COMPLIANCE INFO_2005 - 2012 - Laserfiche WebLink

Home Browse Search

Designated Underground Storage Tailk(UST) tLrNerator Monthly Visual Inspection Checklist 'acilit Name: 99 Shell Date: _C- ,facilil Address: 7700 Moreland Ct 12 City: Stockton Zip Code: Designated UST Operator Conducting the Inspection: Lori Freshour International Code Council Certification#: 5220353-UC Expiration Date: 9/17/07 Si Phone: (916)826-1576 Item I MONITORING PANNI AIARM HISTORY ' Y N NA 1 Monitoring system is powered on and in proper operating wade 2 Monitoring system is not currently showing alarms or warnings 3 Alarm history report/log for the previous mordlt is available,and has been reviewed by the Designated UST Operator. (Attach a copy of the alarm history report/log to this form if avaitab le) 4 Each alarm for the previous month has been responded toappropriately. 5 Sensors located in the lank couLaitunerd humps have not alarmed in Ile month 5a list all tank-top sumps where alarms occurred in the past month: Note:Sumps where an alarm has occurred in the past month must be inspected unless a quahjied service technician responded to,and N properly addressed,the cause of the alarm. Attach documentation verifying appropriate service to this report. If sump inspection is required,record results in item 6,below. UST SYSTEM INSPECTION 6 Tank-top conta orient sumps are free of water,debris,and hazardous substance. Sensors are properly located Note Visual dLVection of sumps is orgy tagured in unps where an alarm has oocured in the past month tar which there is no service record Y N Y N Sump Location: Sump Logon: Sump Location: Sump Location: Sump Location: Sum Location: F--' Tank 11 containment structures are free of water,debris,and hazardous substance. Y N NA Y N NA 1-Contents S tN L__ -_ _y Tank 3-Contents Dt L- 2- _2-Contents _y Tank 4-Contents NA 8 UDC areas are free of water,debris,and hazardous substance. Sensors are properly located Y N NA Y N NA Dispenser 1/2 Dispenser 9110 Dispenser 3/4 Dispense 11/12 t4 fl Dispenser516 Dispenser 12/13 Dispenser 7/8 Dispenser 14/15 PAPERWORK INSPECTION Y N NA DATE DONE 9 Monitoring tern certification has been completed within the past 12 months. 10 Secondary Contaimnent tests have been completed within the reqLxred timeframe.' N L- 11 Spill contairunent structure et testing was completed within the past year. -o 12 Tank ti tltress testing was completed within required timeframe. 13 Line titress testing was completed niith required timeframe. • 14 Other required testing maintenance was corppleted within reored timeframe. List test/maintenance items below Test/Maintenance: T V I Test/Maintenance: Test/Maintenance: FACILITY EMPLOYEE TRAINING Y N NA 15 All facd have received the ired on-the-job train within the ' 16 All facil hired within the 30 have received the red on- ob train A Note:Any answer of"N"should be explained in the comment section on the following page,and will require foll%wr act'oh. Comments: Follow-up action required: i natur : Dealer/Manage{S g s. Date: 4