UST Monthly Visual Inspection Checklist

Are all fill lids present and in good condition?

• Yes
• No
• N / A

Are fills correctly identified by color and located on the correct tank?

• Yes
• No
• N / A

Is the primary space of the spill bucket free of dirt, trash, liquid, cracks and bulges?

• Yes
• No
• N / A

Is the secondary space (if applicable) of the spill bucket free of dirt, trash, liquid, cracks and bulges?

• Yes
• No
• N / A

Does the drain assembly work? (if applicable)

• Yes
• No
• N / A

Is the fill adaptor tight on the riser pipe?

• Yes
• No
• N / A

Is the fill cap in place with a gasket and sealed tightly on the fill pipe?

• Yes
• No
• N / A

Is the overfill device free of obstructions and functional?

• Yes
• No
• N / A

Are all manway covers present and in good condition?

• Yes
• No
• N / A

Is the piping REG STP sump free of dirt, trash, water and product?

• Yes
• No
• N / A

Is the piping PREM STP sump free of dirt, trash, water and product?

• Yes
• No
• N / A

Is the piping DSL STP sump free of dirt, trash, water and product?

• Yes
• No
• N / A

Is the piping Other STP sump free of dirt, trash, water and product?

• Yes
• No
• N / A

Is the piping sump in good condition and free of damage? (No cracks, bulges or holes)

• Yes
• No
• N / A

Are the sump wall piping penetrations in good condition?

• Yes
• No
• N / A

Is the sump cover in good condition?

• Yes
• No
• N / A

Does the sump cover have a gasket in good condition and a tight seal?

• Yes
• No
• N / A

Is the piping in good condition and all connections tight?

• Yes
• No
• N / A

Do all tanks contain less than 1/2 inche of water?

• Yes
• No
• N / A

Tank 1 Water Level

• Yes
• No
• N / A

Tank 2 Water Level

• Yes
• No
• N / A

Tank 3 Water Level

• Yes
• No
• N / A

Tank 4 Water Level

• Yes
• No
• N / A

Tank 5 Water Level

• Yes
• No
• N / A

Is the vapor cap in place with a gasket and sealed tightly on the vent pipe?

• Yes
• No
• N / A

Does the poppet of the vapor recovery adaptor seal tightly?

• Yes
• No
• N / A

Are the vapor recovery lids painted orange?

• Yes
• No
• N / A

Does the ATG have power?

• Yes
• No
• N / A

Is the ATG console in normal status mode? (no warning or alarm lights lit)

• Yes
• No
• N / A

Does the ATG printer have paper and is it in working condition? (If applicable)

• Yes
• No
• N / A

Do the liquid measurements and the ATG readings appear to be accurate?

• Yes
• No
• N / A

Is the leak detection system for the storage tank(s) functional and indicate that no leaks have been detected?

• Yes
• No
• N / A

Is the leak detection system for the piping functional and indicate that no leaks have been detected?

• Yes
• No
• N / A

Are the piping sumps are free of water, debris, and hazardous substances.

• Yes
• No
• N / A

Are sensors properly located.

• Yes
• No
• N / A

STP components are free from rust.

• Yes
• No
• N / A

Any leak from STP system and piping.

• Yes
• No
• N / A

Is piping secondary Is open.

• Yes
• No
• N / A

Electronic monitoring (Annular Sensors) - Interstitial tank sensor alarm - Tank 1

• Yes
• No
• N / A

Electronic monitoring (Annular Sensors) - Interstitial tank sensor alarm - Tank 2

• Yes
• No
• N / A

Electronic monitoring (Annular Sensors) - Interstitial tank sensor alarm - Tank 3

• Yes
• No
• N / A

Electronic monitoring (Annular Sensors) - Interstitial tank sensor alarm - Tank 4

• Yes
• No
• N / A

Vacuum Gauge Reading - Tank 1

• Yes
• No
• N / A

Vacuum Gauge Reading - Tank 2

• Yes
• No
• N / A

Vacuum Gauge Reading - Tank 3

• Yes
• No
• N / A

Vacuum Gauge Reading - Tank 4

• Yes
• No
• N / A

Visual Monitor Tank Annular - Tank 1 Dry?

• Yes
• No
• N / A

Visual Monitor Tank Annular - Tank 2 Dry?

• Yes
• No
• N / A

Visual Monitor Tank Annular - Tank 3 Dry?

• Yes
• No
• N / A

Visual Monitor Tank Annular - Tank 4 Dry?

• Yes
• No
• N / A

Are the nozzles pressure sensitive?

• Yes
• No
• N / A

Are the nozzles and swivels in good condition and free of leaks?

• Yes
• No
• N / A

Are the UDC's free of dirt, debris, and liquid? Is the UDC liner in good condition and free of damage? (No cracks, bulges or holes)

• Yes
• No
• N / A

Are the hoses in good condition and free of leaks?

• Yes
• No
• N / A

Are the breakaway connectors in good condition and free of leaks?

• Yes
• No
• N / A

Reason for breakaway connectors not in good condition

Inspector Signature