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Jul 21 06 12t50p Rfforda Test (2091 744-0116 p- 2 <br /> iArxoraa-,`,eft ,�„-signated Operatolr- L <br /> 800 524-9087 FAX 209 794-0112 <br /> q,1 ira Monthly Inspection Checklist <br /> Facilit Name: <br /> F'acifi Address: affT q . QQ <br /> Date: <br /> zel <br /> Desi noted UST O erator Con uctio the Ins lion. Zi Code: <br /> zANB A INN <br /> InternationnlCode na6iCern (cation#: r✓1o3322- U ExirationDote; d2/03 /OR -- <br /> Si rc- - - <br /> - Phone: 209 rq4 -OIOZ <br /> Item Y•-Yen,N-Nw NA�NdA nrabtr <br /> MONITORING pANEI,r/AI,AItM 1HISTORY N NA <br /> Y <br /> •..:..,.,.......an .•: ,.,....•. . ." . <br /> Monitorin stem is owered on and in o , - ,"•,..• <br /> ' mode. <br /> 2 Monitorin stem is on ' -�-• - <br /> t currend 6howia nn alarms or wamin s k <br /> 3 Alarms history report/log for the previous mouth is available,and has been reviewed by the LL <br /> Desi atedUST(linilill. Attach o cn 0 The alarm histo ee ortgo tothis arm i availn <br /> 4 Each alarm for the rervious month hashres codeable.d to ro riatel . <br /> S Sensors locttcd in tank-to containment sum shave oat alarmed io the ass month. <br /> 54 List all lank-top sumps where alarms occurred in the past month: <br /> Nore:Sumer ill an a/arm hw occurred/n ebe part al mice be Inevard nn/ess a 9710/#7edaereke eeehnielan retponded/o and <br /> properly addre wed,/he carat'Of the ll Anach dbl:e~oMlon vrr&Cvul opproprtue seev/ce ro IAIa roPon, <br /> sum Ina Ilan Ace rrhrd rarordread/s/n teem 6,helow• <br /> --.• 'W>4-.� u •-uWn:,-..n)r4N -. ...R• \y Y'.,-+UMYn'.I'VN'XM '. Ixn <br /> USTSY <br /> 6 Tank-to STEM INSPECTION <br /> p containment sumps are free of water,debris,and harardous substaaCc. Sensors are located <br /> N0/e; VL, a corm im o .nem /s Only Bred ie.mm r where on alarm/rar x71 rred/n ehe ar rrronlh or wh/ch d rrc/r rro.fer Properly. <br /> ly y. rrrord, <br /> N <br /> Sam Location: -D I 4- ( 4 <br /> Sum LOcailon: y q'. S'um Location: -ti <br /> Sum Location: Sum Location <br /> 7 S ill containment structures atC fr ae of water debris,and h Sazvdous substance. <br /> Y N NA <br /> N NA <br /> Y <br /> Tank 1-ConMnts.• D I .( >( Tank 3-Contents: <br /> Tank2-Con/cots: G •Z x <br /> Tank 4-Conrenls: <br /> 8 Under-dis aser containment all are free of water,debris and hamrdouc substance. Sensors are located ro ere . <br /> Y N NA <br /> N NA <br /> Y <br /> Des nser//2 04r rarer 9110 <br /> Dls -314 <br /> nser 3/6 Di nser 11/12 <br /> Dia Dis. nser <br /> D/s nser 7/8 <br /> _ _ __ Di s nser <br /> ,..:PAPERWORK INSPECTION .._ ..N,.~.�..• <br /> NA DATE DONE <br /> Y <br /> 9 Monitorin stem certification has been co feted within asst 12 months, <br /> 10 Sewn containment te.¢tq have been corn feted within the re wired timeframe, <br /> 11 Sill containment shucture bucket testln was corn feted w• I <br /> 12 Tank ti tness testis was corn feted within uircd time5amc. the ass ear, A G• 2t' • o,S <br /> 13 Linc If fitness testis was corn feted within r uircd timeframe. <br /> 24 Ckher re wined[actin maint-------- cam feted within rc uircd time; est tee//mnintennncc iremr be/rnv. <br /> Taet/Maintenance; <br /> TesdMaintenance:. <br /> IlL t(14`y r •- <br /> _'�" <br />