Compliance Calendar for Gasoline Dispensing Facilities 2019-2020 - Created by the Wisconsin Small Business Environmental Assistance Program
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2019-2020
Compliance Calendar for
Gasoline Dispensing Facilities
Created by the Wisconsin Small Business
Environmental Assistance Program
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 1
Welcome!
Welcome to the 2019-2020 edition of the compliance calendar for gas stations and other gasoline dispensing facilities. The
Wisconsin Small Business Environmental Assistance Program (SBEAP) developed this calendar to help gasoline dispensing
facilities comply with environmental requirements related to the transfer of fuel. This calendar can be a useful tracking and
record keeping tool for facilities.
This calendar summarizes the requirements under three sets of regulations affecting gas stations. However, please refer to the
official rule language for more comprehensive information about them:
How to contact the program: • U.S. Environmental Protection Agency (U.S. EPA) standards for gasoline dispensing facilities: https://www.epa.gov/
stationary-sources-air-pollution/gasoline-distribution-mact-and-gact-national-emission-standards,
Small Business
Environmental • Wisconsin Department of Natural Resources (DNR) regulations regarding emissions of gasoline vapor from petroleum
Assistance Program and gasoline sources: https://docs.legis.wisconsin.gov/code/admin_code/nr/400/420 and http://docs.legis.wis-
consin.gov/code/admin_code/nr/400/445.pdf, and
WI Dept. of Natural Resources
Sustainability and Business • Wisconsin Department of Agriculture, Trade & Consumer Protection (DATCP) regulations for gasoline storage tanks
Support EA/7 and piping: https://docs.legis.wisconsin.gov/code/admin_code/atcp/090/93.
101 S. Webster St.
PO Box 7921 This calendar was designed to provide space for recording gasoline throughput, inventory tracking, leak detection
Madison, WI 53707-7921 inspections, repairs and employee training. Keep the completed calendar on file for five years, and it can serve as the
facility’s official record.
855-889-3021 (toll free)
DNRsmallbusiness@wi.gov The 2019-2020 calendar has been updated to reflect the following change:
http://dnr.wi.gov/, search
“small business” • DATCP’s petroleum inspection districts and contact information has changed—DATCP’s Weights & Measures
Bureau administers Wisconsin’s Flammable, Combustible and Hazardous Liquids Rule affecting gasoline storage tanks (ch.
ATCP 93, Wis. Adm. Code). See page 83 to find the appropriate contact for the area or view the map online at https://
datcp.wi.gov/Pages/Programs_Services/WeightsAndMeasuresContacts.aspx.
About the Small Business Environmental Assistance Program (SBEAP)
SBEAP is a free, non-regulatory program that provides information to Wisconsin’s small businesses to help them understand
their environmental compliance requirements. The program provides factsheets, record keeping and reporting tools, U.S. EPA
and DNR compliance documents, required forms and much more. All are available free of charge. For questions or comments
about this calendar or to obtain additional copies, please contact the SBEAP.
