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MAY-08-2006 15:55 TIME OIL CO. 2062864477 P.09 <br /> • 0 <br /> Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name:Time Oil I Date: 73 - - <br /> Facili s: <br /> Ci : t a / Z Code: <br /> Designated UST for Conducting the Ia ation:Dennis Tweed <br /> hitern until CerfificaftIMS244489-UC E iration Date: 10/14 /06 <br /> SiI Phone:( 425 210-7998 <br /> Y=YmN-No.NA=NotA aeable <br /> Item MONITORING PANEL/ALARM IIISTORY I Y N NA <br /> I M mitoring s stem is poWered on and in ro operating mode. <br /> 2 Monitoring system is not current) show' any alarms or warnings. <br /> 3 Alarm history report/log for the previous month is available,and has been reviewed by the <br /> Designated UST Operator. Attach a copy of the alarm hist r ort/lo to this tram i available. <br /> 4 Each alarm for the previous month has been responded to appropriaely. <br /> 5 Sensors located in tank-top containment sum s have ant alarmed in the past month. <br /> Sa List all tank-top sumps where alarms occurred in the past month: <br /> Note:Sumps where an alarm tns occurred In thelxw month must be lnspeded unless a gwkied service aciluicum mipmvsed ta,and <br /> properly addressed,the cause of the alarm-Anach dawmenwvon veri*ng appropriale s&Vkt to this repon- <br /> Ifsump mspecdon is mquim4mcord mmits 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 ins coon o sums is mly requimd in sum whem an alarm has occurred in 1hepast month(Pr which)here is no service record. <br /> Y I N I I IYLNJ <br /> SUMP Location: SUMP Location., <br /> Sump Location: SUMP Location: <br /> Sump Location: Sump Location: <br /> 7 Spill containment structures are free ofwaterdebri and hazardous substance. <br /> , <br /> N NA I NA <br /> Tank 1 -Contents: Tank 3-Contents: <br /> Tank 2-Contents: Tank 4-Contents: <br /> 8 Under-dispenser containment areas are filbe of water debris and hazardous substance. Sensors are located pro <br /> Y I N NA I Y .N I NA <br /> Dis enser 112 Dispenser 9/10 <br /> Dis user 3/4 7 Dispenser 11/12 <br /> Dispenser 5/6 Drs enser 13/14 <br /> �er y/g Dis eraser 15/16 <br /> PAPERWORK INSPECTION Y N NA DATE DONE <br /> 9 Monitoring tem certification has been completed within past 12 months. <br /> 10 2j22nggy containment tests have been completed within therequired timeframe. <br /> ll_ Sin containment structure bucket testing was completed within the pad year. <br /> 12 Tank ti mess to was completed within required timeframe. <br /> 13 Line tightness!Sq!qg was completed within r uired timeframe. <br /> 14 Other required testis maintenance was com feted withinaired tim frame. List tesr/maintenance items below. <br /> Test/Mainttmance: <br /> Test/Maintenance: - <br /> TesdMaintenance: <br /> FACILrrY EMPLOYEE TRAINING Y N NA <br /> 15 Al!faeili em to ees have received the required on-the-iob training within the past ar. 3-10 <br /> 16 All faoili em to ees hired within the ast 30 da s have received thereuired on-rhe ob trainin . <br /> Note: Any answer of"N"should be explained in the comment section on the following page,and will req lre <br /> follow-up action_ <br /> Page 1 oft November 2004 <br />