External Visual Inspection Form Tank ID Code FEUeNC Men cee Name of Registered Facility Address: Town: Province Postal Code: Phone Number Person Conducting the Inspection Transport Canada Facility Registration Number: Inspection Date (dd/mmiyy} rehome conan Name of Tank Owner: Address: Telephone Number: Een micuns eric) Is dataplate legible? “Yes "= No Photo taken of dataplate or copy on file? | -> Yes“ No Rejection Criteria - Failure to meet the minimum standard requiremer under B620 5.1.6.1.5, where the dataplate shall be maintained in legible condition and as required during an external inspection (7.2.1.1 [el). Peewar clans Remorse ner ok oe oleae Tank ID: Serial Number: CRNIASME Designation: MAWP: ~- PSI ~> kPa (choose one) Temperature Rating ~- Fahrenheit *~ Celsius (choose one) Tank Specification: -- Non-spec ~~ Spec (specify Manufacturer: ‘Year of Manufacture: Water Capacity: ~~ Gallons ~~ Litres (choose one) Tank Material Steel Shell Thickness ~ Inches ~ Millmetres (choose one) Head Thickness. ~ Inches ~~ Milimetres (choose one) External 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 GEeeae uel Date of Last Test Less than or equal to a 36-month period (in accordance to 8620 Table 7.1, ‘Periodic Inspection and Test intervals’). The external inspection period may be extended to 3 years, for tanks outlined in CSA B622, clause 6.3, specific requirement 56 ‘Markings on tanks must be legible (CSA 8620 7.2.1.4[el).. 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; safety boots: and NH3 protective suit. General Information for Quick Reference Litres to US gallons = X / 3.77 US gallons to litres =X * 3.77 kPa to PSI =X* 0.145 PSItokPa=X*6.89 Nominal Thickness : Tank Body .375 in. (9.53 mm) for Westeel tanks Tank Ends 322 in. (8.18 mm) for Westee! tanks Consult with manufacturer of other tanks for their thicknesses, General Equipment Required Ladder, metal ruler, telescoping mirror, metal seraper, wire brush, and picks. Acaliper is, 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 debris that would otherwise hinder any observations to tank shell; all external attachments (I. water tank, safety kit, etc.) are removed. List defects and locations below or use additional sheets if required. Comments: External Visual Inspection Form Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 Page 2 of 8 73Tank ID Code Tank Shell Inspe Accept ~ Action Inspect entire area of tank for dents, sorapes, distortions, gouges, bulges, cracks, signs of leakage or any other condition that might render it unsafe for transport (7-2 1.1 [al) Rejection Criteria: + Defects less than the minimum thickness remaining under a cut, dig, or gouge (10% less than the nominal thickness) [7.2.2.2(a)] + Any dent with a depth of more than 12.7 mm (0.5 in) where it includes a weld (72.2.21b)) + Any dent with a depth of greater than 10% of the length of the dent (7.2.2.2 [cl) + Any structural defect (7.2.2.2 el) + Any source of leakage (7.2.2.21f) List defects and locations below or use additional sheets if required: Comments: “Accept ~~ Action Inspect entire area of tank for: corrosion, abrasions, and signs of leakage or any other condition that might render it unsafe for transport (7.2.1.1 fal) Rejection Criteria: + Defects less than the minimum thickness remaining under a cut, dig, or gouge (10% less than the nominal thickness) (7.2.2.2 [al). + Any source of leakage (7.2.2.2 [f)) List defects and locations below or use additional sheets if required: ‘Comments: “Accept ~ Action Ensure all appurtenances (any tank part or accessory that has no produet containment function and provides no structural support to tank (Le. PRV guards, weld pad]) and attachments, support structures, or connecting structures are not damaged or corroded so a8 to affect safe operation of the tank (7.2.1.1[f)) Rejection Criteria: + Includes any structural defect (7.2.2.2 [e]) + Repairs made to liquid retaining components using overlay patches (7.2.2.2{a]) List defects and locations below or use additional sheets if required. ‘Comments: 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 74Tank ID Code inspect every weld on all appurtenances (any tank part or accessory that has no preduct containment function and provides no structural support to tank i.e. PRV guards, weld pad) for cracks, defects, or signs of leakage (7.2.1.1 (a)) Rejection criteria “Accept ~~ Action + Any dent with a depth of more than 12.7mm (0.5 in) where it includes a weld (72.2.2b)) + Includes any weld defect, including a crack, pinhole, or incomplete fusion of weld (7.2.2.2). List defects and locations below or use additional sheets if required: Comments: inspect every tank head circumference weld and rear tank circumference weld for cracks, defects, or signs of leakage (7.2.1.1 (a) Rejection criteria: + Any dent with a depth of more than 12.7mm (0.5 in) where it includes a weld “Accept “Action (7.2.2.2(6)). + Includes any weld defect, including a crack, pinhole, or incomplete fusion of weld (7.2.2.2(4)) + Any source of leakage (7.2.2.2 (A) List defects and locations below or use additional sheets if required: Comments: inspect every longitudinal tank weld and mid tank circumference weld for cracks, defects, or signs of leakage (7.2.1.1 (a) Rejection criteria: + Any dent with a depth