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 2
Wisconsin Compliance Calendar for Gasoline Dispensing Facilities
Table of Contents
Introduction
• Understanding the Regulations Affecting Gas Stations and How this Calendar Can Help 4
Record Keeping Tools
• Instructions for Using the Record Keeping Pages 6
• 2019-2020 Calendar and Record Keeping Pages 8
• Monthly Walkthrough & Inspection Checklist 56
• Weekly Inspection Checklist 58
• Training Logs 59
• Gasoline Inventory Tracking & Verification Worksheet 60
Fact sheets
• Introduction to Vapor Recovery 61
• National Emission Standards for Hazardous Air Pollutants for Gasoline Dispensing Facilities (NESHAP) 62
• Wisconsin’s Regulation for Control of Organic Compound Emissions from Petroleum and Gasoline Sources 65
◆ Stage II Decommissioning Checklist 69
• Wisconsin’s Flammable, Combustible and Hazardous Liquids Rule (Underground Storage Tank Requirements) 70
◆ Owner-Operator Training Requirements 76
• Spill Reporting Requirements and Procedures 78
• Definitions 79
Additional Resources
• Sources of Information 81
• Petroleum Inspection Districts Map & Contact Information 83
• Assistance Available for Gasoline Dispensing Facilities back cover
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 3
Understanding the Regulations Affecting Gas Stations and How this
Calendar Can Help
Gasoline vapors contain volatile organic compounds (VOCs) and several hazardous The DNR’s emissions regulations mainly affect facilities located in 20 Wisconsin
air pollutants (HAPs), such as benzene. Filling gasoline storage tanks can release counties (Brown, Calumet, Dane, Dodge, Door, Fond du Lac, Jefferson, Kenosha,
these compounds to the air. Benzene, for example, is among the 30 HAPs identified Kewaunee, Manitowoc, Milwaukee, Outagamie, Ozaukee, Racine, Rock, Sheboygan,
as posing the greatest public health risk in urban areas. Exposure to benzene can Walworth, Washington, Waukesha and Winnebago counties). Depending on the size
cause drowsiness, dizziness and even unconsciousness. Long term exposure to of their storage tanks, gas stations in these counties may be required to employ Stage
benzene can cause anemia and leukemia. I vapor control systems. See the information on this rule, starting on page 65, for
details.
Leak detection and vapor control are among the methods that gasoline dispensing
facilities use to reduce the emissions of HAPs like benzene into the air. Wisconsin’s regulations for flammable, combustible and hazardous liquids (ATCP
93) affect businesses that sell gasoline or other liquid motor fuels. Most gas stations
In Wisconsin, gas stations and other gasoline dispensing facilities are affected by with gasoline storage tanks are affected by this rule.
various regulations such as:
What is required?
• U.S. Environmental Protection Agency (U.S. EPA) National Emission The regulations generally address the following goals:
Standards for Hazardous Air Pollutants for gasoline dispensing facilities
(NESHAP; 40 CFR part 63, subpart CCCCCC). This rule regulates vapor control • Minimize releases of gasoline vapor from storage tanks - All gasoline
during the filling of gasoline storage tanks. dispensing facilities, regardless of size, must implement management practices
that minimize vapor releases to the atmosphere. The particular vapor control
• Wisconsin Department of Natural Resources (DNR) regulations regarding requirements that apply to each facility may depend on the amount of gasoline
Control of Organic Compound Emissions from Petroleum and Gasoline dispensed at the facility.
Sources (ch. NR 420, Wis. Adm. Code). This rule requires vapor control during
the filling of gasoline storage tanks (Stage I vapor recovery) in some Wisconsin • Minimize leaks (of liquid gasoline from gasoline storage tanks, piping,
counties. Vapor control during the refueling of motor vehicles (Stage II vapor and dispensing equipment) - The regulations for minimizing gasoline leaks
recovery) is no longer required, as many vehicles today are equipped with require regular inspections to monitor equipment function and leak checks for
onboard vapor recovery systems. rapid detection of any leaks in the equipment.
• Wisconsin Department of Agriculture, Trade & Consumer Protection (DATCP) • Testing and compliance demonstration - Some facilities are required to
Regulations for Flammable, Combustible and Hazardous Liquids (ch. test the vapor balance system and equipment to demonstrate compliance with
ATCP 93, Wis. Adm. Code). This rule regulates gasoline storage tanks and regulations. In addition, facilities may be required to measure the leak rate and
associated piping. cracking pressure of pressure-vacuum vent valves on gasoline storage tanks.
Who is affected by these regulations? • Record keeping and reporting - Record keeping requirements include
The U.S. EPA regulations affect “area sources” which include all gasoline dispensing tracking and verifying gasoline inventory, keeping records of regular equipment
facilities that emit less than 10 tons per year of a single HAP or less than 25 tons per tests and keeping records of any required employee training. Some facilities may
year of any combination of HAPs. Most gas stations fall into this group. also be required to file “Initial Notification” and “Notification of Compliance
Status” reports.
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 4What can this calendar do? Why must gas stations inspect storage tanks and
equipment?
