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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION CALTRANS MAINTENANCE STATION ABOVE GROUND STORAGE TANKS AND FUELING FACILITY HQ-MTCE-02(REV 8/1999) DAILY INSPECTION FORM DISTRICT: FACILITY NAME: CONTENTS OF TANK(S): 10 Stockton Yard Diesel,Gasoline,Propane PERMIT NO: DATE(MONTH/YEAR): PT0009997 October 2017 CHECK FOR GOOD DAYS OF THE MONTH OPERATION CONDITIONS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Tank(s) Leak Free x x x x x x x x x x x x x x x x x x x x x x Hoses/Fittings Leak Free x x x x x x x x x x x x x x x x x x x x x x Nozzles/Pumps Leak Free x x x x x x x x x x x x x x x x x x x x x x Fill Ports Spill x x x x x x x x x x x x x x x x x x x x x x Containment D Spill(Tertiary) x x x x x x x x x x x x x x x x x x x x x x Containment D Spill Containment Valve Closed x x x x x x x x x x x x x x x x x x x x x x Auto Shut-off Switch Posted x x x x x x x x x l x x x x x x x x x x x x x Auto Shut-off Switch Operable x x x x x x x x x x x x x x x x x x x x x x Fueling Procedure Posted x x x x x x x x x x x x x x x x x x x x x x Spill Cleanup Procedure Posted x x x x x x x x x x x x x x x x x x x x x x Spill Kit(Essential Material Available x x x x x x x x x x x x x x x x x x x x x x Used Container(Lid Covered From x x x x x x x x x x x x x x x x x x x x x x Rain) Permit(s) Current x x x x x x x x x x x x x x x x x x x x x x Distribution: Original-District Hazmat Mgr. Pink-District Storm H2O Mgr. Yellow-Field Office Q` ADA Notice For individuals with sensory disabilities,this document is available In alternate formats. For alt to format information,-)tact the Forms Management Unit at(916)445-1233,TTY 711,or write to Records and Forms Management,1120 N Street,MS-89,Sa-dTgmento,C..95814. 1 tn