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Designa* Underground Storage Tank (UST) terator <br />Monthly Visual Inspection Checklist <br />Facility Name: CANEPA'S CAR WASH <br />Date: AUGUST 16,2006 <br />Facility Address: 642 N HUNTER <br />1. Monitoring system is powered on and in proper operating mode? <br />City: STOCKTON T State: CA <br />ZIP Code: 95204 <br />Designated UST perator Conducting the Inspection: Ron Sanchez <br />International SWde Council Certifi n #: 5 8997 -UC <br />Expiration Date: December 161h, 2006 <br />Signature: <br />Date: AUGUST 16, 2007 <br />Y= Yac N= Nn NA= Nnt A—li—ki. <br />Item Monitoring Panel / Alarm History <br />Y <br />N NA <br />1. Monitoring system is powered on and in proper operating mode? <br />X <br />2. Monitoring system is NOT currently showing any alarms or warnings? <br />X <br />3. Alarm history report/log for the previous month is available, and has been reviewed by <br />the Designated UST Operator? (Attach a copy of the alarm report/log to this form if <br />available) <br />X <br />4. Each alarm for the previous month has been responded to appropriately? <br />X <br />5. Sensors located in tank -top containment sumps have NOT alarmed in the past month? <br />X <br />5a. List all tank -top sumps where alarms occurred in the past month. <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to, <br />and properly addressed the cause of the alarm. Attach documentation verifying appropriate service to this report. If sump <br />inspection is required, put in item 6. <br />UST System Inspection <br />6. <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection of sumps is only required in sumps where an alarm has occurred in the past month for which there is no <br />service record. <br />Y I N Y N <br />Sump Location UNLEADED X Sump Location SUPREME X <br />Sump Location UNLEADED X Sump Location DEISEL X <br />Sump Location Sump Location <br />7. <br />Spill containment structures are free of water, debris, and hazardous substance? <br />Y N NA I Y I N NA <br />Tank 1. Contents UNLEADED X Tank 3. Contents SUPREME X <br />Tank 2. Contents UNLEADED X Tank 4. Contents DEISEL X <br />8. <br />Under -dispenser containment areas are free of water, debris, & hazardous substance? Sensors are workin 7 properly <br />Y I N I NA Y I N NA <br />Dispenser I& 2 X Dispenser 9& 10 X <br />Dispenser 3 & 4 X Dispenser 11 & 12 X <br />Dispenser 5 & 6 X Dispenser 13 & 14 X <br />Dispenser 7 & 8 X Dispenser 15 & 16 <br />Paperwork Inspection Y N NA Date <br />Done <br />9. <br />Monitoring system certification has been completed within past 12 months? X 7/06 <br />10. <br />Secondary containment tests have been completed within required timeframe? X 1/05 <br />11. <br />Spill containment structure (bucket) testing was completed in the past year? X 7/06 <br />12. <br />Tank tightness testing was completed within required timeframe? X 1/05 <br />13. <br />Line tightness testing was completed within required timeframe? X 1/05 <br />14. <br />Other required testing/maintenance was completed within required timeframe. (List test/maintenance items below.) <br />Test Maintenance <br />Test Maintenance <br />Test Maintenance <br />Facility Employee Training <br />Y <br />N <br />NA <br />Date <br />Done <br />15. <br />All employees have received the required on the job training within the past year? <br />X <br />7/06 <br />16. <br />All employees hired within 30 days have received the required on the job <br />training? <br />X <br />Note: Any answer of --N-' should be explained in the comment section on the following page, and will require follow-up action. <br />