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Site ID:1145 <br /> Afforda-Te$tDesignated Operator Facili Employee TrainingPare 2 of 2 <br /> 416 21a Street All facility employees have received the required on-the-job training within the past year. X <br /> Galt,Ca 95632 Monthly Inspection Checklist All facility employees hired within the past 30 days have received the required on the job training X <br /> 209-744-0112 Fax 209-744-0116 Monthly Inspection— <br /> Y N NA Date Done <br /> Site:ALPIIA FAST GAS Date:03-29-13 Momlonng system certification(within past 12 months) X 04-16-12 <br /> Spell Bucket testing completed(within past 12 months) X 04-16-12 <br /> 2358 EAST WATERLOO Leak Detector-mechanicaUcleclronic for most sites(within past 12 months) X 04-16-12 <br /> Tire above are usually done together ori an annual basis for local regulator. <br /> STOCKTON,CA 95205 Line Tightness(usually upon construction or when no positive shuldown) <br /> ❑Lyle D.Nimmo ❑Zane A.Nimmo ❑David A.Winkler Ill Fella G.Ramirez Tank Tightness(Usually only after construction or when using SIR) <br /> 45249115 45263322 95263373 k5273934 <br /> Secondary containment(SB989)tests have been completed(usually every 3 years) =03-2Signature:t4V-,cs 1V-o NA-ewe arrlicahlrMONITORINGPANELlALARM1315TORY Y N NA Other testing or maintenancecompleredasmqutred.Lisrthemhelow:Test/Maintenance.AQ <br /> nitoring sy7,:,,.o, <br /> owered on and in proper operating mode. X <br /> - TestIlWlaimenance: <br /> uitoring syot currently showing any alarms or warnings. X TestlMaintenance: <br /> Alarm historyg for the previous month is available,and has bean reviewed by the Designated UST X PRINTOUT tNCLUDED Yes No NA Ll <br /> erator. Armo doe alarm histo ^re ort'!a fn this arm i available. <br /> Each alarm foious month has been responded to appropriately X <br /> Sensors located in tank-tap containment sumps have not alarmed in the past month. X _ Comments:PRINT OUT LEFT ON SITE <br /> Lisr all tank-top sumps where alarms accrrrred in rhe past morals: <br /> Nate:tiumps++•here an nlarm leas oexnrreri in etre past mm�dr nares!be urspected unless a qualified semce recluaciau respomled la and properly - <br /> addressed,the cause of the alarm.Allacb rkx:untenratimr vcrifvhrg ppiopnalr service to this report.if aurum,irespecrion is mquired,accord results <br /> iu item 6,helme <br /> UST SYSTEM INSPECTION <br /> - I Y I N I NA Y N NA <br /> Tank-top contaient sumps are tree of water,debris,and hazardous substance.Sensors are located properly. Items Requiring Follow-u Actions' <br /> nm <br /> Nair-VJsvrdie rid.u+rh¢ rm rlr nr which ahere is nc+servin xcnrsL <br /> Sump Location 87 }( Sump l,ocalian: <br /> Sump Location:91 X Sump Location; <br /> Sump Location:DIESEL X Sump Location. <br /> Spill containment structures are free of water,debris&hazardous substance. _ <br /> Tank.l-Regular }[ Tank 4-Diesel X <br /> Tank 2-Plus X Tank 5- <br /> Tank 3-Premium X Tank 6- <br /> Under-dis enwr containment free ofwater,debris,&hazardous substance.Sensors located ro erly. Monthly inspection must be conducted by an TCC licensed Designated Operator. <br /> spenser 112 X Dispenser 19/20 <br /> penser 314 X Dispenser 21 A copy ofthis Checklist must be provided to UST owner or operator,but not to State Water Resources. <br /> ispenser 5/6 X Dispenser 22/21 <br /> Dispenser 7!s X Dispenser 23122 Designator Operator must alert the UST owner or operator of any condition discovered during the monthly <br /> Dispenser 911 o Dispenser 24123 inspection that may require that may require follow-up action. <br /> Dispenser 11/12 Dispenser 25124 <br /> Dispenser t31t4 Dispenser 26125 UST owner or operator must maintain a copy of this monthly inspection and any attachments for the previous <br /> Dispenser 15116 Dispenser 27126 Satellite 12 months.Records must be maintained on-site or,if approved by the local agency,off-site at a readily <br /> Dispenser 17/18 Dispenser 27 available location. <br /> 109199 <br />