yes

  No

  N/A

Pipelines

• Are any pipelines or supports damaged or deteriorating?

  Yes

  No

  N/A

• Is any buried piping exposed?

  Yes

  No

  N/A

• Are there any out-of-service pipes without caps?

  Yes

  No

  N/A

• Are there any liquid leaks?

  Yes

  No

  N/A

Response Equipment

• Response equipment inventory is incomplete?

  Yes

  No

  N/A

Fencing & Gates

• Fencing and gates are damaged or non-functional?

  Yes

  No

  N/A

Lighting

• Is lighting non-functional?

  Yes

  No

  N/A

Signage

• Is proper signage missing?

  Yes

  No

  N/A

Pumps & Valves

• Pumps and valves are not locked (if not in use)?

  Yes

  No

  N/A

Load Lines

• Are load lines damaged or deteriorated?

  Yes

  No

  N/A

Environmental Pots

• Are environmental pots damaged or leaking?

  Yes

  No

  N/A

• Is there any staining beneath environmental pots?

  Yes

  No

  N/A

• Is there any liquid in environmental pots?

  Yes

  No

  N/A

• Additional Comments:

• Has any equipment been added or removed since last inspection? If so, list below.

• Draw new site diagram if needed.

  Drawing

• Signature:

  Sign