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USTSystemMonthlyInspectionForm
Facility:___
CompletethisinspectionformusingtheKeytotheright.
AnyquestionansweredNO()mustexplainfollowupactiontakenbelow. FuelingEquipmentInspection
All caps, adaptersandgasketssealedtightly?
Spillbucketfreeofproduct/water/debris/damage?
Overfilldroptubepresentandfreeofobstructions?
Vaporrecoveryadapterintactandfreeofobstructions?
Tankfreeofwater?1YES
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