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<br /> ,.a i I knot Str,ra.10 Tank
<br /> foal IIns \v UST)Oreratnr t)p^rater I i cli�n
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<br /> �- .is.1-��-� ( I•i _ _ _ 11T71110,1
<br /> C_-t 14. __ � Idllll�n�t �,�,1,. t t'`1-n.
<br /> Inctrurtrnnc - „n n n
<br /> `r..;;.•.or.•,• t,ner•Rto,Mir,iw.%%esses a currrhl"California I.r!;1 Systrm
<br /> -em(mea OCC t nn A 151367'i n rl,a
<br /> r(tr My„k,r p,111iPrl1tM of adv condition diecor2+red durinp the monthly vraual innppctton that ,y__ •,
<br /> n the UST kMmrr,or Operator » '( =
<br /> ^`tw1 .n.. •,t p,.,..r„�.'rM t,.,.....- .,:,, S"Ss n Lunen,^r-artto,n,a t 1 rP>Yst:m 8
<br /> .- tliN mej,PrYMn report and All attachments for 17 the most recent rn—he
<br /> .>>^rorRD b4e'
<br /> {the>vca�enCt oR-la1tP at a readily available location „ It� `oiad,vnrnrt,, ...n n,,. , t '1`he mpq!Fh{WR,68{SnaClakln
<br /> ft encs N4 lr Afar 4nr:tavtVe 4rn answer tit Ar"shl,{rfid he e.r,rr7atrrerl
<br /> r .�t
<br /> *OM Mile US. 1 v nntg t-r the mua,.er�nt t2 e+m,5hr1,
<br /> 11,a , - ,na, ,..for the n,
<br /> M,ntttrrinp PArtPi 'Alarm Nistrry -------Y --_N / NA " aurin est racent,2 mmha „nn
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<br /> _. !'•, ,•_ -_ _ .,,_., I L„ 'N"shnufn IM nrpra,nnd _
<br /> _ _ _ In Panel I Alarm Ilislory D
<br /> =
<br /> any Ieeq 818-ms c*\+`e-mis7Qe° !v 9 _ v
<br /> nr alinN malr� - � -
<br /> • lra
<br /> trtable a++a hag rt freer reyie\yed try the Designated Y I Y ___ N
<br /> arpbprorbe lir ltra6 xrig7erYr[rn funrt rravai18".) k aln,mI or wwnmR?
<br /> ` tnbk+.aro has It been r Y Y_ ,a Dac:gnatie
<br /> c.,.x...d �.... r• arP�v_ __ Y 1 l i/r,, AVI(+Wed b the De51(rna}P(1
<br /> 7 f•,flv�inepecfton torn if.v IfanfFl _
<br /> US 1 r�r_ctem InS�.Iection Y t N ! NA
<br /> dews,
<br /> ww t warcouc sunswnce'Are sensors located property? T 5ysternInspection v
<br /> a
<br /> mom h"rlCCUw OF Ow Pad~trh"we be 9up""W O 6 yualiAed aen+h.-e tecrifvcfap and hazardous substance?Are ser Y I N ; NA
<br /> 9 , � )
<br /> 6�e Jila"Js-jr1D0a ++Vlltn OMWO RIP service should be attalvW to this report nsors located to nMmr h P Warty? - -
<br /> as occured in thaa
<br /> A sf month must he rnspnrd a wa(fiod Mchnmgn
<br /> — Sumpt-oCatipn 'e aiam7.DOcuninnfa ton verifying aPprnpdare servr,-n shoyad uld snMtn
<br /> he attached in this rgprn -
<br /> — Sump Location Sump Location
<br /> Sump Location .. Sump Location
<br /> M31er Oetns and hawrdous substance') Sump Location -
<br /> / ! Tank
<br /> Ir,debris,and hazardous substance''
<br /> Y Tank Y Tank 1
<br /> _ Y i Tank Y Tank - - -- -
<br /> i
<br /> -- Y Tank
<br /> V detrres and hazardous Substance)Are sensors located propertyl debris,and hazardous substances `
<br /> Are sensors located propenyl _ -
<br /> Otspenser 09-10 Y Y Dispenser m-10
<br /> y Despenser 11.12 y�
<br /> T Y Dispenset 11-12
<br /> oipertaer 13-14y - ------ -
<br /> Y Dispenser 13-14 ---- -
<br /> Otspenser 15-18 Y Dispenser 15-16 -
<br /> ip Y / N N4 Date gone We
<br /> aperwork Inspection Y ; �\
<br /> C.pgt 12 tttonttrs _ N I NA Date L one
<br /> i 1 i the past 12 months? Y
<br /> .2 morWilill, ast 12 months?it
<br /> Y 611112 y �, -
<br /> ::rthln die pgol 12 MCKjttts7 , r 3d within the past 12 months? Y 611112
<br /> -
<br /> rrra squired lime frame? Y 1111611 1
<br /> i+ eGurr t''r'r j1/o1 AWl/MeJnWnencn Rema below) Aillih required time frame? ii,.1t testlMafn(enance items below) r t l r 1
<br /> r-,IZ
<br /> N '
<br /> employee Training - - N N v N �� / r r r
<br /> 1 „ '' icily En1�11oyee Training - - _-- JJ I 12 01 J `.
<br /> thr .
<br /> hviyed N\
<br /> a•:.,�-..a }" - �i�� .. �...._.�_.. ..-....:,-ter. -- ^
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