Laserfiche WebLink
Afforda-Te$tDesignated Operator <br /> 416 2nd Street Galt, Ca. 95632 Monthly Inspection Checklist <br /> 209 744-0112 - 800 524-9087 - Fax 209 744-0116 ✓. <br /> Site: &S� 7rwGk<c v Date: ��f X05 <br /> ❑ <br /> LyleD.Nimmo ZaneA.Nimmo DavidA.Winkler Felix G Ramirez#524911 _ ❑ #5263322 1 fA #5263373 ❑ #5273934 <br /> Signature - Yeses N=no NA=not applicable <br /> MONITORING PANEL/ALARM HISTORY Y N NA <br /> Monitoring System is powered on and in proper operating mode. <br /> X�- <br /> Monitoring system is not currently showing any alarms or warnings, <br /> Alarm history report for the previous month is available and has been reviewed by D.O. <br /> (Attach alarm history) Not Available <br /> Each alarm for the previous month has been responded to appropriately. <br /> Sensors located in tank-top containment sumps have not alarmed in the past month. y(' )( <br /> List all tank-top sumps where alarms occurred in the past month: fit- }pAct'/ <br /> Note:Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded <br /> to,and properly addressed, the cause of the alarm. Attach documentation verging appropriate service to this report. <br /> Ifsump inspection is required, record results in item#6 below. <br /> UST SYSTEM INSPECTION <br /> Y N Y I N <br /> Tank-top containment sumps are free of water, debris, and hazardous substance. Sensors located properly. <br /> Note: Visual inspection of sumps only required in sumps where an alarm has occurred in the past month for which there is no service record. <br /> Sump location: Sump location: <br /> Sump location: S' Sump location: <br /> Sump location: Sum location: <br /> Spill containment structures are free of water, debris, &hazardous substance. <br /> Tank 1 -Regular f Tank 4-Diesel <br /> Tank 2-Plus ML Tank 5- <br /> Tank 3 -Premium Tank 6- <br /> Under-dispenser containment free of water debris &hazardous substance. Sensors located vro erl . <br /> Dispenser 1/2 k D <br /> ispenser 19/20 <br /> Dispenser 3/4 21 <br /> Dispenser 5/6 nser 22/21 Satellite <br /> Dispenser 7/8 ser 23/22 Satellite <br /> Dispenser 9/10 -' ^••^^ ^ •• <br /> Dispenser 11/12 <br /> Dispenser 13/14 nD i ?:1:Dd =:�at� is+1:•� n;i �i� z.♦y: .. <br /> Dispenser 15/16 a 'aDb°i a'y :T 07iy'n `v:o "{i } w ncz+:� <br /> Dispenser 17/18 _ j.]q <br /> m <br /> Co <br /> All facili employees have re v a a X <br /> All facili employees hired w n a <br /> p � C��.� � v JAS• X <br /> 3 <br />