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V8. INSPhuIrury rrra,...�. <br /> revioUs inspect on beer completed appropnateh" _ s <br /> ,,��-Jc a4f,cn of Section Ill f xn the p t _��0 <br /> `S - n� }'in SP 're service to this <br /> .�.arentado VIII. — N <br /> a ,AI. RPiI fi1STORY <br /> to this re ri - <br /> F of the alarm his +ePo't —.. e —o <br /> arias"a t ratio mode? - <br /> a nax system veered on and n roee ope n c o^ded to appropriately,°' J <br /> Is Ie previous inspect bAe rep _ - - <br /> Fi-s each teak detect on alarm stn nai�service to this sem E <br /> gtrach documetttaSon that have h,�d a!e'ti detec�an alarm sjn�the previous inspection been r sp s .--, h4 <br /> Have all containment surpsician' <br /> C;;a flied UST Sf'Zoe Tech hat have had a leak detection alarm since the previous inspection and have not been <br /> List . Section IX.11 containment Kumps tlisted below require a <br /> eta Sec qualified USE Service <br /> sensor ecaticiam Contain n. a results of the v s4va9 r`ns ec on must bevrecorded lin Section IX. <br /> isuat inspection for mage,water.debris. <br /> hazardous substance.and rc <br /> 1x. UNDERGROUND STORAGE TANK SYSTEM INSPECTION <br /> de <br /> b^s. and hazardous substance? ---__ <br /> is a containment sump` c`da na "a"r Containment Sum�ID Y N <br /> Y N - ------ <br /> Containment Sump ID x ❑;— —� ❑? <br /> 87 OCTANE S T P — — - ❑ - ❑ <br /> ❑ ❑' ,.,. ,. <br /> ❑ <br /> 01 -C TTAN _►'— <br /> - <br /> ❑ 0 <br /> Are.sit sensors.in containment sumps inspected located to detect a teak at the earliest opportunity? 1] <br /> - <br /> is the spilt container f�-ae cr olamaoe water,debris,and hazardous substance? ❑ <br /> TankiD <br /> TanklD Si OCTAN€ [ Tank ID ❑t <br /> 'ITank ID ,91 OCTANE <br /> is the fill pipe free of obstructions- ❑ Tank ID ❑ <br /> ' Tank ID 487'OCTANE ❑ ❑ <br /> TanklD 191 ❑'OCTANE x ❑I Tank ID <br /> is the fill cap secureiv on the fl!p€oe? ---- - ❑ ❑ <br /> Tank ID ;$7 OCTANE ❑ Tank ID _ <br /> TanklD 91 OCTANE D ❑ TanklD L ❑ ❑ <br /> s the under-dispenser containment free of damac a water,debris,and hazardous substance? <br /> Under-Dispenses Containment ID Y N j NN N <br /> A Under-Dispenser Containment ID Y <br /> dispenser 1/2' _ <br /> D ❑ © i Dispenser 314 ❑1 ❑ <br /> dispenser 56 <br /> R ❑ ❑ Dispenser 7/8 ❑ ❑ <br /> ❑ Eli ❑ ❑ ❑ <br /> _ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑� ❑ ❑ 101 <br /> °5kre all sensors in under-dispenser containment located to detect a leak at the earliest opportunity? ® ❑ ❑ t <br /> L .. <br /> Date Last <br /> X. TESTING AND MAINTENANCEY N NA_ Performed <br /> as the monito�rmc s s er;, ..,., 1:a-,!or been completed within the past 12 months? ®� ❑ <br /> bi12/13/2017 <br /> �-:as t e sp:;i ccntaine:,r test,ng been completed within the past 12 months? Q ❑ 12113120171 <br /> Has the overfill prevention equipment inspection been completed within the past 36 months? ❑ ® ❑ <br /> as the secondary containment testing been completed within the past 36 months? [O ❑ f-112/31/2015 <br /> as the tank tcritness testing been completed within required timeframes? ❑ Q 0 <br /> Oaas;he line tightness festinc been completed within the required timeframes? ❑ D <br /> inc maintenance,las completed within required timeframe. (List test/maintenance items below, <br /> El <br /> TEc. l)ic^ nance El <br /> i fAa,n_enance: --- --- <br /> I. Tes< !Za r-lena ice <br /> -r <br /> i ES,'Van,Fna^jE <br /> t? <br /> V TES?'f4a^`,+r`ianoe , El 1 <br /> XL FACILITY EMPLOYEE TRAINING <br /> vE ail;rid, ,o a!s penton r!Ing factitty employee duties'received the required facility employee training within the past 12 months? <br /> _ <br /> facility has more components than this form accommodates additional copies of this page may be attached. <br />