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UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT <br /> ?acibty Name: Aroh Arco AM-PM Inspection Date: <br /> Facility Address: 4855 South State Hwy,99 Cty: Stockton, CA. 95215 <br /> Name of Designated UST Operator Conducting Inspection: 1 1 . <br /> International Code Council Cortifleatlon No.: A .�2�'� (,( � Expiration Date: — <br /> Signature: Phone: (918)371-2380 ext. <br /> NIA=NotAppActibic <br /> Item MONITORING PANEL/ALARM HWTORY Yes No N/A <br /> 1, is the monitoring s stemveered on and in ro r operating mode? <br /> 2. Is the monitorin system aoCctut•entf showin an leak alarms? <br /> 3. Is the Alarm History ftWrt/log for the previous month available,and has it been reviewed by the <br /> Desi Paled UST O eratoO Artach aro o the alarm histo re Pill 0 to this iree action 6021. <br /> 4. Has each alarm for the revious month been res octad to a r ria[el ? <br /> USC SYSTEM INSPECTION <br /> 5. ...Are tank•top containment Suthps flee oFwater,debris,and hazardous sullstattce? Npte:lfthttuurrurtotrom awes res, r>We <br /> m tlerll 6.Sumps where an alarm Mae oecuncd in the past month must he inspected f a quutflled mpVla admlatm hav not rsgpaded ',and <br /> art Addr ed,elle cause a the atd?ft ppLrmnllfalto/l ver i plate rsrvice should be attached to this"90"t Ya No <br /> Yel No <br /> Sum Loc tilon: �( <br /> Sum Looatlont / Sum Location: sti ,gar <br /> Sum Location: <br /> 6. Are s ill buckets(containment atruduresYese No eN/A ebris,and hazardous substance? Yes No N/A <br /> Tank 1 ID-89 Tank 41D- <br /> 7'snk 2 ID—87 Quad Tank 5 1D— <br /> Tattk 3 ID—91 Tank 61A— <br /> 7. Are under-dis r containment areas free of water.debis,and hazardous sttbst=00? Yes No NIA <br /> Yes No N/A <br /> /2 Dis eager 9110 <br /> Dis enser-1 <br /> Dis <br /> Di riser-3/4 unser11/12 <br /> — <br /> DDis user-13/14 <br /> is enser-5/6 <br /> D' user—15116 <br /> Dis enser—7/8 - 17118 <br /> 8. Leak detection is Pro rl located within under�is enser contatnmellt' Yes No NJA <br /> yes I No N/A <br /> 10 <br /> Dis enser-1/2 Dis enser— 11l/11 <br /> 2 <br /> Dis n3er-3/4 Dis enter—i <br /> Drs enser-13/14 <br /> Dis nser—5/6 pjs enser-15/16• !7118 <br /> Dis e -7/8 <br /> ,-_ .,mit• a No NIA Aate Done <br /> PAPERWORK INSPECTION 12-31-2009 <br /> 9, monitorin S stem Card Vfl ation was com leted within the vast 12 months? 12-31-2009 <br /> 10. Lime Leak Detectors wero testedlcertified within the est 12 months? 12-31-2009 <br /> 11. S ill bucket containment structure to in coin leted within the ast 12 months'? 4.10.2008 <br /> 12. Line ti loess testin com leted within the ret aired time frame? <br /> 13, Line <br /> coriutintnent tests com leted wlthln the re tuired time fnune? <br /> 14. Enihanced Leak Detection com luted within there uited time ti d time liatne7 (Gist tardrnaintenance items below. <br /> 15. Other r aired testin maintenance was com feted within -u 6 Muadts 1 2-14-2009 <br /> posaibe TesdMainteaance:Air alit /Va or rocov <br /> Describe'fcadMaintananca: _ .. yC No NJA <br /> "` FACILITY Elvtpl.oY»E TRAINING . <br /> 16. Have all facili elm to ees received the re aired on-the=ob ttainin within the t �+" <br /> 17. Have all faaili em to ass Hired within the as <br /> 30 da s rooelved the re aired on-the=ob trainin 'T <br /> Note: Explain any"No"answers in the Comments"section on the following page•Those issues requite corrective actio 9�oNus <br /> " wnn•aaieua.ury <br /> the UST owner/operator. <br /> tIN-057.1/1 <br />