This calendar has been designed to help gasoline dispensing facilities comply Properly installed and maintained underground storage system equipment is durable
with the regulations, especially tracking and meeting record keeping obligations. and reliable. However, daily wear and tear; exposure to corrosive effects of soil,
The calendar can be used to: water and stored product; and seasonal extremes of heat and cold can degrade or
damage storage system components and cause product releases or equipment failure.
Assess applicability
The purpose of inspections is to identify any noticeable deterioration or apparent
The fact sheets located at the back of the calendar, starting on page 61, can help
identify which requirements apply to a facility and how the facility is affected. malfunction in the portion of the equipment visible beneath grade-level access
However, they are not a substitute for reading and understanding the rules. Refer covers located over or near the top of the underground storage tank and at the fuel
to the rule language for additional information and clarification. dispensers.
Contact information for the regulatory agencies and other offices, as well as Required regular inspections help protect the public, facility employees and the
resources that can assist with the requirements, are also provided starting on environment from the hazards posed by the release of flammable or combustible
page 81. liquids and exposure to toxic motor fuels. Facilities can also save money by
identifying and repairing leaks of stored fuel.
Record important dates
Facilities can use the monthly calendar, starting on page 8, to keep track of
any important dates. Mark the calendar when tank-use permits are due, Why is leak detection important?
when tank insurance is due and when equipment testing is required. Leak detection can help businesses in numerous ways. Among other things, leak
detection can:
Document inspections and leak-detection monitoring
Each month of the calendar contains space where facilities can track their
• reduce or eliminate loss of product (from theft or leaks)
inspections and keep a maintenance and repair log for equipment. Sample
• reduce fire and explosion threats
checklists for monthly and weekly inspections are also provided starting on page
56. • reduce and/or eliminate contamination of soil, groundwater, streams, rivers,
lakes and drinking water
Document employee training • reduce liability
The log on page 59 can help document required and recommended employee
training. Please contact SBEAP with any suggestions for additions or modifications that will
make this calendar more helpful. Thank you!
Document inventory tracking and verification
Page 60 contains a sample worksheet for recording daily gasoline inventory. In
addition, each month provides space to summarize the total amounts of gasoline
delivered and dispensed. These records are required by both Wisconsin’s state Wisconsin Small Business Environmental
regulations and U.S. EPA’s federal requirements. Assistance Program
Maintain an official record
If a facility saves their completed calendar, it can serve as part of their official
record. Keep this and other records at the facility for five years to demonstrate
compliance.
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 5Instructions for Using the Record Keeping Pages in this Calendar
Attach monthly inventory worksheet(s) or printout(s) here
Monthly inventory worksheets or automatic
tank gauging (ATG) strips can be kept with this
Each month, check for any deadlines calendar. Attach them to the record keeping
approaching for permit renewal, tank page for each month.
insurance, compliance testing and
employee training. Set a reminder to Monthly Inspection, Condensed Record
meet all important dates and deadlines by (perform by end of each month or 30 days apart; see page 56 for expanded checklist)
marking the calendar! Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
record? (initials)
Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Reminders — Permits, Insurance, Testing Release detection system (tank monitor)
and Training Spill buckets
Are tank permits up to date? Yes No Overfill alarm
Impressed current system (if applicable)
Is tank insurance due this month? Yes No
Fill and monitoring probe ports
Is equipment testing due this month?
Yes No Spill and overfill response supplies
Are most recent test results on site?
Is all training up to date for current Dispenser hoses, nozzles and breakaways
Yes No
employees?
Dispenser and dispenser sumps
Piping sumps (submersible)
Use this table to keep a record of Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
required monthly inspections. Read (inspecting the equipment below is optional but recommended - see page 66)
the complete “Monthly Inspection Vapor return line
Checklist” on page 56 and record
inspection results for each month on Nozzle bellows
this table. Each person who conducts Nozzle faceplate / facecones
an inspection should initial their
Nozzles
entries.
