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10878 N. Hwy 99, Stockton, CA 95212 Record ID PR0231598 <br /> 4/25/2016 PHOTO# 15 <br /> June 2015 D.O report with incorrect test dates for MSC, LD and Spill containers <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> PDESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT <br /> I.,; ,�;,m,.: zo1� <br /> FASTS EASY Inspection Date: JUriBJill, <br /> 1, <br /> 10878 N HWY 99 City: STOCTON CA, t <br /> natty 11ST Opemlur Conducting Inspection: <br /> -- Dale Careaga 10/41201 <br /> 6 <br /> odc Council Cenilication No.: 8250093-UC F,zpiration Da[ <br /> �r.. inlllrY: <br /> Phone: (530)749-9892 ext <br /> Yes No N/A <br /> jl� 1p MONITORIN C PANEL/ALARM HISTORY ' <br /> I 1>the monnonn�system powered on and in proper operating mode? ❑ <br /> [he mon nonny s•zlcm not cwrcntly Sljori •any I..k alarms' <br /> Is the Mann Histury Re orUlo g for therevious month availablere <br /> and has it been viewed by the <br /> I Desianand Urly hrs meST Op-rato r° `A to-h p the• ! h-t , r!/lo ro( ecrion arm.) ® ❑ <br /> 4. ! Has each alam, for[he previous month been e ponded lo'appropriately' <br /> UST SYSTEM INSPECTION <br /> i5. Are tank top containment sumps free of water,debris,and hazardous substance' vola 1Jrhe arm er m Ir z rme'frs. -skip - <br /> ar lrem 6 S,,., Iris ulnr n be.'o d rh,pmr n or rb u usr d P ted Ju 4va7fed service techruermr has r t .ponded m. and <br /> -rh df sad rhe rausr o(elrc�larmP evarmn rerr/Svn¢a r� - i rrviceabould be auauredro 1pn'n <nr- <br /> " Yes No <br /> I _ Ycs No ® ❑ <br /> Smnp Location: UNLEADED ® ❑ Sum Location.DIESEL ❑ ® - <br /> Sump Location:PREMIl1M ® ❑ _ Sum Locahon: - <br /> i 6. Are spill buckets(containment structures)free of water,debris.and havardous substance'! i <br /> � Yes No N/A Yes No N1A <br /> Tank 1 ID - UNLEADED I ® ❑ ❑ Tank 4 ID- ❑ ❑ ® t <br /> Tank_' ID-PREMIUM I ® ❑ ❑ 'rank s ID- ❑ ❑ <br /> ��� Tank 3ID-DIESEL ® [El ❑ Tank blD- <br /> • 7. Are under-dispenser containment areas free of water,debris,and hazardous substance? <br /> Yes No N/A Yes No N1.4 <br /> 1 Dis enser-I/2 ® _❑ ❑ Dis enser-9/10 ❑ i <br /> Dis enser-3/4 ® ❑ ❑ Dis enser- 11/12 ❑- ❑ <br /> j <br /> Dispenser-516 ® ❑ ❑ Dispenser- 13/14 ❑ ❑ <br /> Dispenser-718 ® ❑ ❑ Dis enser- 15/16 ❑ ❑ Z <br /> 1 8, Leak detection is properly located within under-dis enser containment. -. <br /> 1 Yes No N/A Yes No NIA <br /> Dis enser- 11,12 ® ❑ ❑ Dis enser-9/10 ❑ ❑ <br /> 1 <br /> ❑ ❑ P'Dis enser- 11'12 ❑ ❑ <br /> i Dispenser- 5' <br /> ® E] ❑ Dis enser- 13114 ❑ _� <br /> ; Dispenser-7/8 ® ❑ E] Dis enser - I5_/I6 [Ell ❑ <br /> PAPEI2wORK INSPECTION Yes No N/A Date Done <br /> ® ❑ ❑ 412112014 ; <br /> i�oflaorink System Ccnificanon was completed witllin the past 12 months'? ® ❑ _ 4121)2014 <br /> i 10. Line Leak Detectors were tested/cerhlled wuhln the past 13 months? _ - <br /> I I. Spill bucket(contammentsnvcwre)testing cunt leted within Ih� 'I 12 months? ® ❑ ❑ 4]2112014 <br /> c is -- <br /> I I?. Line nehtncss leslim� com letcd within the re c utrt,d ume hanie. I I ® alznront5 <br /> Fatinah Zareef, REHS Page 15 of 16 <br />