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F � r <br /> '* <br /> UST OPERATOR MONTHLY INSPECTION <br /> Facility Name:RAMOS OIL,-F'RE7I-1 CAMP <br /> I} , <br /> Facility Address:10842 S FIARL KD <br /> City/Slate/Zip:FRENCH <br /> R 1 fY H <br /> M <br /> Designated USTOpe or.Sa el Igad I'honc:916-371-2570 - �' <br /> ICC Certification umbey- )6520 <br /> Expiration Date:2-25-2013 <br /> Signature: <br /> Date: <br /> Item MONITORING PANEIJALARM HISTORY Y N N/A <br /> 1 Monitoring system is powered on and in proper operating mode. V Jo ❑ <br /> 2 Monitoring system is not currently showing any alarms or warnings. <br /> 3 available,and has been reviewed by the Designated USI'Operalor. 10 <br /> Alarm history report/log for the previous month is <br /> 4 Each alarm for the previous month has been responded to appropriately. ❑ <br /> .5 Sensors located in tank-tap containment sumps have not alarmed in the past month. ED ❑ ❑ <br /> None: sumps where an alarm has occurred in tau:past nunuh MUNI he inspected unkSs:I yualificd service rerhnician restuun:d to,and properly addresscd.Ila caux ol'rhe <br /> alarm. Attach docurtxnmation verif lin+a rt, riate service Ur This re ttr. If sump ins •cliun is 119 ired,ruwrd results in item 6,be-krw. <br /> UST SYSTEM INSPECTION <br /> 6 'rank-top containment sumps are free of water,debris,and hazardous substance. Sensors arc located properly. <br /> Note: Visual insnectiom of sumps is onl•required in sums wlxre:m alrm has occurred in the ast n I lift which Ih-re is nu service rectud. <br /> Y N N/A Y N N/A <br /> Sump Location: ❑ ❑ ❑ Sump Location: ❑ ❑ <br /> Sump Location: ❑ ❑ Sump Location: C3 E-1 ❑ <br /> Sump Location: ❑ ❑ Sump location: ❑ ❑ <br /> Sump location: 1-10-1:11] ❑ Sump Location: <br /> 7 Spill containment structures are free of water,debris,and hazardous ubstance. 0. <br /> Y N N/A Y N N/A <br /> Tank 1-Contents: DI'C ❑ -rank 6-Contents: ❑ ❑ ❑ <br /> Tank 2-Contents: El 'rank 7-Contents: ❑ ❑ <br /> "rank 3-Contents: ❑ ❑ 'rank 8-Contents: ® ❑ <br /> "rank 4-Contents: ❑ ❑ ❑ "rank 9-Contents: ❑ ❑ <br /> -rank 5-Contents: ❑ ❑ ❑ 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 Z ❑ Dispenser# ❑ ❑ Cl <br /> Dispenser# 1, -&-.Q-- ❑ Dispenser# ❑ <br /> Dispenser# 2A&3 Dispenser# <br /> Li ❑ <br /> Dispenser# - Dispenser# ❑ ❑ <br /> -5 F-P-enser# 4A&5 ❑ ❑ Dispenser# ❑ ❑ ❑ <br /> Dispenser#5A ❑ ❑ Dispenser# ❑ <br /> Dispenser# ❑ ❑ U Dispenser# ❑ <br /> P.O. BOX 401,W SACRAMENTO,CA 95691 (800)477-7266 <br />