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10878 N. Hwy 99, Stockton, CA 95212 Record ID PR0231598 <br /> 4/25/2016 PHOTO#12 <br /> October 2015 D.O report with incorrect test dates for MSC, LD and Spill containers <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> SIGNATED UST OPERATOR MONTHLY INSPECTION REPORT <br /> Fact"' Name: FAST&EASY 2015 <br /> Inspection Date: October 14, <br /> Facilih .Addmss: <br /> 10878 N HWY 99 - Cin': STOCTON CA. <br /> r Name of Designated UST Operator Conducting Inspection <br /> inlemational Cod ' Jason Haase <br /> ounci Certification No.: ESPifadOu Date: 2/612017 <br /> n <br /> Sigature: 8165490-UC <br /> Phone: (530)749-9892 esL <br /> a=mor c K.a. <br /> Item MONITORING PANEL/ALARM HISTORY <br /> I. Is the nitorim'evstzm 11,---d on and in Droner o eea[inv mode' —�-� Ll <br /> _'. I Is the monitoring s stem riot currenthshow'ine anv leak alarms? <br /> �. Is the Alarm History Report/1og for the previous month available,and has a been_viewed b, etre <br /> Des'mated UST O eralor? (Attach a cn <br /> P p of I= / i ' rpnrt//ok'to!h7s ma. cnnnJormr <br /> i <br /> 4. I Has each alarm for the previous month been responded to a ro natels! <br /> UST SYSTEM INSPECTION <br /> -. Are lank-top mntamment sumps free of wa[oi debris,and hazardous substance A." <br /> /! - <br /> W/tern 6. tmnPs where un c unn Ivy. n-red m.Irr posr nvin+h mmr A rngner d f' ,, !P d _ + h r+ �r'h 'r op.rLL } <br /> prnprdr cddres drhe.au se nfrh.alar n.Oxumenrauon r,n4mn rrmruver- `lh<"'ldh auaJadmrhrs rr rorr CO <br /> y,a No <br /> Yes No <br /> Surn2 Location:UNLEADED ® Sum Loca[ion: DIESEL <br /> Sump Location: PREMIUM ® ❑ SUM2 Location: [ <br /> 6. i Are spill buekeLs(containment structures)free of water,debris.and hazardous substance" <br /> Yes No N!, <br /> Yes No N!A '& V <br /> j Tank 1 D-UNLEADED ❑ ❑ Tank 4 ID- <br /> Tank? ID-PREMIUM ® ❑ ❑ , Tank- ID- +- <br /> Tank 3 ID- DIESEL ® ❑ ❑ Tank 6 ID- ❑ - <br /> • I 7. Are under-di5 enscr containment areas free of water,debris,and hazardous substance". <br /> ( Yes No N/A 1 rs No NIA % ri <br /> Dispenser- 1/2 Z ❑ ❑ Dis enscr 4110 <br /> Dispenser 3N ❑ ❑ Dispenser 1P12 - <br /> i Dispenser-3/6 Dis enscr 13114 i <br /> Dispenser -7/8 ❑ ❑ Dispenser I5/16 i <br /> i 8. Leak detection is ro erl located within under-dis enscr containment. _ .---- <br /> Dispenser enser P2 Yes No N/A `yes No I N!A. <br /> ❑ ❑ Dis ensei 9110 <br /> ' LN Li Dist user <br /> Dis enser Sib ®_ _ E] Dislen,er I;:14 --- ---� �-- — <br /> Din emcr - I i;16 <br /> j^Dispenser- 7;8 ® El ❑ — <br /> ------- <br /> PAPERWORK INSPECTIONYes I No IN/Al Date Door_ `.,It--- <br /> 9. Monitorimr Svstern Certification was cum feted within the past I'months^ _1 i 3 4rl <br /> �Y 4!°t 2015 ,fj <br /> 10 Linc Leak Detectors were tcsad/ceitificd %villin tlt�a,t I' moods' — _ I _ 421120/4 <br /> r— <br /> I I 5 III bucket(containment svuetmc)lestin��oi>pIncd tt'ilhm the au I'_monthsj�'I 4121i'10_1-0_ - 4 <br /> I?- I Line tightness testis" complucd wahin the re uirrd sine fnurc_ <br /> Fatinah Zareef, REHS Page 1 o` i 3 <br />