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05/08/2008 09:30 FAX SJEH IA 004/005 <br /> f a_ e y . ` Designated Operator <br /> C <br /> 416 2nd Street Galt, a. 95632 Monthly Inspection Checklist <br /> 209 744-0112 - 800 524-9087 - Fit% 209 744-,0116 <br /> Design atied�Oe �ur;�Zaq�eAA. NN�iwnmo ICC # SZ63322-SIC Erpirudiun. .2/3/OS <br /> Signature Y yo, N-no Nn=not qtr►>ucablc <br /> V N NA <br /> Monitorin S stern is powered on and in ru r o statin r muck. <br /> Monitoring astern is not currently showing agy alarms or wamin ls. a ' <br /> Alarm history report for the pEcvious month is available and has been revieweel <br /> (A(Wch alHmi histo violable) <br /> Each alarm for the grevious month has been responded to appropriately <br /> Sensors located.in tank-(«p conutirrrncrrt surnps have not alartned iti lite past month. <br /> List all tank-top sutnps where alarwrs nr:c:ttrred lit the pact month: <br /> Note:Sumps where an alarm has occurreel in the past month mast he Inspected unless a qualified,service technician responded <br /> to, acrd prr perly addressed, the cause of ilia alarm. Attach documentation verifying apprupriate service to thq mport. <br /> 1'sunt.v ins ection 4 mindred,mcor d re-sult.v in item 96 below. <br /> UST SYSTEM INSPECTION <br /> Y I N YIN N <br /> Tank-top containment sumps arc free of wa€cr,debris,and hazardous substance. Sensors located properly. <br /> Note: Visual inspection of sumps only required in aurripy Acre an alarm hus vecurmd in the payt month for which there is no service rt%,Ord. <br /> Surne location: <' .t' Sump location: <br /> Sump location: Sump location: <br /> SuM2 location: Sump location: <br /> Spill containment structures are free of water,debris,&hazardous substance. <br /> Tank 1 -Re alar Tank 4-Diesel <br /> Tank 2-Plus 'lank 5- <br /> Tank 3-.premium Tank 6- <br /> tinder-dis enscr containment(free of water debris &hazardous substance. Sensors located vro eel v. <br /> Dispenser 1/2 ,r Dispenser 19/20 <br /> Dispenser 3/4 pC Dispenser 21 <br /> Dis eraser 5/6 Dispenser 22/21 Satc:llito <br /> Dispenser 7/8 Dispenser 23/22 Satellite <br /> Dispenser 9/10 Dispenser 24/23 Satellite <br /> Dispenser 11/12 Dispenser 25/24 Satellite I -At <br /> Dispenser 13/14 Dispenser 26/25 Satellite <br /> Dispenser 15/16 Dispenser 27n..6 Satellite ., <br /> Dispenser 17/18 Dispenser 27 Satellite <br /> Facility Employee Training <br /> All facility ern In ees have received the required orr-the-iob training within the past car. <br /> All facility carr la ees hired within file past 30 dti s have received the re uircci un the job trainin . <br />