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I ]Iff-1CZIVED <br /> WIGHT ENT.ARCO#2133 2094785552 <br /> JAN 2 7 2014 <br /> UNDERGROUND STORAGE TANK SYST <br /> DESIGNATED UST OPERATOR MONTHLY INSPEC OktrHEALTH <br /> RTMENT <br /> Facility Name: Area AIVI-PIVI Inspection Date: 3> <br /> Facility Address; 2908 W, Benjamin Holt Dr. City: Stockton, CA95207 !- <br /> Name of Designated UST Operator Conducting Inspection: ,1 6 14 <br /> International Code Council Certi Expiration Dat6,: <br /> 57Z 2-7j�o C <br /> ✓ -S. <br /> Signature: ✓ Phone: {916} 71-2380 <br /> i <br /> NIA=Not Applicabte <br /> Item MONITORING PANEL/ALARM HISTORY Xes No I N/A <br /> I. Is the monitoring system powered on and in proper gerating mode? <br /> 2. Is the monitoring svstern not currently showing any leak alarms? :F1 <br /> 3. Is the Alarm History Report/log for the previous month available,and has it been reviewed by <br /> Designated UST Operator? (Attach a copy of the alarm histo Ly rep2Ltllog to this inspection a m.) <br /> 4. Has each alarm for the previous month been responded to appropriately? 0 1 Li <br /> UST SYSTEM INSPECTION <br /> 5. Are tank-top containment sumps free of water,debris,and hazardous substance? Note:if the--+erio Item 4 was Tes'.skip <br /> to Item 6.Sumps where an alarm has occurred in the past month must be inspected if a qualy?ed service technician has not responded to,and <br /> properly addressed,the cause ofthe alarm Documentation very in wo rjare service should be attached to this ort. <br /> Ve! No No <br /> Sump Location: F-1 El Sump Location: I 01-2j <br /> Sump Location: I Ej I " I Sum o Location: I Lj I Li I <br /> 6. Are spill buckets(containment structures)free of water,debris,and hazardous substance? <br /> Y,es No N/A Yes No N/A <br /> Tank I ID—87-1 911 01 Tank 4 ID I <br /> Tank 2 ID—87-2 [K]_[ E] I Tank 5 ID M-1 <br /> I Lj I U —21 <br /> Tank 3 ID—91 [a I F-1 I r] I Tank 6 ID— <br /> 7. Are under-disuser containment areas free of water,debris,and hazardous substance? <br /> Yes No NIA I Yes No N/A <br /> Dispenser—1/2 Dispenser— <br /> j Dispenser—3/4 Dispenser— 0 2u <br /> j Dispenser—5i6 M I Dispense. <br /> 1 Dispenser—7/8 IF] F1 I Dispenser— <br /> 8. Leak detection is roper! located—;thin 1-In- r-dispenser containment. <br /> Yes I No NIA Yes No NiA <br /> Dispenser— 112 Dis ense 4ni <br /> Dispenser—3/4 Dispenser— 0 71 Rr <br /> Dispenser—5/6 '� M El [7- Dispenser— <br /> DiSDenser—7/8 1 E) I EJ Dispenser— <br /> PAPERWORK INSPECTION <br /> PAPERWORKINSPECTION Yes I No I N/A Date Done <br /> —9. Monitoring System Certification was completed within the past 12 months? 1711 1-23-2013,111- <br /> 10. Line Leak Detectors were tested.Icertified within the past 12 months? 1 1-23-2013 <br /> 11. Spill bucket(containment structure)testing completed within the pMt 12 months? 1-23-2013 <br /> 12. Line ti tress tesqg&completed within the required time frame? <br /> 13. Secondary containment tests completed within the required time frame? 4-29-2011 <br /> 14. Enhanced Leak Detection completed within the required time frame? =TTI 0 1 <br /> 15. Other required!Ls�. tenance was completed within required time frame? (List test/maintenance items below) <br /> Describe Test/Maintenance:Air Quality St 27&30 2-9-2013 <br /> Describe Test/Maintenance: <br /> FACILITY EMPLOYEE TRAINING I Yfts I No J_N/A <br /> 16. Have all facili ern plogees received the required on-the-job training within the past year? I <br /> 17. Have all facilt loyees hired within the past 30 d!Xs received the reguired on-!he ob trainaiFT LJ1 <br /> Note: Explain any"No"answers in the"Comments"section on the following page.Those issues require corrective action from <br /> the UST owner/operator. <br /> UN-057-112 www.unidoes.org 9/26105 <br />