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FROM (NE D) AUG 30 2006 107 ' 42/ST, 17:33/No. 6843597301 P 12 <br /> Designated Underground Storage Tank(UST) Operator <br /> monthly Visual Inspection Checklist <br /> Facill Name: Dade: C t ++ <br /> Facility Address: <br /> Ci : zi Code: <br /> Desi rued UST 0 crator Cond=ting the Ina ection: - <br /> Inretnarional Code Cou ' Certification 0. <1r til ^ E iration Date: z/ 07 OL <br /> Si aturo: <br /> Phone:(7;:y- ) e. 4 l\ <br /> Y=Yo N-NJ Na-Nn<Appilobk <br /> Item MONrl'ORINC PANEL r ALARM HISTORY N NA <br /> Y' <br /> t Molritotin^system is Powerd m1 and in ro o erxdn mode. <br /> 2 Monitorirm system is not Current) showin an alarms or warnin <br /> J Alarm history repor0og for the previous month is available,and tws been reviewer)LY the <br /> Desi ed UST 0 calor. dlroch a co v o/rhe alarm hislo ro orl/lo to(his fbern 11 available.) <br /> 4 Each alarm for the erevious month has been responded to appruREiaiely. <br /> 5 Sensors located in WK-top containment sumps have not alarmed in the past month, <br /> 5a _ Liu all ran!-top sumps'wham alarmV occurred in the past monrk <br /> Nnrr,Sumps <br /> property odLwvjad.wsire o e/aorvm+hoow alnmv^a lrl rN�port u,anrh�.IWr 6a lryfyCKJW1IIW Y T nY'+qsd r+rvlCt rnNniti <br /> stn nupanded ro.and <br /> Arwch dacwn+wauon v+riJylrg eppruprinrr�rrol.+rorbi+rafwrs. <br /> i crion u'rc ed recaMrnv/u w(qm a,hdow, <br /> UST SYSTEM INSPECTION <br /> G atilt-top contahvoent swnps are tree of water, debris and hazardous suhsnnoc. Sensors are located properI <br /> Nuri:th+uul Ins coon u sw iron � arr+id to rwn a whirs ys yorm Mr eeearr+d/n rho r munch pr which drr+fr no Y N <br /> Y <br /> Sum Locariow SumpLocation: <br /> Sum Location: Sum Location: <br /> Sum Location. Sum Location: <br /> 7 <br /> Spill conwnment Structures are free of water, debris,and ttamrdous substance. <br /> Y N NA N NA <br /> Y <br /> Tank 1-Cohrenrs: Tank 3-Contents: <br /> Tank 2-Conranrs; Tank 4-Conatus: <br /> I Unda-dispertsof containment areas are free of water debris and hazeMous substance, Seniors are locatedDfOo <br /> Y N NA N NA <br /> Y <br /> DJs At- <br /> 1 Dir ata 9/IO <br /> DJs nrer S/d Drs mar <br /> b nrtr5/ D rererl3/J�'t <br /> DJs tnser Drs rtrerJS/t6 <br /> PAPERWORK INSPECTION N NA DATE DONE <br /> i <br /> Y <br /> 9 Wnbriug Monitor' s stem certill Oilhas been cont IeAd within pest 12 months, <br /> 30 Second cotuattunent tears have Leen cont leted within We r iced timeframe f o Z <br /> 11 Sill centainntent sttuCtUre(bucket)tesd was w feted within the est eat, v as <br /> 12 Yattl tt hmess test was completed within uired timeframe. L/-2. 1- Oki <br /> 13 Lined meas testi Was cont leted within required timeframe, 2 o r <br /> 14 Otho r tilted k malntenance was completed wirhin uirad tlme8ame. srresr/mainrenanea items below,) <br /> 7asr/A4afnrananca: <br /> TssdAlalntenance: <br /> Page l oft November 2004 <br /> I <br /> 00 39Vd DIJIDVd hM-Tdfl 6SL08b660Z 9E19t 900Z/6Z/60 <br />