Title Page

  • Conducted on

  • Prepared by

  • Location

1.0 Tank Containment

  • 1.1 Water in the primary tank, secondary containment, interstice, or spill container?

  • Corrective Action Taken/Needed

  • 1.2 Debris or fire hazard in containment?

  • Corrective Action Taken/Needed

  • 1.3 Drain valves operable and in a closed position?

  • Corrective Action Taken/Needed

  • 1.4 Containment egress pathways clear and gates/doors operable?

  • Corrective Action Taken/Needed

2.0 Leak Detection

  • 2.1 Visible signs of leakage around the tank, concrete pad, containment, ringwall, or grund?

  • Corrective Action Taken/Needed

3.0 Tank Attachments and Appurtenances

  • 3.1 Ladder and platform structure secure with no sign of severe corrosion or damage?

  • Corrective Action Taken/Needed

  • 3.2 Tank liquid level gauge readable and in good condition?

  • Corrective Action Taken/Needed

  • 3.3 Check all tank openings, sanitation caps, and valve positions to ensure the tank is properly sealed

  • Corrective Action Taken/Needed

4.0 Other Conditions

  • 4.1 Are there other conditions that should be addressed for continued safe operation or that may affect the site SPCC Plan?

  • Corrective Action Taken/Needed

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