COMPLIANCE INFO_1985-2005 - Laserfiche WebLink

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DesignatecOnderground Storage Monthly Visual Inspection li Facility Name, Date: Facility Address: ZiD Code: Valley Underground Tank onitorin Mailing and Remittance Address: Valley Underground Tank Monitoring P.O. Box 91 Stockton, CA 95201 Designated UST Operator Conducting the Ins ection: International Qgde Council Certification : Expiration Date: Si nature: Phone: Y=Yes, N=No, NA=Not Applicable Item onitorinPanel/Alarm HistoryY N 7N A onitorin system is powered on and in proper operator mode. onitorin system is not currently showing any alarms or warnings. arm Ristory'repoiffllog fort the previous mint es avis a e,an as been reviews by the Designated UST Operator. (Attach a copy of the alarm history report/log if available). ac a arm 737-the previous month as een respon e to appropriate y. ensors oca e m tan -op containment sumps-h-a—venot alarmed in the past monffi- -Ta— List a tan -top sumps where a arms occurre int a past mont (Vote:Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to, and property 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 an -top containment sumps are tree o water, ens,an azar ous su stance. Sensors are located properly. Note:Visual inspection of sumps are only required i n sumps where an alarm has occurred in the past month for which there is no service record ump ocatson: um Location: bump Location: bump Location: ump ocatson: um ovation: pi containment structures are ree o water, a ns,an azar ous su stance. Tan - intents: v an -Contents: Tan - ontents: an 4- ontents: Under-dispenser containment areas are ree o water, ens, an azar ous su stance. ensors are located properly. aspenser v-- ispenser aspenser I ispenser aspenser aspenser 4 aspenser aspenser Ito Paperwork Inspection Y N NA onitonng system verb ovation has been comp ate —within past 12 mint s. 77 icon ary containment tests have een camp ate wit in re uire time rame. 77'�TP—M containment structure uc et testing was compete wit in past year. an tig tness testing was compete wit in require time rames. ane tagtress testing was comp ate wit in regwre timer—am—e. 4 Uther require es ing mainenanEe was completed within require sine rame. (List maint. items below). es maintenance: es maintenance: es maintenance: Facility Employee Training Y A acs it imp o ees ave received the require on-the-job training in t e past year. 16 All acs ity employees hired within t e past ays ave received the require on-the-job training. Note: Any answer of"N"should be explained in the comment section on the following page, and will require follow-up action. Pg. 1 of 2