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COMPLIANCE INFO 2001-2006
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2300 - Underground Storage Tank Program
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PR0516526
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COMPLIANCE INFO 2001-2006
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Last modified
5/24/2019 9:49:31 AM
Creation date
11/1/2018 9:48:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO 2001-2006
FileName_PostFix
2001-2006
RECORD_ID
PR0516526
PE
2361
FACILITY_ID
FA0012659
FACILITY_NAME
LOVE'S COUNTRY STORES OF CALIF #223
STREET_NUMBER
1553
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
24534024
CURRENT_STATUS
01
SITE_LOCATION
1553 COLONY RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Aug 12 05, 07:47a p.4 <br /> Site Number: 50606A Month: July <br /> Designated Underground Storage Tank(UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name:Love's Fuel Center Date: <br /> Facilit Address:1510 Jack Tone Road <br /> Citv:Ripon,CA [—Zip Code:95366 <br /> Designated UST erator Condyiet en the tns ection:Janine Kirby <br /> Internatioinal C de`Uorx+si atio $2 2 IlExpiration Date:1010212005 <br /> Si natuce 1Z JlPhone: 530 268-3949 <br /> Y=Yes,N=No.NA=Nol Applicable <br /> Item I PANEL 1AI ARM HISTORY Y N NIA <br /> 1 Monitorin system is powered on and in propera eratin mode. <br /> 2 Monitoring system is not currently showing any alarms or wamin s. <br /> 3 Alar history report/log for the previous month is available,and has been reviewed by the <br /> Designated UST Operator.Wfech ern or rhe akurn htstatyreport4og to this form it aveiteeM.) <br /> 4 Each alarm for the previous month has been responded to appropriately. <br /> 5 Sensors located in tanK-top containment sums have not alarmed in the past month. <br /> 5a List al!tank-top sumps where alarms occurred in the past month.- <br /> Note:Sumps where an alarm has occurred in the past morxh must be inspected unless a qu3ll8ed service technician responded to, <br /> and properly eadressed,,the cause ofthe alarm.AHech documentation verifying appropirata service to lhis report. <br /> if sump inspedioni is required,reccro results in item 6,below. NWAUMM <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps are free of water,debris,and hazardous substance.Sensors are located properly. <br /> Note:Wsual inspection of sumps is only required in sumps where an alarm hes occurred in the past month for which there is no <br /> service recard- <br /> Y N Y N <br /> Sump Location: Sump Location: <br /> Sump Location: Sump Location.- <br /> Sump <br /> ocation.Sum Location: Sump Location: <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N NIA Y N NtA <br /> Tank 1 -Contents:87 < Tank 4-Contents.--& f diesel i lu ld <br /> Tank 2-Contents:89 ITank 5-Contents.•#trek diesel 2— <br /> Tank <br /> Tank 3-Contents:9i 1 ITank E-Contents: X <br /> 8 Under-dls ensercontainmetn areas are free of water,debris,and hazardous substance.Sensors are located pro erl . <br /> Y N NIA I Y N NIA <br /> Dispenser 1/2 1 Dispenser 19/20 , <br /> Dispenser 3/4 V 10ispens-gr 21 <br /> Dispenser 5/6Dis nser 22/21 Satellite <br /> Dispenser 7/8 Dispenser 23/22 Satellite <br /> Dispenser 9/10 Dispenser 24/23 Satellite <br /> Dispenser 11/12 Dispenser 25/24 Satellite <br /> Dispenser 13/14 Dis enser 26/25 Satellite <br /> Dispenser 15/16 Dispenser 27/26 Satellite <br /> Dispenser 17/18 Dis enser 27 Satellite <br /> PAPERWORK INSPECTION Y N N/A DATE DONE <br /> r13 <br /> Monitorin system certification has been com feted within st 12 months.Seconds containment tests have been com leted within the re uired timeframe.S f11 containment structre bucket testin was com feted within the est ear. X 71612005 <br /> Tank tlohtness testin was com leted within re uired timeframe. <br /> Line ti htness testin com feted within re uired timeframe. <br /> Other required testing!maintenance was completed within required timeframe. List lest/maintenance items Below. <br /> Test/Mainten arice: <br /> Test/Maintenance: <br /> TesWaintenance: <br /> FACILITY EMPLOYEE TRAINING Y, N NiA <br /> 15 mfacilit employees have received the required or-the-job training within the past year. <br /> 16 JAII facility employees hired within the past 30 dayse h_aye receved the required on-the-job training. <br /> Note: Any answer of"N"should be explainged in t comment section on the following page, <br /> and will require follow-u ctlo <br /> w <br /> Signature <br /> D -7 2� Q� <br />
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