Annual Facility Inspection Checklist

  • This inspection record must be completed each year. If any response requires further elaboration, provide comments in Description & Comments space provided. Further description and comments, if necessary, must be provided on a separate sheet of paper and attached to this sheet. *Any item that receives “yes” as an answer must be described and addressed immediately.

Storage Tanks

Tank FO-1

  • Tank surface shows signs of leakage

  • Description & Comments

  • Tank is damaged, rusted, deteriorated or corroded

  • Description & Comments

  • Bolts, rivets, or seams are damaged

  • Description & Comments

  • Tank support is deteriorated or buckled

  • Description & Comments

  • Tank foundation has eroded or settled

  • Description & Comments

  • Level gauge or alarm is inoperative

  • Description & Comments

  • Vent is obstructed

  • Description & Comments

  • Interstitial space contains no liquid

  • Description & Comments

Tank FT-1

  • Tank surface shows signs of leakage

  • Description & Comments

  • Tank is damaged, rusted, deteriorated or corroded

  • Description & Comments

  • Bolts, rivets, or seams are damaged

  • Description & Comments

  • Tank support is deteriorated or buckled

  • Description & Comments

  • Tank foundation has eroded or settled

  • Description & Comments

  • Level gauge or alarm is inoperative

  • Description & Comments

  • Vent is obstructed

  • Description & Comments

  • Secondary containment is damaged or stained

  • Description & Comments

Piping

  • Valve seals, gaskets, or other appurtenances are leaking

  • Description & Comments

  • Pipelines or supports are damaged or deteriorated

  • Description & Comments

  • Joints, valves and other appurtenances are leaking

  • Description & Comments

  • Fill and discharge piping is not properly connected

  • Description & Comments

Loading/unloading and transfer equipment

  • Connections are not capped or blank-flanged

  • Description & Comments

  • Secondary containment is damaged or stained

  • Description & Comments

Security

  • Fencing, gates, or lighting is non-functional

  • Description & Comments

Response equipment

  • Response equipment inventory is incomplete

  • Description & Comments

  • Additional Remarks:

  • Print Name and Sign

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