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Quarterly Inspection Checklist
Dipenser Fueling Point#'s 1 2 3 4 5 6 7 8 9 10 11 12
Check for leaks
Check hoses
Check nozzles
Check breakways
Check nozzle cover splash guards
Check regulatory and octane decals
Are dispensers anchored
Is dispenser containment free of products/water/debris?
Is fire extinguisher charged and dated?
Tank/Tank Monitor Regular Midgrade Premium Diesel
Ok Need Maint Ok Need Maint Ok Need Maint Ok Need Maint
Check M/H covers and fill caps, verify all 4" caps have gaskets and are liquied light
Check spill buckets for cracks
Check vent caps
Check drop tubes and over fill valves
Are all probes operational and calibrate correctly?
Are STP Containements free of product/water/debris?
Are fills/vapor recovery free of product/water/debris?
verify the test boots for the D/W are not blocking liquid access into the sump?
YesNoN/A
Check for presence of overfill
Is overfill alarm functioning properly?
Is tank monitor time set corrrectly?
Is E-stop operational and at least 20' but no more then 100' from dispensers?
General Items YesNo
Does inrercom function at all islands?
Current tank registration certificate present on site ?
Tank registration information correct?
Annuaul Requirments YesNoN/ADate of Last Test
Impact valve tested?
Leak detector tested(No electonic leak detection)?
If electronic leak detection 1,2, or 3 test being ran?
ElectronicManualSensorsDate of Last Test
Method of line testing
Method of tank testing?
Corrosion Systems YesNoN/ADate of Last 3 Year Inspection
Galvanic : Anoode test records current? (Must be conducted every 3 years)(The previous 2 inspections must be available)
Impressed Current : Rectifier functional today?
Impressed Current : Readings recorded on schedule?(every 60 days)(The previous 3 readings are required the previous 2 inspections must be available )
Leak Detection Systems YesNoN/A
Has each alarm condition been responded to appropriately? (Record comments below)
Comments :
Additional Comments :
DESIGNATED B OPERATOR :
ALTERNATE B OPERATOR :
Signature :
Printed Name :
Candidate ID:
Signature :
Printed Name :
Candidate ID:
Data Reviewed & Approved By Designated B Operator :
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