Api 653 Tank Inspection Summary
Api 653 Tank Inspection Summary
Api 653 Tank Inspection Summary
INSTRUCTIONS: Fill in ALL applicable data. A copy of this completed form shall be kept on site; available for viewing by the authorized Wisconsin Inspection
Agency upon request.
OWNER INFORMATION
Customer ID#
Name
PROJECT INFORMATION
Site ID#
Facility Name
Company Name
Site Address
City
INSPECTOR INFORMATION
Facility ID#
Inspector Name
Company Name
Village
Town of:
County
Telephone Number
Fax Number
API Cert. #
Tank #
Construction Date
Telephone Number
Fax Number
Type:
Purpose:
Type:
External
Scheduled
Ultrasonic
Unscheduled
Internal
Other (specify):
External
Ultrasonic
Internal
TANK SPECIFICATIONS:
Manufacturer:
Contents:
Dimensions:
Specific Gravity:
Capacity:
Product heated:
Yes
No
Fill Height:
Bare Steel
2.
3.
Coated Steel
4.
Double Bottom
6.
Lined
7.
Other (specify):
5.
Galvanic or B.
Double Wall
Bottom:
Welded
Shell:
Welded
Riveted
Leak Detection
Date Installed:
Foundation:
Grade
Concrete Pad
1.
Concrete Ringwall
Stone Ringwall
Other
2.
3.
4.
Groundwater monitoring
Roof: 1.
3.
Open
2.
Floating:
Fixed:
Internal
5.
Vapor monitoring
Cone
External
Dome
6.
Interstitial monitoring
Umbrella
Other: ______________________________
None
TANK INSPECTION:
Non-Destructive Test Method:
(Check where test applied)
Visual
Ultrasonic (Spot)
Ultrasonic (Scan)
Liquid Penetrant
Penetrating Oil
Magnetic Particle
Radiography
Mag Flux Scan
Vacuum Box
Tracer Gas
Holiday (Coatings)
Other (Describe)
ERS-10737 (N. 1/02)
Bottom
Weld
Shell
Plate
Weld
Roof
Plate
Weld
Plate
Settlement Evaluation:
Yes
No
INSPECTION RESULTS:
Bottom
(External)
Bottom
(Internal)
Shell
(External)
Shell
(Internal)
Roof
Fixed
Floating
Bottom:
Settlement Within
Tolerance?
Bottom (max.):
Yes
No
Shell:
Yes
No
Yes
No (Suspected releases shall be investigated and reported per Comm 10.635 & 10.64)
Differential:
Yes
No
Edge:
Yes
No
Bulges/Ridges:
Yes
No
Comments: _____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
REPAIR SUMMARY: (Include description, date completed, and date of post-repair inspection)
Foundation:______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Bottom:_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Shell:__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Roof:__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Appurtenances:__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Hydrostatic test required?:
Yes
No
Results: _____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
INSPECTION SCHEDULE: (Supporting calculations must be available for review upon request)
External (ultrasonic): Corrosion rate known?:
Yes
No
(Year)
Date: