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Section 5: Tank Top Components and Vent Pipe Inspection

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  • 5.

    a. Tank Top Inspection

    • #

      Complete 1-3. Answer (P)ass, (PC), (F)ail

or (NA) for 1a, 1b, and 4 -7 for each tank

Tank #

_

Tank #

_

Tank #

__

Tank #

__

Tank #

__

2 3 4 7 5 1 6 1b 1a. Storage tank equipped with ATG? If Yes, complete 1a., 1b. ATG riser is capped and electrical connection secure with proper grommet. ATG manway lid properly fitted and not in contact with riser or electrical wires. Flex connector present on STP? If in contact with soil complete Section 8. Interstice monitoring system (double wall tank) or inspection station present? Ball Float riser and other riser pipes are fitted with proper caps; manway covers are not in contact with cap or riser pipe. No petroleum vapors present during ATG, Ball Float, or Vent riser inspection, or STP without sump. Note all vapor field readings if taken for ATG, Ball Float, or Vent riser, or STP without sump. Marina. Each pipeline has a readily accessible shut- off valve grouped at one location on shore near approach to pier or dock and marked “emergency shut-off”? Tank Top Components passes inspection. Questions 1a., 1b.and 4 – 7are (P) or (PC) and 3 yes or component not required Note: If the answer to any question is (F), explain below. List any problems noted during inspection. Note corrections. (Circle one) (Circle one) (Circle one) Y/N Y/N Y/N (Circle one) (Circle one) (Circle one) Y/N Y/N Y/N (Circle one) (Circle one) (Circle one) Y/N Y/N Y/N (Circle one) (Circle one) (Circle one) Y/N Y/N Y/N

(Circle one)

Y/N

(Circle one)

Y/N

(Circle one)

Y/N

Comments: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

5.b. Vent Pipe Inspection

#

Answer (P)ass, (PC), (F)ail or (NA) for

Tank#

__

Tank#

__

Tank #

__

Tank #

__

Tank #

__

1 2

3

4

each vent Vent pipe riser is constructed of steel?

Vent pipe is properly anchored and protected from vehicle traffic (bollards or secured to building)? Vent pipe is proper height (flammable liquids 12 feet above ground surface and 2 feet above any attached building). (Combustible liquids minimum 3 feet above ground surface)? Equipped with vent cap (flammable liquid with Stage I vapor recovery must have pressure vent cap)?

Vent passes inspection. Questions 1 – 4 are (P) or (PC) Note: If the answer to any questions is (F), explain below. List any problems noted during inspection. Note corrections.

Comments: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Form Number: MDE/WAS/COM.055 Date: April 3, 2007 TTY Users: 800-735-2258

Facility I.D.

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