Laserfiche WebLink
Citn 111- l n i n 4 <br />Afforda-Te$t Designated 416 2nd Street g Operator <br />Galt, Ca 95632 Monthly Inspection Checklist <br />209-744-0112 Fax 209-744-0116 <br />Site: CD&R - CJ CHEVRON <br />7501 W 11TH ST <br />TRACY, CA 95304 <br />❑ Zane A. Nimmo <br />#5263322 <br />❑ David A. Winkler <br />#5263373 <br />® Felix G. Ramirez <br />#5273934 <br />Date: 10-08-15 <br />❑ Edward Stearns <br />#5250492 <br />ri <br />Y = yes N = no, INA = not applicable <br />MONITORING PANEL / ALARM HISTORY Y N NA <br />Monitoring system is powered on and in proper operating mode. X <br />Monitoring system is not currently showing any alarms or warnings. X <br />Alarm history report/log for the previous month is available, and has been reviewed by the Designated UST X <br />Operator. Attach a copy of the alarm history report/logreportllog to thisform i available. <br />Each alarm for the previous month has been responded to appropriately X <br />Sensors located in tank -top containment sumps have not alarmed in the past month. X <br />List all tank -top sumps where alarms occurred in the past month: <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to, and properly <br />addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. If sump inspection is required, record results <br />in item 6, below. <br />AST SYSTEM INSPECTION <br />Y I N I NA I I_Y_7N I NA <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection of sumps is only required in sum s where an alarm has occurred in the past month for which there is no service record. <br />Sump Location: VAPOR X Sump Location: <br />Sump Location: Sump Location: <br />Sump Location: Sump Location: <br />Sump Location: Sump Location: <br />Sump Location: Sump Location: <br />Spill containment structures are free of water <br />Tank 1 - Regular <br />Tank 2 — Plus <br />Tank 3 - Premium <br />Tank 4 - Diesel <br />Under -dispenser containment free of water, d <br />Dispenser 1/2 <br />Dispenser 3/4 <br />Dispenser 5/6 <br />Dispenser 7/8 <br />Dispenser 9/10 <br />Dispenser 11/12 <br />Dispenser 13/14 <br />Dispenser 15/16 <br />Dispenser 17/18 <br />s, & hazardous substance. <br />X <br />Tank 5 - <br />X Tank 6- <br />X <br />Tank 7- <br />X Tank 8- <br />& hazardous substance. Sensors located proper] <br />X <br />Dispenser 19/20 <br />X <br />Dispenser 21 <br />X <br />Dispenser 22/21 <br />X <br />Dispenser 23/22 <br />Dispenser 24/23 <br />Dispenser 25/24 <br />Dispenser 26/25 <br />Dispenser 27/26 Satellite <br />Dispenser 27 <br />