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Facility Em to ee Trz�mwg a e 2 of 2 <br /> All facility employees have received the required on-the-job training within the past year. g <br /> All facility employees bared within the past 34 days have received the required on the job training. x <br /> Monthly Inspection— <br /> Y N NA Date Done <br /> Monitoring system certification(within past 12 months) X 4/21/2017 <br /> Spill Bucket tesbmg completed(within past 12 months) x 4/21/2017 <br /> beak Detector-mechanical/electronic for most sites(within past 12 months) X 4/21/2017 <br /> The above are usually done together on an annual basis for local regulator. <br /> Line'Tightness(usually upon construction or when no positive shutdown) � <br /> Tank Tightness(Usually only after con0uction or when using SIR) g <br /> Secondary eontaimment(SB989)tests have been completed(usually every 3 years) X 2/12/2015 <br /> Other testing or maintenance completed as required List them below <br /> Test/Maintenauce:.A,Q M D X 4/5/2017 <br /> Test/Maintenance: <br /> TesvMaintenance: <br /> PRINTOUT INCLUDED: Yes® No ❑ NAQBINDER UP To DATE: <br /> Comments:ACTIVE ALARM ON AST TANK ANNULAR SPACE ALARM TANK 6 SYPHON TANK <br /> SITE NEEDS TO CALL KAWTENANCE TO REMOVE AND DETERMINE LIQUID TYPE OR POSSIBLE SENSOR <br /> HAS GONE BAD. <br /> H <br /> Items Re Follow-up Actions: <br /> OCT `"►i' 7 <br /> ENVIRONN, l-:i�SAL HEALTH <br /> Monthly inspection must be conducted by an ICC licensed Designated Operator. <br /> A copy of this checklist must be provided to UST owner or operator, but not to State Water Resources. <br /> Designator Operator must alert the UST owner or operator of any condition discovered during the monthly <br /> inspection that may require that may require follow-up action. <br /> UST owner or operator must maintain a copy of this monthly inspection and any attachments for the previous <br /> 12 months. Records must be maintained on-site or, if approved by the local agency,off-site at a readily <br /> available location. <br />