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0e-si.2nate[Wnder9MW d StOFW (VST)-Opemtor <br /> MOnthtyvisual3nspec ' Checklist <br /> Facilik y Name. . ,p::.. ";7 ..,S 'I r -1 <br /> act tAd teas •.t � '? ,�-> ;ro; ....,:'�• <br /> _De atod i,lST for ottducti the Inspect' <br /> 7mmrac+arratCode fbunuitfexliTitaTiontt: =" ".r-r s iratlonDatc: r"' /i' I'.:' <br /> r <br /> ore: <br /> �Y-Yw.N-No,NA=Not A Iteuble <br /> ..... ... ..... - ...WYWTMRTNG'PANM/ALAR HISTORY . ... N A <br /> TY 1vTonhorin s stem is owered on and rt er-o node. <br /> 2 monitorin s stem is not currently showing any alarms or warnin <br /> 1 Alarm history report/log I'or the previous month is available,And _bcensevsgwed by the <br /> fl ated t7STI I perator. (Attach a co m r o the alarm history re rt ft to this form i avoilah/e. <br /> 4- 'Each a arse 1 I v revious month has been res onded to a ro cl . <br /> 5 Scnsor6 iocetad imattk-to containment sums have not alarmed i the flat month. 4 <br /> Liar of L <br /> sumps where alarms occurred in rhe,past <br /> Noce: wan olen-m hw'oea:urred in thepasr month mus/Ae int ..,,..nes.t. <br /> ro nus ,pal' niryr T_ twice Il'<'hnlrian lvsprmGMt ,uml <br /> P p elM<maalfihr olornr.Anaah dneur.mniall..I wri�nng' rnp"air•xervlcr to this n/NW. <br /> /farm /m erlinnh aWrgrd.ew(tyJMkyn,(r,{Klew. <br /> Mcontainmenj <br /> rtairtnirr[t Sumps are free of <br /> n <br /> UST SYSTEM INSPECT <br /> p water,debris,and hazard substance. Sensors are located properly. <br /> n rmA d M ' Md In thr artmonth n which these n m ltmv r onwd..' <br /> V Nian- Swn L •orlon: <br /> ion' h°''-ons L tan: <br /> ment suvctures are fro, af+varea,ilabris u»d <br /> x" -N -%%A, Y 14 NA <br /> Tank I -Conlems. . : .Tomsk 3 rtmtctrlsr <br /> Tank 2-Contents. L. • Tank <br /> B Under-di s onset conlalnment areas are tree<)f w debzis floc cs• Sensors ore learod <br /> Y N JYA V N 1JA <br /> Dis cnser!/? D 4<1D <br /> 71m enser3/Q L ars ,Jl/1.2 1. <br /> Dispenser 5/6 L-' Di.s ens <br /> Hi.. onset <br /> 778 pi en J1L16 <br /> irECTtoN - - Y N... Nil I DA BD NE <br /> 9 <br /> Mon'ler oe+tificeHon hea been emn leted w 13 maks. <br /> 10 Secondar ContninmrntlCStS 11.,,.k-cGIM eplated+Wiin the, r <br /> .11 S ill canrainment st buCI.lasting t2k22Epleted withm - <br /> 12 Tank ti Illness testis was laced iuithin Lired tion&ame. <br /> 13 Line ' testi ascom feted <br /> wasithin eted wd it•hmincfrramccd,14 Otherre <br /> iListirstfmm'merrostCeitems below.) <br /> Test/MAlnte----- <br /> Test/Maintenance; <br /> Test/Malnrrnance: <br /> s JS Allfaci{u �t16fEfTVtMPtVVSETRA V N NA <br /> IQ ees have received the re u"rtdd ort-the=ob trainin ithin the flat car. <br /> 6 All facli cm !o shired wµhin the Vast 30 trevexeceived-rh res uired on-the-'ob trainin . ,*, - <br /> .Wute: Any answer of"N"4hqaW 8e••eupft*"d in"*comment section be fogowing page,and will rewire <br /> follow-up action. <br /> CPaye I of 2 <br /> September 2440 <br /> ZI ,a W" go:" 6002—£0—d3S <br />