SPCC Monthly Tank Assessment Form

Copy this sheet as needed.

Date	Tank Description	Initials	Comments

For instructions, refer to Appendix D.1 in your SPCC Plan.

Use one line for each tank inspected.

Initial the form after thoroughly checking the following:

Tanks:

Signs of leakage; Tank condition; Foundation condition; Gauges/alarms working properly

Containment Area:

Signs of oil in containment area; Cracks in containment; Drainage valves/openings closed

Transfer Operations:

Signs of leakage from pipes, valves, flanges; Pipeline condition; Out-of-service pipes capped

Truck Loading and Unloading Areas:

Signs of leaks/spills – Warning signs posted or wheel chocks used.

NDOT Form 197, August 17