COMPLIANCE INFO_1985-2005 - Laserfiche WebLink

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DesignateRinderground Monthly sInspection Checklist Facility am � Date: Facility Address Ci Zi C e: Valley Underground Tank Monitoring Mailing and Remittance Address: Valley Underground Tank Monitoring P.O. Dox 91 Stockton, CA 95201 Designated UST Operator Conducting the Inspection: linternational,Cp,de Council Certification t Expiration Date: Si nature: Phone: /f Y=Yes, N=No,NA=Not Applicable Item Monitoring Panel/Alarm Y N NA onitorin system is powers on an i��e perator mo e. onitorin s stem is not current sowa arms or warnin s.arm istory repo og or t e previousis avai a e,an as sen reviewe by the Designated UST Operator. (Attach a copy of the alann history report4og if available). ac a arm ort e previous mint as sen responded to appropriate y. ensors oca a in tan -top con ainment sumps have not alarmed in TFe past mon a List a tan -top sumps where alarrrisiocwrred int the past mint � � t, Note: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 Tank-lop containment sumps are reeo water, a ris, 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 ovation: ump ovation: ump ovation: Sump ovation: Sump ovation: umLocation: pi containment structures are tree of water, de ns,and hazardous substance. T an - ontents: an - ontents: Tanonts: an - ontents: containment areas are ree o water, debris, and hazardous substance. Sensors are located properly. Di-spenser7TT Dfspenser 9/10 ispenseris enser ispenserDispenser 13/14 is enser ispenser TO Paperwork Ins ection Y N RIA onitonng system cern ication as een compete wit in past mont s. Secondary containment tests ave been comp ete wit in require time rame. pi containment structure uc et testing was compete wit in past year. Nan tig tness testing was compete wit in require time rames. Line tig tness testing was compete wit in require time rame. 4Other require es ing main enance was comp e e wi in requirelime rame. (List maint. items below), es maintenance: es maintenance: es maintenance: Facilit to a Trii Y N NA aci it imp ogees ave receive t e require on-t a-jobtraining in the pas----. aci ity imp ogees ire wit int a past ays ave received the require on-the-job training. ote: answer o " shout explains i the c int section on the following page, and ill require follow-up action. Pg. 1 of 2