Laserfiche WebLink
FROM FAX NO. 19 2013 04:29PM P3 <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT <br /> Facility Name, 8B Gas&Mart inspection Dafe�---Ish 12, 2013 <br /> Facility Address: 6615*� <br /> 1 St. City: Tracy <br /> Name of Designated UST Operator Conducting XW000n: Robert Barnhart <br /> Intern , a -1 Certification No.: 6252640-Ur- Expiration Date: 1/28/2014 <br /> SignIntern <br /> . --- --- 11 <br /> Phone: (209)604-9,336 e,-t. <br /> =Not Applicable <br /> Item MONITORING PANEL/ALARM HISTORY Yes No NIA <br /> I. Is the monitoqq&system powered on and in proL)er operating mode? <br /> 2. Is the monitor <br /> in <br /> Z system not currently showing any,leak aim=? <br /> 3. Is the Alarm History Report/log for the previous month available,and has it bee;reviewed by the <br /> Desi UST Operator7 (Attach o 1�e alarm history teport1log to this ins pectionf <br /> L <br /> 4. Has each alarm for the previous month been responded to appropriateW <br /> UST SYSTEM INSPECTION <br /> Are tank-top containment sumps free of water,debris,and hazardous substance? Note:Ifthe answer tollem 4 was"Yes,"skip <br /> to Item 6 Sumps where an alarm has occurred in the past month must be inspected if a qua1&dwrW&v sechairdan has not responded to,and <br /> eNeerly addressed,the cause of the alarm. taionver* ' oppp4wriateservice should beattached iothis report, <br /> Yes---Li El <br /> WC-97!�?3 Yes No <br /> Sump Location: U,: Sump Location: 10 <br /> ----------------- <br /> Sump Location; t4.s. Sump Location: <br /> 6. .. <br /> ate and hazardous substance? <br /> � <br /> Fr <br /> Are spill buckets(containment structures)free of--Wttm—a-dM <br /> YesNo N/A Yes No NIA <br /> - <br /> Tank I ID Regular 1--a-1 F1 I El I Tank 4 ID- <br /> Tank 2 ID-Diesel Z I Lj I Q I Tank 5 ID- <br /> Tank 3 ID-Premium N I Lj I Ll I Tank 6 ID- <br /> 7. Are under-di ner containment areas free or water,debris,and hazardous substance? <br /> Yes No I N/A Yes No I N/A- <br /> JR enser-1/2 fn <br /> �p Dispenser-9/10 <br /> Dis or-3/4 Lj Dispenser 11/12 <br /> Dispenser-5/6L11 Li Di ser 13/14 <br /> DisperiseT-7/8 LJ I LJ Dispenser-15/16 <br /> 8. Leak detection is property located withinunder-dispenser containment. <br /> Yes No I N/A Yes No <br /> Disp2nser-1/2 _Rispenser-9/10 ❑ <br /> Dispenser-3/4 L Dispenser-11/12 <br /> F-1 Di, <br /> ser-13/14 <br /> Dispenser-7/8 Dispe��g:J5/16 <br /> PAPERWORK INSPECTION Yes-FN-o--FN/A Date Done, <br /> 9. Monitoring System Certification was completed within the past 12­Fmonft! LJ I U 6/1/2012 <br /> -TO. -Ulfie Leak Detectors were tested/certified within the past 12 months? 0 LJ 6/1/2012 <br /> if Spill bucket(containment structure)testing completed within the past 12 months? -IT 6/1/2012 <br /> 127-Line tightness testing coMpleted within the required time frame? <br /> 13. Secondary containment tests completed within the required time frame? <br /> El F-1 6/20/2012 <br /> 14, Enhanced Leak Detection completed within the required time frame? <br /> IS. Other re aired testintmaintenance was,completed withineeealmaintena items below.) <br /> Describe Test/Maintenance:Air QualityL ed time Ist-,9 F-1 8/ <br /> Describe Test/Maintenance:V/L 2/61/2012 <br /> LJ /2111012 <br /> .r N1 ....Xl4. . <br /> FACILITY EMPLOYEE TRAINING I Yes No I NIA <br /> 16. 1 I-lave all facility empi received the required on-the-job trainin within the past year? <br /> 17, 9 reqej <br /> I Have all fhcil!E�employees hired within the past 30 day-received the uird on-the---trainin .? <br /> - <br />