External Visual Inspection Form Tank ID Code Part 4 (a): Information on Registered Facility Name of Registered Facility Address Town Province Postal Code: Phone Number Person Conducting the Inspection Transport Canada Facility Registration Number: Inspection Date (ddimmivy) erenO mene Name of Tank Owner: Address: Telephone Number. Part 1 (c): Tank Data 's cataplate leoibie? Photo taken of dataglate or copy on fe? | -- Yes “No Rejection Crteria- Failure to meet the minimum standard requiremen under 8620 5.1.6.1.5, where the dataplate shail be maintained In iegibe condition and as required during an external inspection (7.2.1.4 [el). Pericles Reker eee eed eee Omene Tank ID; ‘Serial Number. CRNIASME Designation: MAW: *= PSI “kPa (chose one) Temperature Rating ~ Fahrenheit ~ Celsius (choose one Tank Specification ~" Non-spec “Spec (specify ) Year of Manufacture Water Capacity ~ Gallons ~~ Litres (choose one) Tank Material Steel Shell Thickness. ~ Inches ~ Milimetres (choose one) Head Thickn = Inches ~~ Millmetres (chaose one) Extemal Visual Inspection Form Page 1 of 8 Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 72Tank ID Code ies Date of Last Test Less than or equal to a 36-month period (in accordance to B620 Table 7.1, “Periodic Inspection ang Testintervais"), The external inspection period may ve extended to 3 years {or tanks outlined in CSA BE22, clause 6.3, specific requirement 56. ‘Markings on tanks must be legible (CSA 8620 7.2.1.1fel). Record all test markings on tanks below. ‘Test Dates (mmiyy): Safety Requirements Close proximity to Fresh Water; take note of wind direction (always approach upwind). ‘goggles: gloves; safaty boots: and NH3 protactive suit General Information for Quick Reference Litres to US galons = x /3.77 US gallons to lires = X*3.77 kPa to PSI=X* 0.145, PSI tokPa=X" 6.89 Nominal Thickness : Tank Body 375 in. (9.53 mm) for Westee! tanks Tank Ends 222 in. (8.18 mm) for Westee! tanks Consult wih manufacturer of other tanks for thelr thicknesses. General Equipment Required Tadder, melal ruler, telescoping miror, metal scraper, wire brush, ard picks. Acaliper & required only if certification for a “Thickness Test” is granted to the testing facility Tank Preparation “Accept ~ Action Tank is free of any dirt and deoris that woule otherwise hinder any observations to tank shell all external attachments (Le. water tank, safety kit, ete.) are removed, List defects and locations below or use additional sheets if required. ‘Comments: Extemal Visual Inspection Form Page 2018 Nurse Tank Safety Gouncil of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5Tank ID Code Inspect enire aea of tank fordents, scrapes, distortions, gouges, bulges, cracks, signs of leakage or any ather condition that might render it unsafe for transport (72.1.1 fa). Rejection Criteria: + Defects less than the minimum thickness remaining under 2 cut dig, or gouge Tank Shell Inspection (10% less than the nominal thickness) [7.2.2 2(a)] Any dent wih a depth of more than 12.7 mm (0.6 in) where it includes a weld ~ Accept ~ Action (7.2.2.200) Any dent with a deptn of greater than 10% oftne length of tne dent (7.2.22 fe]) Any structural defect (7.2.2.2 lel) Any source of leakage (7.2.2 2ifl) List defects and locations below or use additional sheets if required: Inspect entre area of tank for corrosion, abrasions, and signs cf leavage or any oher condition that might render it unsafe for transport (72.41 [a}) Rejection Criteria: ‘Accept “Action |+ Defects less than the minimum thickness remaining under a cut, dig, or gouge (10% less man te nominal tnickness) (7.2.22 fa). + Any source of leakage (7.2.2.2 If). List defects and locations below or use additional sheets if required: Ensure all appurtenances (any fank pat or accessory that has no product containment Tunction ard provides no structural supporto tank (Le. PRV guards, weld pad)) and attachments, support structures, or connecting structures are nat damaged or correded so 435 10 affect Safe operation of the tank (7.2.11If) Accept Action | Rejection Criteria: + Insludes any structural defect (72.22 fel) + Repairs made to liquid retaining components using overiay patches (7.2.2.2{a]) List defects and locations below or use additional sheets if required, Extemal Visual Inspection Form Page 3 of 8 Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5