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Designated Underground Storage Tank (UST) Op <br />r <br />Monthly Visual Inspection Checklist <br />AR WASH Date: JU <br />Facili Name: CANEPA'S CNE 28, 2006 <br />Facili Address: 642 N HUNTER ST te: CA ZIP Code: 95204 <br />Cl : STOCKTON <br />Designated UST O ator Conducting the Inspection: Ron Sanchez tration Date: December 16th, 2006 <br />International ouncil Cert! f catio. 524899 -UC Date: JUNE 28, 2006 <br />Signature:A 4'_ _.�* fv <br />Y= Yes N= I NA= Not A II <br />• Y N NA <br />Item Monitoring Panel / Alarm History <br />x <br />1. Monitoring system is powered on and in proper operating mode? x <br />2. Monitoring system is NOT currently showing any alarms or warnings? <br />3. Alarm history report/logtorthe Attach a copy of the alarm) report/109 to this formeif <br />d by X <br />the Designated UST Operator? <br />available) <br />4. Each alarm for the previous month has been responded to appropriately? <br />5. Sen all tank top in tansumpwhere alarms occurr a in the paO month ed in the past month? x <br />Sa. List <br />ded to. <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless aualifie ed seryoIce th this If sump <br />and properly addressed the cause of the alarm. Attach documentation verifying appropriate <br />ins tion is requiredput In item 6. UST System Inspection Ss <br />ted <br />nd <br />ns <br />6 Nan toote: Visual i stpect on of sumpssiss onlyerequired in sumps wheare fre of 6vr, debris, re an hazardous <br />m has occurred in the epastrmon hlfor awhich thereIsno <br />service record. Y N <br />Y N x <br />x Sum Location SUPREME x <br />Sum Location UNLEADED x Sum Location DEISEL <br />Sum Location UNLEADED Sum Location <br />Sum Location <br />substance? <br />7. Spill containment structures are free 01 atN, debNA <br />and hazardous Y N NA <br />Tank 3. Contents SUPREME x <br />Tank 1. Contents UNLEADED x x <br />2. Contents UNLEADED <br />x Tank 4. Contents DEISEL <br />Tank <br />8. Under -dispenser containment areas are free of water, debris, &hazardous substance? Sensors areY or' in pr Iy <br />NA <br />Y N NA <br />x Dis enser 9 & 10 xx <br />Dis enser 1 & 2 x Dis enser 11 & 12 <br />Dis enser 3 & 4 x Dis enser 13 & 14 <br />Dis enser 5 & 6 x Dispenser 15 & 16 <br />Dispenser 7 & 8 Y N NA Date <br />Paperwork Inspection Done <br />9. Monitoring system certification has been completed within past 12 months? x -6ft <br />10. Secondary containment tests have been completed within required timeframe? x U <br />11. Spill containment structure (bucket) testing was completed in the past year? <br />12, Tank tightness testing was completed within required timeframe? <br />13. Line tightness testing was completed within required timeframe? <br />14, Other required testing maintenance was completed within required timeframe. (List test/maintenance items below.) <br />Test Maintenance <br />Test Maintenance <br />Test Maintenance Y N NA Date <br />Facility Employee Training Do e <br />r <br />15. All employees have received the required on the job training within the past year? <br />16. All employees hired within 30 days have received the required on the job <br />trainin 7 e and will require oliow-up action. <br />Note: Anv answer of "N" should be explained in the comment section on the following pag . <br />