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Y -J <br /> Q�si�ared Un&- g WWW Storage .T Rk (UST)Operator <br /> Morlthly Visual hWe Checkiist <br /> -Paclit Name: I Ite: ; 77 17 <br /> 'TaciljU AddTCaa: b r <br /> � rr <br /> E <br /> - r ' I DIE)Code. <br /> 'Deet tedV$T ratorConductin theins ection r„•?.. <br /> hrtemariontrl-Ctidt Caoncil Cettification p - iration Date: <br /> �- <br /> - . V-VN,N�N NA-VotA linblc <br /> item `MONTT'ORi1'+GYANEL/AL HIST'ORV Y I N I -NA <br /> 1r Wonitoring system is Powered on and in Dr oro era <br /> 2 Monitoring s stem is not currently showing any alarms or warnin <br /> 7 Me=history reportAog for file previous month is available,and h been reviewed by the <br /> Desi nated UST rotor: Atlach a copy of the alarm hiSlOrV re r/lo io this oim if available. <br /> 4 fachatarm for The e revious month has been res ondetfto a run el ,�. <br /> s Smsors+aca/edin[an -to contammentsum shavenotalarmedi he postmonth. y <br /> Mr all funk-Iap.rumps where alarms occ w•red in rhe pasl mon <br /> „..... <br /> NoceSanpa where all alarm hay ut cumed In rhe//aat naMA Mutt hr Mrpe4r unto$apual d aervar leaMrirlan rrslnmded lrr.aro/ <br /> parperlj addressed the cmneaJlhe alarm.Anrah Outram mNinn r-erffrina ul rrpr lah'vrrvire m rho rrpan. <br /> f nr i"r1w Ma mqwmd.l watt-erdm ln'aerj.A,hi <br /> UST SYSTEM INSPECT N <br /> 6 ank-tUV c0l,, hinnem sumps are Tree otwater,debi is.and hazardu substance. Sensors are located properly. <br /> Nule:Visual n+umzf h nn! re ullrrl m.. r whrrr vn dm m rm r wnvd in rh,pai m nAfi rwhn:h chem h+m ierwt<rrtmYl. <br /> Y N 1 N i <br /> Sam Location; y�Y�„;, L otian: <br /> Sam LOCaI%an: �,k=�•.' <br /> Sum Locwtionr t �' athm: <br /> 7 Spill containment structures ase-s fwuw' debris, e: <br /> V -W <br /> Tank 1 -Contents: Ten” <br /> Tank 2-Conlenls: <br /> 8 Undet•dis user comaittment areas are frcc of >,thtis, ue substance. Seasurs.ate loeafcd ex <br /> Y X AIA Y 1V NA <br /> Dia• eraser 1/2 D' ells P/1Q <br /> Litt eraser 3 14 <br /> Du enser 516 Ols ans !3/14 <br /> Di. enser7/8 i ./S//6 <br /> cesafre>tsoniwsbaen Bre <br /> p+kPERW6R'fEf1t1SP€ETIEjN� it N NA DA'i'E tVE <br /> 9 Monitor' s within 12 hs. <br /> 10 Secunda write, tt tests lot vebeeac tad dwithint i- <br /> 11 S ill containment atNeture I <br /> hs' saes lotedwttitin t r. ';.' <br /> IZ Tank ti htneaa tesfin was c leted within aired tiatefrattte. <br /> 13 Linc ti huwsa testing was uwm lclod withip mcgowedtatinfianne <br /> 14 Other re uircd testin /maintenance was cont IC1Cd within-requircd ' frame. Llsf iewknainrenaneairenrs below.) <br /> Tesr/Maintenance: <br /> esr/Malnlenanee: <br /> J5` All faciht etnalo eeshave+ecei+cdlx u�itanlM t <br /> 16 All faciltt c to erxhued wait t iLiTY Eyfi�t6Y€g Y N NA <br /> fr�C <br /> obtrairritt nhm the est car. t. <br /> receive Tred on rho-'ob trainin . <br /> •1Yose• .Aloy answer io N sharWbeeaplNnMTMthe cvmtnern seetton a foltowlne page,and W, requirs <br /> follow-up action. <br /> `•PuBc I of 2 <br /> SepfanYer BOW <br /> t30 'd WH £0: 00 6002-£0-d3S <br />