COMPLIANCE INFO_2005 - 2012 - Laserfiche WebLink

Home Browse Search

Designall Underground Storage Tank (UST) __derator Monthly Visual Inspection hecklist Facility Name: 99 Shell Date: to Facihly Address: 7700 Moreland Ct Cit : Stockton Zip Code: . • '°. l3csigmted UST Operator Conducting the Inspection: Lori Freshour International C90s Counc I Certification#: 5220353-UC Ex irationDate:'9/17/07 Si tire: Phone: (916)826-1576 Item MONITORING PANEL ALARM HLSMRY Y N NA 1 Monitoring system is powered on and in proper operating mode 2 Monitoring system is not currently showing alarms or warnings 3 Alarm history report/log for the previous month is available,and has been reviewed by the Designated UST Operator. (Attach a copy of the alarm history report/log to this orm if available) 4 Each alarm tar the previous month has been responded W appropriately. •5 Sensors located in the tank-top containment swmps have not alarmed in th past month 5a list all tank-top sumps where alarms occurred to the past month: _ Note:Sumps where an alarm has occurred in the past month must be lnspmled unless a qualified service technician responded to,and d properly addressed,the cause of the alarm. Attach documentation verifying appropriate service to this report '1 If suTp ins non is required,record results in item 6,below. UST SYSTEM INSPECTION 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are properly located Note Vk-uWtoonotsumpgjsordyreWredin sumps where an alarm has omued in the t month for which there is no service recced Y I N Y N Sump Location: $ump Location: Sump Location. 'Sump Localion.- Sump Location: Sump Location: 7 Spill containment structures are free of water,debris,and hazardous substance:. Y I N NA I Y N NA Tank 1-Contents At_ Y I j Tank 3-Contents E Tank 2-Contents p I yj I Tank 4-Contents •.., 8 UDC areas are free of water,debris,and hazardous substance. Sensors are properly located Y N NA Y N NA Dr 1/2 DiSpeWr 9/10 6141 D. nser 3/4 Dispenser 11/12 N Dispenser 5/6 Di' nser 12/13 k Dispenser 7/8 Poenser 14/15 PAPERWORK INSPECTION Y H NA DATE DONE 9 Monitoring tem certification has been completed within the past 12 months. -p 10 Secondary Contairrrtent tests have been completed wittin the regured timeframe. y &)Zl ill 11 Spill containment structure et testing was completed within the past year 12 Tank tightness testing was completed within required timeframe. 13 Line fightriess tesfing was cornpleted with required timeframe. INA 14 Other required testing maintenance was cornpleted within required timeframe. List test/maintenance items below Test/Maintenance: --q•p Test/Maintenan e: Test/Maintenance: i FACILITY EMPLOYEE TRAINING Y N NA 15 All facility have received the recluired on-too training within the past 16 t.AJI facility tired wittin the past 30 day have received the rewired qn-thajob training Note:Arry answer of"N"sWd be explained in the comment section on the following page,and will require follow-up action. '-Comments: ' • Follow-up action required: 1 Dealbr/Manager Signature: :pate: