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Underground Storage Tank (UST) rator <br />9 <br />Designated Underg g <br />Monthly Visual Inspection Checklist <br />Facili Name: CANEPA'S CAR WASH Date: AUGUST 24, 2005 <br />Facili Address: 642 N. HUNTER ST. ZIP Code: 95204 <br />Ci : STOCKTON I State: CA <br />Designated UST Operator Conducting the Inspection: Ron Sanchez <br />Internationa de Council C rtifi ation #: 5 48997 -UC DateaAUGUSExpirtion T Date: December 2005 16t", 2006 <br />Signature: <br />` Y= Yes N= No NA= Not A licable <br />Item Monitoring Pan Alarm History Y N NA <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? X <br />3. Alarm history report/log for the previous month is available, and has been reviewed by X <br />the Designated UST Operator? (Attach a copy of the alarm report/log to this form if <br />available) <br />4. Each alarm for the previous month has been responded to appropriately? X <br />5. Sensors located in tank -top containment sumps have NOT alarmed in the past month? 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 />Ins ction is re uired, put in item 6. <br />UST System Inspection <br />6. 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. Y N Y N <br />X Sum Location SUPREME X <br />Sum Location UNLEADED <br />Sum Location UNLEADED X Sum Location DEISEL X <br />Sum Location Sum Location <br />7. Spill containment structures are free of water, debris, and hazardous substance? Y N NA <br />Y N NA X <br />Tank 1. Contents UNLEADED X Tank 3. Contents SUPREME <br />Tank 2. Contents UNLEADED X <br />Tank 4. Contents DIESEL X <br />8. Under -dispenser containment areas are freeNof w NA, debris, & hazardous substance? Sensors are lworlkiin t NA l <br />Dispenser 1 & 3 <br />X Dis enser 9 & 11 X <br />Dispenser 2& 4 X Dis enser 10& 12 X <br />is enser 5 & 7 X Dis enser 13 & 14 <br />Dispenser 6& 8 X Dispenser 15 & 16 <br />Paperwork inspection Y N NA Date <br />Done <br />9. Monitoring system certification has been completed within past 12 months? X <br />7105 <br />1/05 <br />10. Secondary containment tests have been completed within required timeframe? X 7/05 <br />11. Spill containment structure (bucket) testing was completed in the past year? X 1/05 <br />12. Tank tightness testing was completed within required timeframe? X 1/05 <br />13. Line tightness testing was completed within required timeframe? X <br />14. Other required testing/maintenance was completed within required timeframe. (List test/maintenance items below.) <br />Test Maintenance <br />Test Maintenance <br />Facility Employee Training Y N NA Date <br />Done R <br />15. All employees have received the required on the job training within the past year? X 1/05 <br />16. All employees hired within 30 days have received the required on the job <br />X <br />trainin t require follow-up action. <br />? <br />ite: Any answer of "N" should be explained in the comment section on the following page, and wil <br />