Red (R) : Maintenance Required

Green (G) : In Good Condition

Referred Source : www.pei.org/RP900

30 Days Walk Through Inspection

FID :

TANKS DATA Contact Number :

Contact email :

Date of Inspection :

Select Date (custom date ) :

Name of the person Conducting Inspection :

Operator on Duty Name :

Operator Training

Operator Training current :

Yes

No

Operator Notified :

Yes

No

Registration/Notification Form

Is Registration current with correct owner, operator etc. :

Yes

No

Operator Notified :

Yes

No

Release Detection	Yes/No
Release Detection Method : ATG CIM SIR IC other
Make & Model
Does it have paper?	Yes No
Is it in Alarm mode?	Yes No
Interstitial Monitoring Sensor Status Normal	Yes No
Necessary Monthly Printout Taken	Yes No

Spill Buckets	Yes/No	Tank1	Tank2	Tank3	Tank4
Are Spill Buckets Clean and free from water, debris, product etc?	Yes No	R G	R G	R G	R G
Are the Spill Bucket in good condition and free of damage/cracks	Yes No	R G	R G	R G	R G
Are the Spill Bucket covers in good condition ?	Yes No	R G	R G	R G	R G

Fill Ports	Yes/No	Tank1	Tank2	Tank3	Tank4
Is Fill pipe cap tight and fill pipe free from any obstruction?	Yes No	R G	R G	R G	R G

Piping/STP Sumps	Yes/No	Tank1	Tank2	Tank3	Tank4
Are Sumps Clean and free from water, debris, product etc?	Yes No	R G	R G	R G	R G

Under Dispenser Containments (UDC)	Yes/No	Tank1	Tank2	Tank3	Tank4
Are UDCs clean and free from water, debris, product etc?	Yes No	R G	R G	R G	R G

Observation and Monitoring Wells	Yes/No	Tank1	Tank2	Tank3	Tank4
Observation Well cover is properly identified and secured	Yes No	R G	R G	R G	R G

Stage I Vapor Recovery	Yes/No	Tank1	Tank2	Tank3	Tank4
The Spill Containment manhole is clean and free from water, debris, product, etc?	Yes No	R G	R G	R G	R G
The Spill Containment manhole is free of damage/cracks?	Yes No	R G	R G	R G	R G
The Spill Containment manhole cover is in good condition?	Yes No	R G	R G	R G	R G
Is Vapour Adapter cap tight and in good condition ?	Yes No	R G	R G	R G	R G

Tank Vent Lines	Yes/No	Tank1	Tank2	Tank3	Tank4
Are the vent lines vertical and firmly supported ?	Yes No	R G	R G	R G	R G

Operator Notified :

Yes

No

Deficiencies / Discrepencies Note :

Note :

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