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Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name: Sprint Stockton Switch#38254 Date: 10-24-07 <br /> -Facility Address: 3807 Coronado Avenue <br /> -City: Stockton Zi Code: 95204 <br /> -Designated UST Operator Conducting the Inspection: Darren Rieck <br /> International Code Council Certification#: 5311-006-UC Ex iration Date: 05/03/09 <br /> Signature: Phone: 310 698-2486 <br /> Y=Yes,N—,No,NA=Not A licable <br /> Item MONITORING PANEL/ALARM HISTORY Y N NA <br /> I Monitoring system is powered on and in proper operating mode. X <br /> 2 Monitor7ing system is not currently showing any alarms or warnings, X <br /> 3Alarm history report/log for the previous month is available,and has been reviewed by the X <br /> Designated UST Operator. (Attach a copy Of the alarm history report/7oreporil7og to thisform if available. <br /> 4 Each alarm for the previous month has been responded to appropriately. X <br /> Sensors located in tank-top containment sum2s 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 <br /> properly addressed,the cause of the alarm.Attach documentation verging appropriate service to this report. <br /> isump inspection is required,record results in item 6,below. <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Note: Visual inspection o sums is only re uired in sums where an alarm has occurred in the past month for which there is no service record. <br /> Y N Y N <br /> Sum Location: Tank I Piping X Sum Location: <br /> Sum Location: Sum Location: <br /> Sum Location: Sump Location: <br /> 7 <br /> Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N NA Y N NA <br /> Tank 1 -Contents: Diesel X Tank 3-Contents: <br /> Tank 2-Contents: Tank 4-Contents: <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located propail . <br /> Y N NA Y N NA <br /> Dispenser 112 X Dispenser 9110 <br /> Dispenser 3/4 Dispenser 11/12 <br /> Dispenser 5/6 Dispenser 13/14 <br /> Dis enser 7/8 1 Dispenser 15/16 <br /> PAPERWORK INSPECTION Y N NA DATE DONE <br /> 9 Monitoring system certification has been completed within past 12 months. X 9-12-06 <br /> 10 Second9a containment tests have been completed within the required timeframe. X 11-15-06 <br /> 11 Spill containment structure bucket testing was completed within the past year. X 11-15-06 <br /> 12 Tank tightness testing was completed within required timeframe. X Continuous <br /> 13 Line tightness testing was completed within required timeframe. X 11-15-06 <br /> 14 Other required testing/maintenance was completed within required timeframe. List test/maintenance items below. <br /> Test/Maintenance: X <br /> Test/Maintenance: X <br /> Test/Maintenance: X <br /> FACILITY EMPLOYEE TRAINING JYJ N INA <br /> 15 All facility employees have received the required on-the-job training within the past year. X <br /> 16 All facility employees hired within the past 30 days have received the re uired on-the-job training—. X <br /> Note: Any answer of"N"should be explained in the comment section on the following page,and will require <br /> follow-up action. <br /> Page 1 of 2 November 2004 <br />