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Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name:Trace Blvd.Shell Date:09/22!2010 <br /> Facility Address:3725 Tracy Blvd. <br /> d 1376 <br /> 9' <br /> /i Code: <br /> Cit <br /> 'raev <br /> mated Conductin Ins i n Dunahav i Co c: 95376 <br /> ""i'Ite UST <br /> crator the ectIon. it�3 <br /> IC tj ate� <br /> internationalCodcCounci nif cation P� 80214�61 UC D _ 1 2/06/2010 <br /> Ex iration Date: 12/06/2010 <br /> Phone:'xI <br /> Siaturc <br /> t888� 0 PIC <br /> n (888)700 EPIC <br /> V=Yes N v No NA Not A Itcable <br /> [ten) MONITORING PANEL/ALARM HISTORY Y N NA <br /> I Nionitorin s stem is owered on and in ro cr o cratin mode, <br /> 2 Monitorin s ste is not currvntl showing ttny <br /> alarms or warnitj <br /> 3 Alarm history reportlog for the previous month is available, <br /> and has hcell reviewed iewed by the <br /> - Designated UST Operator. (Attach a eoj)t,of the alarm histon,relmrillog to this 161-ni j1*avajIahIe.) <br /> 4 Each alarm for the previous month has been responded to a propriatel <br /> 5 -Scissors located in tank-top containment sum s have not alarmed in the est month. <br /> :)a List till t(nik-tolisumps where alarens occurred in the past month: <br /> ,Vote:Suentis where on alas-in teas occurred in the past month must he inspected unletv a quialified service technician revponded it),and <br /> prnperli,addressed,the cause of the alarm.Attach dotionentation irriti-ing appropriate service to this report, <br /> lfsi,---lac cctian ie re tired,rccrxrtl rcrtrtda in item 6,hetow. <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps arc free of water,debris,and hazardous substance. Sensors are located properly. <br /> ,vote,YieuaJ ins et tion of sums is only required insunt ps where an nlarnr Jtar occurred ire then rust urnuth nr which(herr i,c nn senvice recnrd <br /> V N <br /> Stitt)Location: <br /> Sunt Location: <br /> Sump Location: <br /> 7 S ill containment structures are free of water,debris,and hazardous substance. <br /> Y N NA V N NA <br /> Tank I Conletils: 87 Tank 3-Conlenti:91 <br /> Tank 2-Contents: 89 Tank 4-Contents: Diesel <br /> 8 Under-dispenscr containment areas are free of water,debris,and hazardous substance. Sensors arc located )rocr,ly. <br /> 1� <br /> Y IN, NII Y N NA <br /> 19ist)eIlser 112 Gilbarco NtPD IM IM <br /> El .r enser 17 I J2 Gilbarco MPD <br /> Im is eraser 1 14 Gilbarco I•PD X <br /> Dir c>nrer 7 d 8 Gilbarco MPD Ibis tenser 15/16 Gilbarco MPD <br /> PAPERWORK INSPECTION V N NA DATE DONE <br /> 1) Monitoest 12 months. 12122/2009 <br /> 10 Seconda containment tests have been corn leted within the rc tired timefranic. 12/22/2009 <br /> within the P!Ltear. 0 12/122/2009 <br /> 12 <br /> 13 Line ti htness testis was tom lvtvd`within rc aired timefratnc. <br /> 14 ed timeframe. (List test/maintenance items helow.) <br /> — -IM 3/05/2010 <br /> es aintenance: <br /> TestAVIaintenatice., <br /> FACILITY EMPLOYEE TRAINING- —V—T—N—TNA <br /> All acilit em on-the- in --T--T- <br /> 15 All facility em have received the required <br /> c "'in meo�jjslj'vc.ar�tr. <br /> _tj _0 aim� <br /> w 'ju, <br /> 11 cd, iv 'ra.. <br /> 0 sl c tile s have <br /> received <br /> --7--T <br /> ELAEfaE Etynj� jec Hired ithin ast 30 d, received the re aired on-the-'ob trainina. <br /> .�6 <br /> Note: Any answer of"N"should be explained in the comment section on the following page,and will require <br /> follow-up action. <br /> Page I of <br />