Tank Battery Inspection Sheet

• Audit Title

• Lease Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Signs at Facilities & Tanks

• On the tanks<br>NFPA Warning Labels

  Yes

  No

  N/A

  Hazard

• Confined Space Labels Present?

  Yes

  No

  N/A

  Hazard

• Other Signage Present

  Yes

  No

  N/A

  Hazard

Are all of the following located on one sign or decal?

• DANGER

  Yes

  No

  N/A

  Hazard

• Petroleum Crude

  Yes

  No

  N/A

  Hazard

• Extremely Flammable Liquid and Vapor

  Yes

  No

  N/A

  Hazard

• May Cause Flash Fire Statement

  Yes

  No

  N/A

  Hazard

• No Trespassing Statement

  Yes

  No

  N/A

  Hazard

• No Smoking or Open Flame Statement

  Yes

  No

  N/A

  Hazard

• Other

  Yes

  No

  N/A

  Hazard

Miscellaneous

• Is the Lease sign present?

  Yes

  No

  N/A

• MSDS form available upon request statement

  Yes

  No

  N/A

• Hydrogen Sulfide may be present (H2S)

  Yes

  No

  N/A

H2S fixed monitors present at site ?

Scott / MSA / AV 2000 mask available .

Breathable air bottles / cascade system / regulators.

Air hoses / fitting for air bottles serviceable .

• Equipment May Start Automatically

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Tanks, Stairways & Walkways

• Condition of Tanks

  Safe

  Unsafe

  Hazard!

• Connections / Bullplugs

  Safe

  Unsafe

  Hazard!

• Are there any Visible Leaks?

  Yes

  No

• Condition of Piping

  Safe

  Unsafe

  Hazard!

• Is there a proper ground?

  Present

  Not present

• Is the stairway safe?

  Yes

  No

  N/A

• Are the stairs in good condition?

  Safe

  Unsafe

  Hazard!

• Are handrails present?

  Safe

  Unsafe

  Hazard!

• Are the walkways in a safe condition?

  Safe

  Unsafe

  Hazard!

• Is the handrail present?

  Safe

  Unsafe

  Hazard!

• Is the midrail present?

  Safe

  Unsafe

  Hazard!

• Are toeboards present?

  Safe

  Unsafe

  Hazard!

• Is there a Windsock at the facility?

  Yes

  No

• Other comments

  Safe

  Unsafe

  Hazard!

Firewall

• Condition of the firewall

  Yes

  No

  N/A

• Is there any evidence of salt kill in, on or around the firewall?

  Yes

  No

  N/A

• Is the firewall breached or eroded?

  Yes

  No

  N/A

• Does it appear large enough to contain fluids per state guidelines?

  Yes

  No

  N/A

• Are fluids present in the firewall?

  Yes

  No

  N/A

• Is vegetation present in or on the firewall?

  Yes

  No

  N/A

• Are there any other concerns about the firewall?

  Yes

  No

  N/A

Electrical

• Electrical connection on the Triplex Pump

  Safe

  At Risk

  N/A

• Electrical connection on the transfer pump

  Safe

  At Risk

  N/A

• Chemical Pumps

  Safe

  At Risk

  N/A

• Transformers

  Safe

  At Risk

  N/A

• Overhead Lines

  Safe

  At Risk

  N/A

• Extension Cords Present

  Safe

  At Risk

  N/A

• Exposed electrical conductors

  Yes

  No

• Electrical boxes labeled for voltage?

  Yes

  No

  N/A

• Electrical boxes labeled for Arc-flash hazard

  Yes

  No

  N/A

• Arc-Flash boundary labeled

  Yes

  No

  N/A

• Are outlets that are located outdoors protected by a Ground Fault Circuit Interrupter (GFCI)

  Yes

  No

  N/A

• Are there any additional comments regarding the electrical components of this Tank Battery?

  Yes

  No

  N/A

Injection & Transfer Pumps

• Are drip pans present and functional?

  Yes

  No

  N/A

• Is any of the equipment or piping leaking?

  Yes

  No

  N/A

• Are the gauges functioning properly?

  Yes

  No

  N/A

• Are pop off's in place and in serviceable condition?

  Yes

  No

  N/A

• Is the piping in good condition?

  Yes

  No

  N/A

• Are machine guards in place?

  Yes

  No

  N/A

• Are there any other issues identified?

  Yes

  No

  N/A

Facility Housekeeping

• Are there any slip, trip or fall hazards present?

  Yes

  No

  N/A

• How is the General Overall Condtion / Appearance of the site?

  Yes

  No

  N/A

• Are there any other housekeeping issues identified?

  Yes

  No

  N/A

Chemicals and Storage

• Stored properly (Drip Trays?)

  Yes

  No

  N/A

• Are secondary containers labeled properly (HMIS label)

  Yes

  No

  N/A

• Is an SDS sheet available for chemicals used?

  Yes

  No

  N/A

• Are there any other chemical issues identified?

  Yes

  No

  N/A

Pits

• Is the netting over the pit adequate?

  Yes

  No

  N/A

• Is there evidence of spillage of oil/BS outside the pit?

  Yes

  No

  N/A

• Are there any other considerations / issues regarding pits at this location?

  Yes

  No

  N/A

• Add signature

  Sign