Link Inspect Pro

Tank Compliance Inspection (Lawrence Co-op Bid)

General Information

Information

Date

Is Tank Registered?

Facility I.D. #

Facility Name

Facility Address

Facility Phone Number

Facility Owner Name

Facility Owner Address

Type of Owner

Type of Petroleum Facility

Tax Map Info

Federal Tax ID No

Inspector

Facility Rep Name

Facility Rep Title

Facility Rep Phone

Facility Rep Company Name

Facility Rep Address

Class A Operator Name

Class A Operator Auth #

Class A Operator Title

Class B Operator Name

Class B Operator Auth #

Class B Operator Title

Asset Information

Information

Tank System Category

Tank Type

Is the inspection announced or unannounced?

Is the registration certificate posted a the facility?

Is the registration information current and correct?

Tank Diameter/Dimensions

Tank Size

Tank Contents

Tank Installed Date

Tank Manufacturer

Material of Construction

Tank Service or Use

Tank Monitoring System (TMS) Make

TMS Model

TMS Serial #

Is there a Printer?

Other Equipment (RA, Gauge, Sensors, Probes, Alarms etc.)

Other Equipment 1 Name

Other Equipment 1 Make

Other Equipment 1 Model

Other Equipment 1 Serial #

Other Equipment 2 Name

Other Equipment 2 Make

Other Equipment 2 Model

Other Equipment 2 Serial #

Other Equipment 3 Name

Other Equipment 3 Make

Other Equipment 3 Model

Other Equipment 3 Serial #

Other Equipment 4 Name

Other Equipment 4 Make

Other Equipment 4 Model

Other Equipment 4 Serial #

Manhole #1 Make

Manhole #1 Model

Manhole #1 Diameter

Manhole #2 Make

Manhole #2 Model

Manhole #2 Diameter

Manhole #3 Make

Manhole #3 Model

Manhole #3 Diameter

Manhole #4 Make

Manhole #4 Model

Manhole #4 Diameter

Fuel Management System Make

Fuel Management System Model

Fuel Management System Serial #

Tank Registration Information

Information

1. Action

2. Tank #

3. Tank Location

4. Tank Status

5. Date Installed

6. Tank Capacity (Gallons)

7. Product Stored

7a. If Waste/Used/Other Oils 9999. Other-Please list

8. Tank Type

8a. If Other- Please list

9. Internal Protection

9a. If 99. Other-Please list

10. External Protection

10a. If 99. Other-Please list

11. Tank Secondary Containment

11a. If 99. Other-Please list

12. Tank Leak Detection

12a. If 99. Other-Please list

13. Tank Overfill Prevention

13a. If 99. Other-Please list

14. Tank Spill Prevention

14a. If 99. Other-Please list

15. Dispensing Method

16. Piping Location

17. Piping Type

17a. If 99. Other-Please list

18. Piping External Protection

18a. If 99. Other-Please list

19. Piping Secondary Containment

19a. If 99. Other-Please list

20. Pipe Leak Detection

20a. If 99. Other-Please list

21. Under Dispenser Containment (UDC) present?

Tank Information

A. System Operation

Is 'Permit to Operate' current, accurate and posted in a conspicuous place?

Is system operating properly?

Are monitoring/observation wells marked and secured?

Have dispenser sumps been properly maintained?

For motor fuel tank systems with pressurized piping, are shear valves properly installed and operable?

Was the tank properly permanently closed or did it undergo a change-in-service?

If the tank system is out-of-service, has it been out-of-service for more than 12 months?

Were any spills observed? (Include suspected releases from leak detection equipment and uninvestigated inventory discrepancies.)

Have tank top sumps been properly maintained?

Is there a 5 gallon spill bucket (catch basin) installed?

Have spill buckets been properly maintained?

Is the fill port/tank color coded/marked to identify the product in the tank system?

Does labeling meet Nassau County Dept. of Health standards?

Tank is labeled with tank working capacity, tank number, Facility I.D. #, contents and hazard signs?

High-level alarm can be easily seen and heard?

Tank has secondary containment

Daily inventory records are complete and have been kept for five years?

30-day release detection monitoring record is complete?

B. Pump Transfer Station

Is there a pump transfer station?

Is pipe bowing between supports?

Do all supports appear to be secure?

Are there any visible leaks?

Is there any visible corrosion?

Does anything (piping, valves, etc.) look unordinary or of concern, such as loose fittings, swelling gasket, exposed wire, etc.?

Aboveground Storage Tank System (AST)

A. Tank Condition

Are there any leaks or spills?

Are there any cracks/bulges/corrosion?

Are exterior tank surfaces painted?

Are gauge or high level alarm working?

Is leak detection equipment being monitored and inspected?

Is interstitial port labeled and locked?

