Laserfiche WebLink
Site ID: 1010-6 <br />Afforda-Te$t Designated Operator <br />416 2"d Street g p <br />Galt, Ca 95632 Monthly Inspection Checklist <br />209-744-0112 Fax 209-744-0116 <br />Site: CJ CHEVRON <br />11TH STREET <br />TRACY CA CA 95304 <br />❑ Zane A. Nimmo <br />#5263322 <br />® David A. Winkler <br />#5263373 <br />RECEIVED <br />OCT 19 2017 <br />ENVIRONMENTAL HEALTH <br />PERMIPSERVICES <br />❑ Felix G. Ramirez ❑ Edward Stearns <br />#5273934 #5250492 <br />L <br />Date: 7-14-15 <br />Y = yes N = no, NA = not applicable <br />MONITORING PANEL / ALARM HISTORY <br />Y <br />N <br />NA <br />Monitoring system is powered on and in proper operating mode. <br />X <br />Monitoring system is not currently showing any alarms or warnings. <br />X <br />Alarm history report/log for the previous month is available, and has been reviewed by the Designated UST <br />Operator. Attach a copy of the alarm history report/logreporillog to this form if available. <br />X <br />Each alarm for the previous month has been responded to appropriately <br />X <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />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. Ifsump inspection is required, record results <br />in item 6, below. <br />AST SYSTEM INSPECTION <br />Y I N I NA Y I N NA <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection of swn .s is only required in sums where an alarm has occurred in the past month for which there is no .service record. <br />Sump Location:87 X Sump Location: <br />Sump Location:91 X Sump Location: <br />Sump Location:DSL X Sump Location: <br />Sump Location: Sump Location: <br />Sump Location: Sump Location: <br />Spill containment structures are free of water, debris, & hazardous substance. <br />Tank 1 — Regular X Tank 5 - <br />Tank 2 — Plus Tank 6 - <br />Tank 3 - Premium X Tank 7 - <br />Tank 4 - Diesel X Tank 8 - <br />Under -dispenser containment free of water, debris, & hazardous substance. Sensors located properly, <br />Dispenser % X Dispenser 19/20 <br />Dispenser % X Dispenser 21 <br />Dispenser 5/6 X Dispenser 22/21 <br />Dispenser 7/8 X Dispenser23/22 <br />Dispenser 9/10 Dispenser 24/23 <br />Dispenser 11/12 Dispenser 25/24 <br />Dispenser 13/14 Dispenser 26/25 <br />Dispenser 15/16 Dispenser 27/26 Satellite <br />Dispenser 17/18 Dispenser 27 <br />