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UST OPERATOR MONTHLY INSPECTION <br /> Facility Name:RAMOS OIL-FRECH CAMP <br /> Facility Address:10842 S HARLAN RDy Qj'�7 <br /> jt.lt <br /> City/State/Zip:FRENCH CAMP/C <br /> Designated UST_O el D ado Phone:916-371-2570 '­, 7-ALT' <br /> ICC Certific on Nu r:1 65 3'u Expiration Date:2-25-2013 w <br /> Signature: Date: <br /> Item MONITORING PANEL/ALARM HISTORY Y N/A <br /> I Monitoring system is powered on and in proper operating mode. ❑ <br /> 2 Monitoring system is not currently showing any alarms or warnings. ❑ <br /> 3 Alarm history report/log for the previous month is available,and has been reviewed by the Designated UST Operator. ❑ <br /> 4 Each alarm for the previous month has been responded to appropriately. IZI ❑ <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. 11 el ❑ <br /> Nate: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician respond u>,and properly addressed,the cause of the <br /> alarm. Attach documentation verif in i a ro riate service to this re ort. If sum ins fiction is re wired,record results in item 6,below. <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are located property. <br /> Nate: Visual inspection of sums is only required in sums where an alrtn has occurred in the past month lit which there is no service record. <br /> Y N N/A Y N N/A <br /> Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ ❑ <br /> Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ ❑ <br /> Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ ❑ <br /> Sump Location: ❑ ❑ .❑ Sump Location: ❑ ❑ ❑ <br /> 7 Spill containment structures are free of water,debris,and haza ous substance. <br /> Y IN N/A Y N N/A <br /> Tank 1—Contents: DFC ❑ ❑ Tank 6—Contents: ❑ ❑ ❑ <br /> Tank 2—Contents: ❑ ❑ ❑ Tank 7—Contents: ❑ ❑ ❑ <br /> Tank 3—Contents: ❑ ❑ ❑ Tank 8—Contents: ❑ ❑ ❑ <br /> Tank 4—Contents: ❑ ❑ ❑ Tank 9—Contents: ❑ ❑ ❑ <br /> Tank 5—Contents: ❑ ❑ ❑ Tank 10—Contents: 13 ❑ <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Y N/A Y N N/A <br /> Dispenser# 1 ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser 2, ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# 2A&30- 11 ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser#e4A-&rd 0 lf3,o ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# 4A&5jA ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser 4—'A— E ❑ ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# ❑ ❑ ❑ Dispenser# ❑ ❑ ❑ <br /> P.O.BOX 401,W SACRAMENTO,CA 95691 (800)477-7266 <br />