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05/02/2008 09:42 FAX SJEH IM004/005 <br /> Afforda-TeSt Designated OEner atov, <br /> 416 2nd Street Calt, Ca. 95632 Montilly Inspection Checklist <br /> 209 744-0112 - 800 524-90137 - Fax 209 744-011(, <br /> Date: -7/ 6) <br /> Site: <br /> 9 <br /> Desigmated.0perptor: D4vid A. Winkler ICC A 5263373-CIC Lxpircwoo: 3131081 <br /> Signature Y yo:i N=no NA=notaj)plic, <br /> X40N I TORING PANEL Y N N A <br /> Monitoring;System is powered <br /> Monitoring systefli is not-Currently showing any alarms or warnities. <br /> Alarm history is available and has been reviewcd by D.O. <br /> (Attach alarm history,if rmtiLihle) <br /> Fach atarm for the.previonq niondi has been responded to appropriately. <br /> L <br /> Sensors located in tank-top containment sumps have not al -A <br /> 'armed in the past month. <br /> List all tante-tut, — r)U - ( <br /> Nolo: Vainpv where an alurni has ocrurred In the part month muyl be iny1jected unless a quafljP?d,Fiv-vie.-r-.-lechnidr.yn ivspondcd <br /> to,and pmperly addressed,the rimse of the alarm. Attach documentation verifying approprialem-o-vica to this reI201% <br /> Ifsum p ins #1 is I-equir.-d.record=dgs in imn? 116 below. <br /> UST SYSTEM INSPECTION <br /> Y LN -JA Y 1 N INA <br /> Tank-top cont;iinnient sumps are free of water,dcbrj,,-, and hazardous substance. Sen sot-.,located properly. <br /> ---Note: visual itmpectiov of sumps only required in sumps where an alarm has occurred in the plViL month For which there is no vrvice-reunrd. <br /> -Sump location: X Sump location: <br /> Sump location: <br /> _$urng location: <br /> :—SUDIP IOCati0n' 0,11,111, location: <br /> Spill contairunent structure~ are free of water,debris, &hazardous substance. <br /> Tank I -Regular )ol I -I—'Tank 4-Diesel <br /> .'I,allk 2-Plus )<> Tank 5- <br /> Tank 3 -Premium <br /> Under-dispenser contagunent free of water debris, &hazardous substance. Scissors located ro erly. <br /> Dispenser 10 A I Dispenser 19/20 <br /> Dispenser 3/4 I)ispetiser 21 <br /> Dispenser 5/6 Dispenser 22/21 Satellite <br /> Dispenser 7/8 Dispenser 23/22 Satellite <br /> Dispenser 9/10 Dispenser 24/23 Satellite <br /> Dispenscr 11/12 --Disp�:aser 25/24 Satellite <br /> Dispenser 13/14 2,619.5 Satellite <br /> Dispenser 15/16 Dispenser 27/26 Satellite <br /> Dispenser"17/18t'" s enser 27 Satellite <br /> IP-1�sLe- <br /> BMW= NINSEEMENZIM OEM <br /> Facility Employee Training <br /> All facility employees have received the required on-the-job training within the tist ycilt, <br /> All Ricility employees lairtxl within the past.30 clays have received the required on the job training. <br />