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4315 E Waterloo Rd PR0231760 <br />04/18/18 PHOTO # <br />Designated operator monthly inspection report dated 12/4/17. <br />UNDERGROUND STORACF[1,TANK SYSTEM <br />DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT <br />I `i`tlt al-ne: Waterloo Shell <br />--_ <br />�cllit-V Address: 4315 E. Waterloo Rd <br />Name (--)I.Designated (IST operator Conducting lnspectic,n <br />Inspection Date: 12/4/2017 <br />City: Stockton <br />Alex Jabbari <br />International Code Council C'crtit7cation No.: 5243897 -UC <br />Signature: <br />Expiration Date: 10/3/2018 <br />Phone* (925) 389-1262 <br />Item MONFFORINC PANEL/ ALARM HISTORY <br />I. is the monitorin , .s stem owered on and in proper operating mode? <br />2 Is the monitorin r s stem not current) showingan leak alarms? <br />3. Is the Alarm 1-listory Report/log for the previous month available, and has it been reviewed by the <br />Desi mated UST Operator? (Attach a copy of the alarm hislor <br />y report/logreportllog to this ins ection orm. <br />4. 1 Has each alarm for the previous month been responded to appropriately? <br />\/A - tint A lieahle <br />�Yesl No N/A <br />THIN <br />UST SYSTEM INSPECTION <br />5. Are tank -top containment sumps free of water, debris, and hazardous substance? ,vote: l/ the rinsti+ger to Item was "Yes. "or <br />"NA"skip to /tem 6 Sumps where an alarm has occurred in the past month must he inspected ija quuhried senvire tee{lrucrun has not responded <br />to and ro erl addressed, the cause of the alarm. Documentation veri in g appropriate service should he uttached m this report. <br />Yes I No Yes I No <br />Sump Location: L U Surnp Location: <br />_ <br />Sump Location: ❑ ❑ Sump Location: <br />6. Ares ill buckets (containment structures) free of water, debris, and hazardous substance," <br />Yes No N/A <br />Tank I ID —Regular Tank 3 ID - <br />Tank 2 ID — Premium Tank 4 ID — <br />7. Are under- is enser containment areas free of water, debris, and hazardous substance? <br />Yes No N/A �_r IS!lPdlser— 1/7F1 I flicnonser 9/10 <br />Aaron Hang, EHS <br />Yes 1 No I N/A <br />Yes I Net I N/A <br />Page 27 of 36 <br />