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April 2012 <br />Monthly Inspection Checklist <br />Page C -2 <br />This general inspection record for the facility must be completed each month except the month in <br />which an annual inspection is performed. Provide further description and comments, if <br />necessary, on a separate sheet of paper and attach to this sheet. *Any item that receives "yes" as <br />an answer must be described and addressed immediately. <br />Yes" No Description and Comments <br />Storage tanks <br />Tank surfaces show signs of leakage <br />Tanks are damaged, rusted or deteriorated <br />Bolts, rivets, or seams are damaged <br />Tank supports are deteriorated or buckled <br />Tank foundations have eroded or settled <br />Level gauges or alarms are inoperative <br />Vents are obstructed <br />Secondary containment is damaged or stained <br />Piping <br />Valve seals, gaskets, or other appurtenances are leaking <br />Pipelines or supports are damaged or deteriorated <br />Joints, valaves and other appurtenances are leaking <br />Buried piping is exposed (if applicable) <br />Loading /unloading and transfer equipment <br />Connections are not capped or blank - flanged <br />Secondary containment is damaged or stained <br />Berm drainage valve is open or is not locked <br />Security <br />Fencing, gates, or lighting is non - functional <br />Pumps and valves are locked if not in use <br />Response Equipment <br />Response equipment inventory is incomplete <br />(spill kits -2 locations) <br />Notes: <br />Date: <br />Date of last inspection: <br />Signature: <br />SPCC <br />MR 115 Page 27 -35 Rev. May 2012 <br />