Is cathodic protection monitored and inspected?

Is tank elevated on saddles?

Is tank in contact with ground?

Is tank partially buried?

Does anything (piping, valves, etc.) look unordinary or of concern, such as loose fittings, swelling gasket, exposed wire, etc.?

For Cat. 2 and 3 ASTs, does the AST meet standards?

If not, how is the tank deficient?

Is the cathodic protection system being evaluated regularly?

For ASTs greater than 10,000 gallons (or ASTs less than 10,000 gallons within 500 feet of a sensitive receptor), is the secondary containment adequately designed and in good condition?

For ASTs less than 10,000 gallons that are using alternatives to secondary containment, are DER-25 issues addressed?

Does the AST have a gauge, high-level alarm, high-level liquid pump cut-off controller, or an equivalent device?

Is the tank marked with design and working capacities and tank ID number?

Does the facility conduct monthly inspections for all AST systems?

Does the facility conduct ten-year inspections for Cat. 1 AST systems?

Does the facility conduct tightness testing at ten-year intervals for underground Cat. 1 piping?

B. Foundation/Structural

Is there any settlement/cracks/corrosion?

Are anchor bolts tight?

C. Secondary Containment

Are there any cracks/gaps/punctures/corrosion or areas of potential containment breech?

Is paint/sealant in good condition?

Is there stormwater build-up?

Stormwater discharge date

Is drainage valve locked closed?

Are dike drain valves locked in a closed position?

D. Pipes/Valves/Pumps/Sumps

Are there leaks or spills?

Is there any corrosion/discoloration?

Are supports in good condition?

Are valves operational?

Are vents visually free from blockage or obstruction?

Is a solenoid or equivalent valve in place for gravity-fed motor fuel dispensers?

Is a check valve in place for pump-filled ASTs with remote fills?

Is an operating valve in place on every line with gravity head?

E. Sumps

Are manhole covers secured properly?

Are manhole covers gaskets in good condition?

Are the sumps free of product, debris, rainwater, dirt, etc.?

Are there any visible leaks?

Is there any visible corrosion?

Does anything (piping, valves, etc.) look unordinary or of concern, such as loose fittings, swelling gasket, exposed wire, etc.?

Are there sumps?

If more than one sump, list on diagram and identify AOC and sump #

F. Tank Monitoring System

Is there a tank monitoring system?

Are sensors hard mounted?

Is system operating properly?

Does system pass routine test when depressing test button?

Are there any alarm conditions or concerns?

Does printer have paper?

Is printer working properly?

Print and attach test

Are all visual and audible alarms working?

Remote Annuciator - Light and sound works

Is the main alarm panel properly labeled?

Does remote annunciator test sound/light when button is pressed?

Does sump test sound/light when button is depressed?

Does double wall test sound/light when button is depressed?

Does overfill alarm test sound/light when button is depressed?

G. Fill or Remote Fill Location

Is there a catch basin?

Is the catch basin aboveground?

Is the catch basin belowground?

Is there a remote fill?

If there is a remote fill, is the piping below ground?

Are remote fills locked?

Do all fill pipes have caps?

Are there any visible leaks?

Is fill port API color coded?

Is there a 5 gallon spill bucket (catch basin) installed?

Have spill buckets been properly maintained?

Is the tank color coded/marked to identify the product in the tank system?

Is there any visible corrosion?

Does anything (piping, valves, etc.) look unordinary or of concern, such as loose fittings, swelling gasket, exposed wire, etc.?

Underground Storage Tank System (UST)

A. Tank Condition

Are there any leaks or spills?

Are there any cracks/bulges/corrosion?

Are exterior tank surfaces painted?

Is tank labeled properly (design/working capacity/tank #)?

Is gauge or high level alarm working?

Is leak detection equipment monitored and inspected?

Is interstitial port labeled and locked?

Is cathodic protection monitored and inspected?

For Cat. 2 and 3 UST systems, does the UST system meet standards?

If not, how is the tank system deficient?

B. Leak Prevention

Is the spill prevention device (i.e., spill bucket) present and functional?

Is the overfill prevention device (i.e., automatic shut-off, high-level alarm, ball float valve) present?

Is the overfill prevention device set to activate at an appropriate level?

Is the overfill prevention device operational?

If not

Are metal tank system components in contact with soil (including fittings, connections, etc.) continuously protected from corrosion?

If not

Is the cathodic protection system (for steel tank and piping systems) tested within the required time frame and does it provide continuous protection?

If not

If an impressed current system is in use, has the system been operated continuously?

If not

Is the impressed current system inspected every 60 days?

For lined Cat. 1 USTs, is the internal lining being inspected periodically (i.e., within 10 years after installation and every 5 years thereafter)?