of more than 12.7mm (0.5 in) where it includes a weld “Accept “Action (7.2.2.2(b)) + Includes any weld defect, including a crack, pinhole, or incomplete fusion of weld (7.2.2.2(4)) + Any source of leakage (7.2.22 (f) List defects and locations below or use additional sheets if required: Comments: External Visual Inspection Form Page 4 of 8 Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 75Tank ID Code inspect all valves and valve welds including self closing stop valves, excess flow valves, and pressure relief valves for corrosion, distortion, wear, signs of leakage, or any other damage that would prevent their normal operation (7.2.1.4(¢)). i 1 ~ Accept ~ Action | EnSU"® PRV rating matches the data plate rating and record PRV expiry date! PRV 1 expiry date PRV 2 expiry date List defects and locations below or use additional sheets if required. Comments: For Twin Tank Wagons: Ensure all bolts or nuts on any flanged connection or blank flange ~ Accept ~ Action | #2IN Place and property tightened (7.2.1.1). List defects and locations below or use additional sheets if required. Comments: Ensure that hose assemblies mounted on or accompanying the tank does not display any of the rejection criteria listed below 7.2.1.1 (g)). Rejection criteria 7.2.10.4: Hose assembly bolts missing or loose Hose couplings show excessive wear or damage Hose has exposed reinforcement showving ‘The wire braid is kinked, flattened, or permanently deformed Hose bulges under pressure or has soft spots when not under pressure Loose outer covering Hose serial number or ID and HAWP deteriorated legibly or absent “Accept -~ Action List defects and locations below or use additional sheets if required. ‘Comments: Hose markings are displayed as follows (7.2.10.6) + Hose tag securely fastened “Accept ~~ Action |+ Letter on tag are not less than 5 mm (0.2 in.) high + The month and year of test and inspection are stamped on tag List defects and locations below or use additional sheets if required. Comments: Extemal Visual Inspection Form Page 5 of 8 Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 76Tank ID Code “Accept ~~ Action Corroded or abraded area of the tank wall shall have their thickness tested in accordance with Clause 7.2.6. (7.2.1.3) NOTE: Must be registered with Transport Canada (TC) to conduct thickness testing. If thickness testing is performed, please indicate the TC registered facility that con- ducted the thickness testing and attach the report. List defects and locations below or use additional sheets if required. Comments: * Accept ~“ Action Inspect all re-closing pressure relief valves for any corrosion or damage that could prevent their safe operation. (7.2.1.4 (a)) List defects and locations below or use additional sheets if required. Comments: ~ Accept ~ Action Inspect all gauges (pressure gauge, float gauges, etc) for corrosion, distortion, wear, signs oF leakage, or any other damage that would prevent their normal operation. List defects and locations below or use additional sheets if required. ‘Comments: External Visual Inspection Form Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 Page 6 of 8 7Tank ID Code ue! oan If the tank has successfully passed the external visual inspection, the following information shall be durable and legibly marked in letters no less than 32 mm (1.25 in) high on the tank shell near the metal identification plate or anywhere on the front head where it will be clearly visible from the ground: 1. Month and year of inspection. 2. The letter “V" 3. The last three digits of your facility registration number given by Transport Canada ‘The markings should appear as follows: 06 08 V 123 (where “123” is the TC registered facility number). Markings applied as follows: Month/Year of Visual Inspection “Vi marking affixed GEUeMene ecw = curketrue eel Tank removed from service for repairs Tank retumed to service Tank to be scrapped ~ NOTE: Facilities must be registered with Transport Canada (TC) to conduct any repairs to the structural integ- rity of the tank i.e, welding. If any repairs have been performed directly on the tank body, please indicate the TC registered facility that con- ducted the repairs and attach the report. me OM eC RACE M Om OMNeR Ren Tank constructed of (choose one) “ Quench Tempered (QT) Steel += Non-quenched Tempered Steel For OT Tanks “Yes Since the last inspection, has each shipment of NH3 con-|~ No tained at least 0.2% water by weight? Tank stress relieved after manufacture? “> Yes" Tank stress relieved ~> Yes - see attached repair report. “Not atter repair? No - not required as no repairs “Verify with information recorded on certificate of done compliance issued by manufacturer. [iceokeruenn | certify that | have inspected the tank identified in this report in accordance with CSA 8620-09. Name of Inspector: Signature of Inspector: Daie Inspection Completed. External Visual Inspection Form Page 7 of 8 Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 78Tank ID Code Appendix 1 Location of Tank Deficiencies discovered during external visual inspection: “A End “B" End End Top View C— Bottom View C— Extemal Visual Inspection Form Page 8 of 8 Nurse Tank Safety Council of Canada - Quality Control Manual Inspection and Testing Protocol - Issued 2013, Revision 5 79