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UST OPERATOR MONTHLY INSPECTION ° <br /> A <br /> Facility Name:RAMOS OIL-FRECH CAMP w-• ,.. <br /> Facility Address:10842 S HARLAN RD <br /> 2 S f w <br /> City/State/Zip:FRENCH CAMP/CA J <br /> Designated UST rat • am 1 Delgado Phone:916-371-2570 <br /> ICC Certific ion Nu er.10 5203- c Expiration Date:2-25-2013 <br /> Signatur i ' Date: i <br /> Item MONITORING PANEL/ALARM HISTORY Y NTA <br /> — <br /> 1 Monitoring system is powered on and in proper operating mode. ❑ ❑ <br /> i <br /> 2 Monitoring system is not currently showing any alarms or warnings. 7E-1 ❑ <br /> 3 Alarm history report/log for the previous month is available,and has been reviewed by the Designated UST Operator. 0 ❑ ❑ <br /> 4 Each alarm for the previous month has been responded to appropriately. ❑ <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. ❑ ❑ <br /> Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responed to,and properly addressed,the cause of the <br /> alarm. Attach documentation verif mi a ro riate service to this re ort. If sum ins fiction is re uired,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 properly. <br /> Note: Visual inspection of sums is only required in sumps where an alrm has occurred in the pasi month for which there is no service record. <br /> Y N N/A Y N N/A <br /> Sump Location: ❑ ❑ 1 ElSump Location: —11 -0- 11Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ ❑ <br /> Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ Cl <br /> Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ ❑ <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N/A Y N N/A <br /> Tank I-Contents: DFC Rrl ❑ ❑ 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: ❑ [1 ❑ 1 Tank 10-Contents: ❑ ❑ ❑ <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Y N N/A Y N N/A <br /> Dispenser# 1 ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# i A-&_7: 1 RI(E] ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# 2A&31k ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# A4 ❑ Dispenser# El El ❑ <br /> Dispenser# 4A&5 ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser#.5A "Iel� E] E] Dispenser# El11 11 <br /> Dispenser# ❑ ❑ ❑ Dispenser# ❑ ❑ ❑ <br /> P.O.BOX 401,W SACRAMENTO,CA 95691 (800)477-7266 <br />