Vapor processing unit working properly
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 6Monthly Gasoline Throughput Summary
Facilities that choose to retain Stage II systems can
Amount Amount Within use this table to keep a log of their weekly inspections
Product type
delivered dispensed variance? (weekly inspections of Stage II equipment are optional
but recommended - see page 66). Record the date of
+ + Yes / No
each weekly inspection. The person who conducts the
inspection should initial the table.
+ + Yes / No
+ + Yes / No
Monthly totals = = Weekly Inspection Record
Inspection date Inspected by (initials)
Use this table to summarize the monthly gasoline
throughput at the facility. For each tank (or product),
record the total amount of gasoline delivered to and
dispensed from that tank during the month. Mark yes if
the tank is within the allowable variance for the month
(if using inventory control). For more information about
inventory recording and verification, and for help with the
calculations, see the worksheet on page 60 of this calendar.
System Maintenance and Repair Record
Inspection Name of Identify problem/defective Replacement part
Repair date
date inspector part manufacturer/part number
Use this table to help meet the requirement to keep a system maintenance and repair log. Record the date when inspections
are conducted and the name of the person who inspected the equipment. Also record information about any problem or
defective part discovered, the date the equipment was repaired, and the manufacturer and part number of any parts replaced.
Alternatively, documentation of repairs may be kept in a separate file. This table can be used to record the date of repairs and
note the location where the complete explanation and record is stored.
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 7Attach monthly inventory worksheet(s) or printout(s) here
January 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 8Compliance Calendar for Gasoline Dispensing Facilities
January 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5
Need reminders of any
deadlines this month?
Mark this calendar!
Weekly Inspection
6 7 8 9 10 11 12
Weekly Inspection
13 14 15 16 17 18 19
Weekly Inspection
20 21 22 23 24 25 26
Weekly Inspection
27 28 29 30 31
Questions? Call 855-889-3021
Monthly Inventory
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 9Attach monthly inventory worksheet(s) or printout(s) here
February 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 10Compliance Calendar for Gasoline Dispensing Facilities
February 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2
Need reminders of any deadlines this month? Mark this calendar!
Weekly Inspection
3 4 5 6 7 8 9
Weekly Inspection
10 11 12 13 14 15 16
Weekly Inspection
17 18 19 20 21 22 23
Weekly Inspection
24 25 26 27 28
Questions?
Call 855-889-3021
Monthly Inventory
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 11Attach monthly inventory worksheet(s) or printout(s) here
March 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 12Compliance Calendar for Gasoline Dispensing Facilities
March 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2
Need reminders of any deadlines this month? Mark this calendar!
Questions? Call 855-889-3021
Weekly Inspection
3 4 5 6 7 8 9
Weekly Inspection
10 11 12 13 14 15 16
Weekly Inspection
17 18 19 20 21 22 23
Weekly Inspection
24/31 25 26 27 28 29 30
Monthly Inventory
Monthly Inspection Weekly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 13Attach monthly inventory worksheet(s) or printout(s) here
April 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 14Compliance Calendar for Gasoline Dispensing Facilities
April 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5 6
Weekly Inspection
7 8 9 10 11 12 13
Weekly Inspection
14 15 16 17 18 19 20
WPMCA Annual Convention
Weekly Inspection
21 22 23 24 25 26 27
Weekly Inspection
28 29 30
Need reminders of any deadlines this month?
Mark this calendar!
Monthly Inventory Questions? Call 855-889-3021
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 15Attach monthly inventory worksheet(s) or printout(s) here
May 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 16Compliance Calendar for Gasoline Dispensing Facilities
May 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4
Need reminders of any deadlines this month?
Mark this calendar!
Questions? Call 855-889-3021
Weekly Inspection
5 6 7 8 9 10 11
Weekly Inspection
12 13 14 15 16 17 18
Weekly Inspection
19 20 21 22 23 24 25
Weekly Inspection
26 27 28 29 30 31
Monthly Inventory
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 17Attach monthly inventory worksheet(s) or printout(s) here
June 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 18Compliance Calendar for Gasoline Dispensing Facilities
June 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1
Need reminders of any deadlines this month? Mark this calendar!
