Title Page
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Conducted on
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Prepared by
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Location
1.0 Tank Containment
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1.1 Water in the primary tank, secondary containment, interstice, or spill container?
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Corrective Action Taken/Needed
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1.2 Debris or fire hazard in containment?
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Corrective Action Taken/Needed
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1.3 Drain valves operable and in a closed position?
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Corrective Action Taken/Needed
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1.4 Containment egress pathways clear and gates/doors operable?
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Corrective Action Taken/Needed
2.0 Leak Detection
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2.1 Visible signs of leakage around the tank, concrete pad, containment, ringwall, or grund?
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Corrective Action Taken/Needed
3.0 Tank Attachments and Appurtenances
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3.1 Ladder and platform structure secure with no sign of severe corrosion or damage?
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Corrective Action Taken/Needed
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3.2 Tank liquid level gauge readable and in good condition?
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Corrective Action Taken/Needed
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3.3 Check all tank openings, sanitation caps, and valve positions to ensure the tank is properly sealed
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Corrective Action Taken/Needed
4.0 Other Conditions
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4.1 Are there other conditions that should be addressed for continued safe operation or that may affect the site SPCC Plan?
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Corrective Action Taken/Needed
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