COMPLIANCE INFO_2010-2018 - Laserfiche WebLink

Home Browse Search

UNDERGROUND STORAGE TANK SYSTEM DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT APR 17 2012 Facility Name: country Club Mini Mart Inspection Date: April 9, 2012 Facility Address: 1856 Country Club Blvd. City: Stockton Name of Designated UST Operator Conducting rnspec art Internati Co ouncil Ce ation No.: 5252940,UC- Expiration Date: 1/28/2014 Signa e: Phone: 604-9336 ext. I N/A N = Not Applicable Item MONITORING PANEL ALARM HISTORY Yes No 1. Is the monitorin system powered on and in proper operating mode? 17. Have all facility employees hired within the past 30 days received the required on -training.? 2. Is the monitoring system not currently showing any leak alarms? I Z 3. Is the Alarm History Report/log for the previous month available, and has it been reviewed by the Designated UST Operator? (Attach a copy ofthe alarm history reportllog to this ins pectionform) 1E] El I 4. Has each alarm for the previous month been responded to a22r2griately? El ED (VAKI"V, OFM UST SYSTEM INSPECTION 5. Are tank -top containment sumps free of water, debris, and hazardous substance? Note: If the answer to Item 4 was "Yes, " skip to Item 6. Sumps where an alarm has occurred in the past month must be inspected if a qualified service technician has not responded to, and properly addressed, the cause of the alarm. Documentation verifying appropriate service should be attached to this report. Yes I No I= I Yes Sump Location: E] I [:] Sump Location: ❑1 El [71 0 Sump Location: 10 Sump Location: 19 M 6. Are spill buckets (containment structures) free of water, debris, and hazardous substance? Yes No N/A Yes No I N/A I Tank I ID — 91 1 Z I [—] I E] Tank 4 ID — El ❑ El Tank 2 ID — 87 1 N I El I [j Tank 5 ID — El El El Tank 3 ID — I E] I E] I L] Tank 6 ID — El 1:11 El 7. Are under -dispenser containment areas free of water, debris, and hazardous substance? Yes I No N/A I Yes No I N/A Dispenser — 1/2 El ❑ Dispenser — 9/10 Dispenser — 3/4 Z 1:1 [:] Dispenser —11/12 Dispenser — 5/6 ❑ -0- El Dis enser _ 13/14 ol El I U-1 Dispenser — 7/8 ispenser — 15/16 El ICEFFIE-1 8. Leak detection is properly located within under -dispenser containment. Yes I No I N/A Yes I No N Dispenser — 1/2 M ❑ Ej Dispenser— 9/10 Dispenser — 3/4 Z❑ El Dispenser — I 1/ 12 El El 1:1 Dispenser — 5/6 0 El El Dispenser — 13/14 El F1 El Dispenser -7/8 [_1 El 1 [:1 , Dispenser — 15/16 1:1 1:1 1 1:1 WrAWN W*kMVAWW%W PAPERWORK INSPECTION Yes I No IN/A Date Done 9. Monitoring System Certification was completed within the past 12 months? ❑ Z El 1/21/2011 10. Line Leak Detectors were tested/certified within the past 12 months? ❑I M 1 [:1. 1/21/2011 11. Spill bucket (containment structure) testing completed within the past 12 months? E] I Z I El 1/21/2011 12. Line tightness testing completed within the required time frame? ❑ El 0 13. Secondary containment tests completed within the required time frame? El M E] 12/23/2008 14. Enhanced Leak Detection completed within the required time frame? 1:1 El 1 2 1 15. Other required testing/maintenance was completed within required time frame? (List test/maintenance items below.) , Describe Test/Maintenance: Air Quality I N 10 1 0-F-1/24/2012 Describe Test/Maintenance: I El I El El FACILITY EMPLOYEE TRAINING Yes I No I N/A 16. Have all facility employees received the required on-the-job training within the past year? 0 E] ❑ 17. Have all facility employees hired within the past 30 days received the required on -training.? Lj I Ll I Z 9/26/05 UN -057 -1/3 www.unidocs.org