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FROM (WED) AUG 30 2006 17 ' 12/ST. 17:33/No. 6843597301 P 10 <br /> besignated Underground Storage Tank CUE Operator <br /> Monthly Visual Inspection Checklist <br /> Pec ' Nemo: baro: z_7 0J_Bacili Address; <br /> CI SI" Zi Code: 1 vL <br /> Desi ated UST O orator Conductin the fns' Zenon, to e'!,4 <br /> lnttraiWOnal Code Cound Ctruncatim#: <br /> Si tort: <br /> Phonc:(t>51 �i53 Sl7S <br /> = N=N0.NU+NofA Itadle <br /> Item MONITORING PANEL/ALARM HISTY 1'm. <br /> ORY N NA <br /> Y <br /> 1 Monitor sys[em is 0wc'04d un acid in propor o oratina mode, <br /> .^. Monitorin s stem is nut currentl showing any alarms or warnings. <br /> 3 Alarm history mporviog for the previous month is available,and has been reviewed by the <br /> Desi edUST10111wrator. Rauch a r D U rhe Dlarm h slory rr ar[ik lD[his rDrrn l!availahle,l <br /> i <br /> Each alarm for the revious month has been res onded to approptiafe / <br /> 5 Sensors located in=K.iop conteitunent awns have not atarnied in the pa month. <br /> Sa List all rank-lop sumps where a(arvns t ce,1p ed is the pas!momh: <br /> Nor.;5'ump;+hery an rdmm Moa a:cvrrrM in rhr parr moved prey er.irupeerrd..d<!�o yw/(lied service wckn cj n reap.wdcd ru,veal <br /> yroperd oadreueQ rhe cmvc gfrhe dmn.,4fiaNr dxwunmrimi Wrtryine,approprvrtv rervme rt.this repore. <br /> eW' Tarecurdraula in rum d Delo«, <br /> UST SY6TEM INSPECTION <br /> 6 Tattk•top containment sumps are free of water,debris,and hazardous subswice. Sensors ere located properly. <br /> Naq'YbuvrlM eriono u ern aired w>ym swMlre ml dorm Acs aeeurrtd in fly relorah er,rdlch dart it no nrvnr mord <br /> Y N N <br /> Y <br /> S Locarion: Sun Locarioar <br /> SumE Lwarfam S' Loccoan: <br /> Lwarioa: Sit LDcarion: <br /> 7 Sill containmau structures are fret of vests,debris,eod harsrdous substance. <br /> Y N NA I I N NA <br /> Y <br /> Tank 1—Conrersrs: J� TaNc 3—COnrerrr,': <br /> Tank 2—Conrerrrs tL 1 Tank 4—Conrrarsr <br /> a Under-dispenser containment areas ere free of water.debris,and hL=d0tUsUbStMce. Sensors are lo— d l . <br /> Y N NwN I NA <br /> Y <br /> Dir reser 1/2 Dls rster 9/10 <br /> DIs nsrx 3/ Di aver 11112 <br /> Dis eraser s/ D' enrer 1�/14 <br /> i <br /> Dh �' DTs rrscrlSJr6 <br /> PAPERWORK t1VSPECTIONN NA DATE DONE <br /> Y <br /> 9 <br /> Monitorlag s stem certification has been com leted within set 12 months, D v a9f' <br /> 10 Seconds cotuelntnenr tests have been Com leted within the uired timefiame. / 12 I o2 <br /> 11 S ill contaisrment struo4ua ucket test' was co feted within the ear. / ,r� <br /> 12 Tank d truss was completed within r ulrod timeframe. a tr <br /> 13 Llna d rittss tessinswas tom feted within aired timeframe. y z y o y <br /> 14 Ocher to ulred tesel maintenance was cOm leted within required timeframe, List welmainlena=items below. <br /> Zesr/rldaiarenan, <br /> !'esr/rLlalnrrnance: <br /> Page 1 oft November 2004 <br /> I <br /> i <br /> 90 30" OIdIOdd A3-1-lVn 99L08G669Z 96:91 900Z/U/80 <br />