If cathodically protected tank or piping was structurally repaired, were CP systems tested/inspected within 6 months after repair?

Were structurally repaired tank and piping tested for tightness within 30 days after repair completion? (Tightness test not required when internal inspection is conducted after repair or if weekly leak detection method is in use.)

C. TMS and Leak Detection

Is there a tank monitoring system?

Is system operating properly?

Does system pass routine test when depressing test button?

Are there any alarm conditions or concerns?

Does printer have paper?

Is printer working properly?

Print and attach test

Are all visual and audible alarms working?

Remote Annuciator - light and sound works

Is the main alarm panel properly labeled?

Does remote annunciator test sound/light when button is pressed?

Does sump test sound/light when button is depressed?

Does double wall test sound/light when button is depressed?

Does overfill alarm test sound/light when button is depressed?

Is sensor(s) hard mounted?

Is leak monitoring being performed?

Specify method(s) of tank leak detection used

Specify SECOND method of pressurized piping leak detection used aside from ALLD

Specify method of suction piping leak detection used

Is the Automatic Tank Gauging (ATG) on the National Work Group on Leak Detection Evaluations list?

Is the ATG set up properly to conduct leak tests?

Did the ATG conduct leak tests while the tank contained the routinely highest level of product?

D. Manual Tank Gauging (MTG)

Is tank size appropriate for using MTG (under 1000 gal. only)?

Do records indicate that MTG is being conducted correctly?

Is MTG equipment capable of 1/8" measurement?

E. Pipes/Valves/Pumps/Sumps

Are there leaks or spills?

Is there any corrosion/discoloration?

Are supports in good condition?

Are valves operational?

Are vents visually free from blockage or obstruction?

F. Sumps

Are there sumps?

If more than one sump, list on diagram and identify AOC and sump #

Are manhole covers secured properly?

Are manhole covers gaskets in good condition?

Are the sumps free of product, debris, rainwater, dirt, etc.?

Are there any visible leaks?

Is there any visible corrosion?

Does anything (piping, valves, etc.) look unordinary or of concern, such as loose fittings, swelling gasket, exposed wire, etc.?

G. Fill or Remote Fill Location

Is there a catch basin?

Is the catch basin aboveground?

Is the catch basin belowground?

Is there a remote fill?

If there is a remote fill, is the piping below ground?

Are remote fills locked?

Do all fill pipes have caps?

Are there any visible leaks?

Is Fill Port API Color Coded?

Is there a 5 gallon spill bucket (catch basin) installed?

Have spill buckets been properly maintained?

Is the fill port/tank color coded/marked to identify the product in the tank system?

Is there any visible corrosion?

Does anything (piping, valves, etc.) look unordinary or of concern, such as loose fittings, swelling gasket, exposed wire, etc.?

H. Line Testing

Does line testing apply?

Is line testing method on the National Work Group on Leak Detection Evaluations (NWGLDE) list?

Is line testing method being conducted according to the manufacturer's instructions? (Compare test report with NWGLDE specifications for the test method.)

Is line testing conducted within the appropriate time frame?

I. Inventory Monitoring

Is this a motor fuel or kerosene tank?

Does the facility have adequate inventory records for metered tanks storing motor fuel/kerosene that will be sold as part of a commercial transaction?

If not, which items are deficient?

J. Groundwater/Vapor Monitoring

Does this site require groundwater/vapor monitoring?

Is there a site assessment report indicating location and number of groundwater/vapor monitoring wells?

Are wells properly designed and positioned?

According to the site assessment report, is groundwater always detectable in the monitoring well (i.e., groundwater is never more than 20' from the ground surface)?

Is the vapor monitoring well not affected by high groundwater levels?

K. Interstitial Monitoring

Does the tank have interstitial monitoring?

Does secondary containment appear to have integrity?

Is the sensor properly positioned in the sump?

L. Automatic Line Leak Detector (ALLD)

Is an ALLD in use?

Is the ALLD present and does it appear to be operational?

Has the annual functionality test of the ALLD been conducted, and are records available?

M. Statistical Inventory Reconciliation (SIR)

Is the SIR method on the National Work Group on Leak Detection Evaluations (NWGLDE) list of leak detection methods?

Is SIR required for this site?

N. UST Operator Training

Is there a designated Class A Operator and is that person properly authorized?

Is there a designated Class B Operator and is that person properly authorized?

Is there a designated Class C Operator and is that person properly trained?

O. UST Closure

If the tank is permanently closed or underwent a change-in-service within the last 3 years, was a site assessment performed?

For Cat. 2 and 3 UST systems, does the UST system meet standards?

If not, how is the tank system deficient?

Is cathodic protection for steel tank and piping systems monitored annually?

Is leak monitoring being performed?

For Cat. 1 UST systems, has tightness testing been conducted within the last year?