Questions? Call 855-889-3021
2 3 4 5 6 7 8
Weekly Inspection
9 10 11 12 13 14 15
Weekly Inspection
16 17 18 19 20 21 22
Weekly Inspection
23/30 24 25 26 27 28 29
Monthly Inventory
Monthly Inspection Weekly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 19Attach monthly inventory worksheet(s) or printout(s) here
July 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 20Compliance Calendar for Gasoline Dispensing Facilities
July 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5 6
Weekly Inspection
7 8 9 10 11 12 13
Weekly Inspection
14 15 16 17 18 19 20
Weekly Inspection
21 22 23 24 25 26 27
Weekly Inspection
28 29 30 31
Need reminders of any deadlines this month?
Mark this calendar!
Monthly Inventory Questions? Call 855-889-3021
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 21Attach monthly inventory worksheet(s) or printout(s) here
August 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 22Compliance Calendar for Gasoline Dispensing Facilities
August 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Need reminders of any deadlines this month? 1 2 3
Mark this calendar!
Questions? Call 855-889-3021 Weekly Inspection
4 5 6 7 8 9 10
Weekly Inspection
11 12 13 14 15 16 17
Weekly Inspection
18 19 20 21 22 23 24
Weekly Inspection
25 26 27 28 29 30 31
Monthly Inventory
Weekly Inspection Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 23Attach monthly inventory worksheet(s) or printout(s) here
September 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 24Compliance Calendar for Gasoline Dispensing Facilities
September 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5 6 7
Weekly Inspection
8 9 10 11 12 13 14
Weekly Inspection
15 16 17 18 19 20 21
Weekly Inspection
22 23 24 25 26 27 28
Weekly Inspection
29 30
Need reminders of any deadlines this month? Mark this calendar!
Monthly Inventory Questions? Call 855-889-3021
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 25Attach monthly inventory worksheet(s) or printout(s) here
October 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 26Compliance Calendar for Gasoline Dispensing Facilities
October 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5
Need reminders of any
deadlines this month?
Mark this calendar!
Weekly Inspection
6 7 8 9 10 11 12
Weekly Inspection
13 14 15 16 17 18 19
Weekly Inspection
20 21 22 23 24 25 26
Weekly Inspection
27 28 29 30 31
Questions?
Call 855-889-3021
Monthly Inventory
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 27Attach monthly inventory worksheet(s) or printout(s) here
November 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 28Compliance Calendar for Gasoline Dispensing Facilities
November 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2
Need reminders of any deadlines this month? Mark this calendar!
Questions? Call 855-889-3021
Weekly Inspection
3 4 5 6 7 8 9
Weekly Inspection
10 11 12 13 14 15 16
Weekly Inspection
17 18 19 20 21 22 23
Weekly Inspection
24 25 26 27 28 29 30
Monthly Inventory
Weekly Inspection Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 29Attach monthly inventory worksheet(s) or printout(s) here
December 2019 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 30Compliance Calendar for Gasoline Dispensing Facilities
December 2019
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5 6 7
Weekly Inspection
8 9 10 11 12 13 14
Weekly Inspection
15 16 17 18 19 20 21
Weekly Inspection
22 23 24 25 26 27 28
Weekly Inspection
29 30 31
Need reminders of any deadlines this month?
Mark this calendar!
Monthly Inventory Questions? Call 855-889-3021
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 31Attach monthly inventory worksheet(s) or printout(s) here
January 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 32Compliance Calendar for Gasoline Dispensing Facilities
January 2020
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4
Need reminders of any deadlines this month?
Mark this calendar!
Questions? Call 855-889-3021
Weekly Inspection
5 6 7 8 9 10 11
Weekly Inspection
12 13 14 15 16 17 18
Weekly Inspection
19 20 21 22 23 24 25
Weekly Inspection
26 27 28 29 30 31
Monthly Inventory
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 33Attach monthly inventory worksheet(s) or printout(s) here
February 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 34Compliance Calendar for Gasoline Dispensing Facilities
February 2020
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1
Need reminders of any deadlines this month? Mark this calendar!
