Transcription of NYSDEC Petroleum Bulk Storage (PBS) Inspection …
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PBS Inspection Form (7/25/18) Page 1 of 7. New York State Department of Environmental Conservation Petroleum bulk Storage (PBS) Inspection Form DATE: DEC INSPECTOR: FACILITY REP. PBS #: - or Unregistered NAME & TITLE: FACILITY NAME: FACILITY ADDRESS: FACILITY PHONE: Facility-Level Information 1. Is the Inspection announced or unannounced? Announced Unannounced 2. Is the registration certificate posted at a conspicuous location at Y N 1 (not signed). the facility? Y N (inaccurate information) 1 (expired registration). 3. Is the registration information current and accurate? 2 (unregistered facility) 3 (unregistered tank). 4. Does the facility have an as-built diagram? Y N X (not required) 1 (incomplete).
PBS Inspection Form v.6 (7/25/18) Page 3 of 7
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