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103-1 <br />or � .-Te I�esi�niteal � erator <br />416 2nd Street Galt, Ca. 95632 Monthly Inspection Checklist <br />209 744-0112 - 800 524-9087 Fax 209 744-0116 ] <br />Site: cf(11`}S_Y_ i-V\c,'Date: <br />Designated b' o ,. A. 1inkler ICC . -UC08 <br />Signatu <br />re Y�Ycs • NA� not applicable <br />1saw�L ;�A Fx.7„ r�..:�„tui:W. r�i€, to E'a 'N'a2�57.',...�..zi�`a <br />I 1 r <br />x 1V 'VA, <br />Monitoring S stem is powered on and in proper operating mode. <br />Monitoring system is not currently showing any alarms or warnings. <br />Alarm histo report for the previous month is available and has been reviewed bv D.O. <br />(Attach alarm history, if available) <br />Each alarm for the previous month has been responded to aporopriately. k <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />List all tank -top sumps where alarms occurred in the past month: 40 <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded <br />to, and properly addressed, the cause of the alarm. Attach documentation verging appropriate service to this report. <br />l(sumv ins <br />ection is required, record results in item #6 below. <br />MEN= R <br />UST SYSTEM INSPEC'T'ION <br />Y N .. Y N N <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors located properly. <br />—Note: Visual <br />inspection of sumps only required in sumps where an alarm has occurred in the past month for which there is no service record. <br />Sum location: jp Sump location: <br />..Sump location: PIT Sump location: <br />"hum location: Sump location: <br />Spill containment structures are free of water, debris, & hazardous substance. <br />Tank i - Regular Tank 4 - Diesel <br />Tank 2 -Plus Tank 5 - }� <br />Tank 3 -Premium Tank 6 - <br />Under -dispenser containment free of water debris & hazardous substance. Sensors located ro <br />erl . <br />Dispenser 1/2 1 %k' Dis enser 19/20 <br />Dispenser 3/4 j712 X Dispenser 21 <br />Dispenser 5/6 Dis enser 22/21 Satellite <br />Dispenser 7/8 Dis enser 23/22 Satellite <br />Dispenser 9/10 "Dis' enser 24/23 Satellite <br />--Dispenser 11/12 --Di enser 25/24 Satellite <br />Dispenser 13/14 .I7s enser 26125 Satellite <br />Dispenser 1 Dispenser 27/26 Satellite <br />Dispenser 17/11 8 Dispenser 27 Satfe <br />Facility Employee Training <br />All facility employees have received the re uired on-the-job trainin within the ast <br />ear. <br />All facility employees hired within the past 30 days have received the required on the job training. <br />