Questions? Call 855-889-3021
2 3 4 5 6 7 8
Weekly Inspection
9 10 11 12 13 14 15
Weekly Inspection
16 17 18 19 20 21 22
Weekly Inspection
23 24 25 26 27 28 29
Monthly Inventory
Weekly Inspection Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 35Attach monthly inventory worksheet(s) or printout(s) here
March 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 36Compliance Calendar for Gasoline Dispensing Facilities
March 2020
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5 6 7
Weekly Inspection
8 9 10 11 12 13 14
Weekly Inspection
15 16 17 18 19 20 21
Weekly Inspection
22 23 24 25 26 27 28
Weekly Inspection
29 30 31
Need reminders of any deadlines this month?
Mark this calendar!
Monthly Inventory Questions? Call 855-889-3021
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 37Attach monthly inventory worksheet(s) or printout(s) here
April 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 38Compliance Calendar for Gasoline Dispensing Facilities
April 2020
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4
Need reminders of any deadlines this month?
Mark this calendar!
Weekly Inspection
5 6 7 8 9 10 11
Weekly Inspection
12 13 14 15 16 17 18
Weekly Inspection
19 20 21 22 23 24 25
Weekly Inspection
26 27 28 29 30
Questions?
Call 855-889-3021
Monthly Inventory
Monthly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 39Attach monthly inventory worksheet(s) or printout(s) here
May 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 40Compliance Calendar for Gasoline Dispensing Facilities
May 2020
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2
Need reminders of any deadlines this month? Mark this calendar!
Questions? Call 855-889-3021
Weekly Inspection
3 4 5 6 7 8 9
Weekly Inspection
10 11 12 13 14 15 16
Weekly Inspection
17 18 19 20 21 22 23
Weekly Inspection
24/31 25 26 27 28 29 30
Monthly Inventory
Monthly Inspection Weekly Inspection
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 41Attach monthly inventory worksheet(s) or printout(s) here
June 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 42Compliance Calendar for Gasoline Dispensing Facilities
June 2020
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 2 3 4 5 6
Weekly Inspection
7 8 9 10 11 12 13
Weekly Inspection
14 15 16 17 18 19 20
Weekly Inspection
21 22 23 24 25 26 27
Weekly Inspection
28 29 30
Need reminders of any deadlines this month?
Mark this calendar!
Monthly Inventory
Monthly Inspection
Questions? Call 855-889-3021
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 43Attach monthly inventory worksheet(s) or printout(s) here
July 2020 Monthly Inspection, Condensed Record
(perform by end of each month or 30 days apart; see page 56 for expanded checklist)
Logged on Inspected
Inspection area Inspected? Repaired? maintenance by?
Reminders - Permits, Insurance, Testing and record? (initials)
Training Underground storage tanks and gasoline dispensing equipment (includes Stage I vapor control
system for facilities in Stage I areas)
Are tank permits up to date? Yes / No
Release detection system (tank monitor)
Is tank insurance due this month? Yes / No Spill buckets
Is equipment testing due this month? Overfill alarm
Yes / No
Are most recent test results on site? Impressed current system (if applicable)
Is all training up to date for current Fill and monitoring probe ports
Yes / No
employees?
Spill and overfill response supplies
Monthly Gasoline Throughput Summary Dispenser hoses, nozzles and breakaways
Dispenser and dispenser sumps
Amount Amount Within
Product type
delivered dispensed variance? Piping sumps (submersible)
+ + Yes / No Stage II vapor recovery systems for gasoline dispensing facilities retaining these systems
(inspecting the equipment below is optional but recommended - see page 66)
+ + Yes / No Vapor return line
Nozzle bellows
+ + Yes / No
Nozzle faceplate / facecones
Monthly totals = = Nozzles
Vapor processing unit working properly
System Maintenance and Repair Record Weekly Inspection Record
Inspection Name of Identify problem/defective Replacement part
Repair date Inspection date Inspected by (initials)
date inspector part manufacturer/part number
2019-2020 Compliance Calendar for WI Gasoline Facilities, page 44You can also read
