Laserfiche WebLink
01/26/2012 11:41 1561 CHEVRON PAGE 02/05 <br /> Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> I Date: <br /> Facility Name,Chevron --)1-7 ------- <br /> r n# <br /> Address: <br /> acility Address: I t Q_ <br /> I Zip Code: <br /> City: 4raA O&L <br /> y <br /> tL UST <br /> S <br /> i UDesl na!Ediii��erator �ducting the Inspection: Edward Dahl gren <br /> i IC T C C1 ------ <br /> T Council <br /> t9/28/2012 <br /> nten-iationsLl Code Courcil.CexttlLagoR: 8016980-'UC 0 <br /> T Ex Date; <br /> Si irate: Movie-(916) 271-2363 <br /> V-Yes,N=No, A=Not AppUcable <br /> Tteue Y N NA <br /> MONMONI'T'ORINGORINPANEL ALARM HISTORY <br /> Z_ <br /> J <br /> I monitoriug tern is powc ode. N <br /> 2 monitoritig system is not ctrrrentl showzn an alarms or warnings. <br /> 3 Alarm history report/log for the previous month is available,and has been reviewed b the <br /> ne <br /> history report1log to thisfo�Lif�avwaifa�ble.) <br /> Designated UST Operator. (Attach a the alarm <br /> 4 Each alarm for the previous month has been re§ponded to approl2riately. <br /> .5 Sensors located in tank-to cQntainment sum shave not alarrrxed in the )ast month. _*Z <br /> 5a - List all tank-top rumps where alarms occurred in the past month: <br /> Note:Sumps where an alarm hay occurred if,the past month must be inspected unicas a qualified service technician reg onded to,and <br /> properly addressed,the cause of Ow alarm.Attach documentation verifying appropriate service to this report. <br /> 1 1 rIVI/1-11 <br /> if su I�,ewction is re aired record rmits in item 6,below. <br /> T <br /> UrZT SYSTEM INSPECTION <br /> J� <br /> 6 Tank-top <br /> op contttinment sumps acre free of water,debris,and hazardous substance. Sensors are located properly. <br /> -umps wh mo rw there Is service <br /> record <br /> —ONote:P"aual in��crjon qf��m uired in A ere an alarm has occurred bt the ich th 0 service <br /> �s is only rea re Y N .N <br /> Sump Location: 87#1 Sum Location: 97 <br /> Sump Location. 87#2 sum Location:.Diesel <br /> Sum Location:89 Sum Location: <br /> 7 Sill containment structures are free of water,debris and hazardous substance. <br /> YT_N NA <br /> Tank 1--Contents:87#1 Tank 3—Contents:89 or 91 <br /> Tank 2—Contents:8742 or 69 —Contents:91 or Diesel <br /> containment areas are free of water,debris and hazardous substance. Sensors are located erIy- <br /> Y N NA Y_ N_ NA <br /> 11/12 <br /> D'sp eraser 1 2 Drs user <br /> Dispen er 3 4 Dispenser 13 114 <br /> Das enser 5 6 Dispenser 15 116 .1-1 <br /> Disp�enser 7/8 71 Dispenser 17118 <br /> Dispenser 9/10 D!'Menser 19120 <br /> PAPERWORK INSPECTION Y N NA DATE DONE <br /> Y <br /> 9 Monitoring s stem certification has been co feted within past 12 months. <br /> 10 Secondary containment tosts have been 0--U—(0 <br /> I I Svill containment structure(bucket)testing was coLaplge <br /> 12 Tank tightness testing was completed within required timeframe. <br /> 13 Line tightness testinE was con feted within reauired timeframe. <br /> within required timeframe. m ten --- <br /> 14 Other rcquired testin aintenance was completed e me, (List testl ance items below. <br /> T <br /> TestlMaintenance:LLD tej�E _was corn �tdrleted within the timeframe <br /> Test/.maintenance: <br /> TestlMaintenance <br /> FACILITY EMPLOYEE TRAINING Y <br /> 15 All facility cmployees have received the required on-the-job training within the est year. inin& <br /> 16 All facili!y employees hired within the past 30 kshave <br /> Note: Any answer of"IN"should be explained in thecommentsection on the following page,and will require <br /> follow-up action. <br /> Page I of 2 November 2004 <br />