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FUST OPERATOR MONTHLY INSPECTION ' r <br /> F,-7111 <br /> W4 <br /> Facility Name:RAMOS OIL-FRECH CAMP <br /> Facility Address:10842 S HARLAN RD 3 <br /> City/State/Zip:FRENCH CAMP/CA <br /> Designated UST Operator. amSdo Phone:916-371-2570 <br /> ICC Certification N er.1 uc Expiration Date:2-25-2013 : <br /> Signature: Date: <br /> Item MONITORING PANEUALARM HISTORY Y N/A <br /> 1 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. 0010 <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 he inspected unless it qualified a;rvice technician respond it),and properly addressed,the cause of the <br /> alarm. Attach documentation verif in j a ro riate service:to this rcort. If sum ins •coon is ro 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,. rm has occurred in the ast month for which there is no service record. <br /> Y I 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 hazardous su lance. <br /> Y N A Y N N/A <br /> Tank i—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: 0101 <br /> ❑ ❑ <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# t <br /> ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# lDispenser# ❑ ❑ ❑ <br /> Dispenser# 2A&3 ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# 3,4-Fe 4- OOF❑ ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# 4A&5 yd, ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser#37t 5"' ❑ ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser# ❑ ❑ ❑ Dispenser# ❑ ❑ ❑ <br /> P.O.BOX 401,W SACRAMENTO,CA 95691 (800)477-7266 <br />