"Monthly Walk-Through Inspection Checklist" - North Dakota

Monthly Walk-Through Inspection Checklist is a legal document that was released by the North Dakota Department of Health - a government authority operating within North Dakota.

Form Details:

  • Released on May 1, 2015;
  • The latest edition currently provided by the North Dakota Department of Health;
  • Ready to use and print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

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MONTHLY WALK-THROUGH INSPECTION CHECKLIST
North Dakota Department of Health
Division of Waste Management – Underground Storage Tank Program
Revision: 05/2015 (Page 1 of 2)
Facility Name: _________________________________________________________Facility Location Address: ________________________________________
Class B Operator Performing or Overseeing Inspection (print name):___________________________________________________________________________
Date of Inspection: mm/dd/yy)
Release Detection System: Inspect for the proper operation
of your release detection system and indications of potential
leaks in the underground storage tank system(s).
Spill Buckets: Ensure spill buckets are clean, in good
condition, and empty of liquid and debris.
Overfill Alarm: Inspect for proper operation.
Fill and Monitoring Ports: Inspect all fill/monitoring ports and
other access points to make sure that the covers and caps are
secured and tightly sealed.
Spill and Overfill Response Supplies: Ensure you have
available on site appropriate supplies for cleaning up spills or
overfills; i.e., an absorbent such as cat litter or floor dry.
Dispenser Hoses, Nozzles, and Breakaways: Inspect for loose
fittings, deterioration, improper functioning and signs of
leakage. Call your tank contractor to repair obvious problems.
Dispenser and Dispenser Sumps: Open each dispenser and
inspect all visible piping, fittings, and couplings for any signs of
leakage. If any water or product is present, remove it and
dispose of it properly. Investigate and report to the North
Dakota Department of Health reasons for the presence of
product. Remove any debris from the sumps.
Piping Sumps: Inspect all visible piping, fittings, and couplings
for any signs of leakage. If any water or product is present,
remove it and dispose of it properly. Investigate and report to
the North Dakota Department of Health reasons for the
presence of product. Remove any debris from the sumps.
MONTHLY WALK-THROUGH INSPECTION CHECKLIST
North Dakota Department of Health
Division of Waste Management – Underground Storage Tank Program
Revision: 05/2015 (Page 1 of 2)
Facility Name: _________________________________________________________Facility Location Address: ________________________________________
Class B Operator Performing or Overseeing Inspection (print name):___________________________________________________________________________
Date of Inspection: mm/dd/yy)
Release Detection System: Inspect for the proper operation
of your release detection system and indications of potential
leaks in the underground storage tank system(s).
Spill Buckets: Ensure spill buckets are clean, in good
condition, and empty of liquid and debris.
Overfill Alarm: Inspect for proper operation.
Fill and Monitoring Ports: Inspect all fill/monitoring ports and
other access points to make sure that the covers and caps are
secured and tightly sealed.
Spill and Overfill Response Supplies: Ensure you have
available on site appropriate supplies for cleaning up spills or
overfills; i.e., an absorbent such as cat litter or floor dry.
Dispenser Hoses, Nozzles, and Breakaways: Inspect for loose
fittings, deterioration, improper functioning and signs of
leakage. Call your tank contractor to repair obvious problems.
Dispenser and Dispenser Sumps: Open each dispenser and
inspect all visible piping, fittings, and couplings for any signs of
leakage. If any water or product is present, remove it and
dispose of it properly. Investigate and report to the North
Dakota Department of Health reasons for the presence of
product. Remove any debris from the sumps.
Piping Sumps: Inspect all visible piping, fittings, and couplings
for any signs of leakage. If any water or product is present,
remove it and dispose of it properly. Investigate and report to
the North Dakota Department of Health reasons for the
presence of product. Remove any debris from the sumps.
MONTHLY WALK-THROUGH INSPECTIONS AT
UNDERGROUND STORAGE TANKS SITES
North Dakota Department of Health
Division of Waste Management – Underground Storage Tank Program
Revision: 05/2015 (Information Sheet - Page 2 of 2)
As part of the 2005 Energy Policy Act, facilities that operate regulated
underground storage tank (UST) systems are required to have their Class B
operator perform or oversee the performance of a monthly inspection of their
UST system(s). These inspections are conducted to ensure essential
equipment is operating properly. The North Dakota Department of Health’s
Underground Storage Tank Program has developed a “Monthly Walk-Through
Inspection Checklist” in order to assist UST owners and operators with this
requirement (see reverse).
Inspections are required on a monthly basis and must be documented to be in
compliance. Initial each box below the date of inspection to indicate that the
device/system was inspected and found to be operating properly on that date.
A minimum of one year’s monthly walk-through inspections must be
kept on site. If the monthly inspection results indicate a potential leak in
your underground storage tank system, the reason for the leak must be
investigated and corrective action taken to address the source. In addition, if
a release of product has occurred, it must be reported to the North Dakota
Department of Health’s Underground Storage Tank Program at
(701) 328-5166.
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