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Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name:Tracy Blvd.Shell Date: 10127/2010 <br /> Facility Address:3725 Tracy Blvd. <br /> City:Tracy Zip Code: 95376 <br /> Designated UST Operator Conducting the Inspection:Brian_ Dunaha <br /> International Code CoMWWVLil Certification#: 8021436-UC I Expiration Date: 12/06/2010 <br /> Si mato Phone:(888)700 EPIC <br /> Y=Yes.N=No.NA=Not Applicable <br /> Item MONITORING PANEL/ALARM HISTORY Y N NA <br /> I Monitoring system is owered on and in proper operating mode. <br /> Monitoring system is not currently showing any alarms or warnings. <br /> 3 Alarm history reportllog for the previous month is available,and has been reviewed by the <br /> Designated UST Operator. (,Ittach a co►v of the alarm hision,reportllog to this form if available.) <br /> 4 Each alarm for the previous month has been responded to appropriately. <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. <br /> Sit _ List all tank-top stamps whe►-e alar►►►,ovetared in the past month: <br /> .Vote.Sumps where at alarm Inas wcurred it)the past month omit be tespected unless a yualilied sen-ice technician re.gnmded to,and <br /> properly addre.tsed.the cause of the alarm;I each documentation veru rink;appropriate serrire to this report, <br /> ift'sump ins ection is re uired,record results in item h•/rehrw. <br /> UST SYSTE51 INSPECTION <br /> 6 Tank-top containment sumps arc free of water,debris,and hazardous substance. Sensors are located properly. <br /> Nate:Visual itis ection o sou .s is aniv re uired in stuns where an alarm has occurred in the past month or which there is no sender record <br /> Y I N Y N <br /> Sump Location: Stn►►Location: <br /> Sum►Location: Swill)Location: <br /> Sunt o Location: Sump Location: <br /> 7 Spill containment structures arc free of water,debris,and hazardous substance. <br /> Y N NA Y N NA <br /> Tank I -Contents: 87 M Tank 3-Contents:91 O <br /> Tank 2--Contents: 89 ® 1 1 Tank 4-Contents: Diesel <br /> 8 Under-dis cnser containment areas are free of water,debris,and ha7ardous substance. Sensors are located properly. <br /> Y N NA Y N NA <br /> Dispenser l/2 Gilbarco MPD ® Dis vitser 9110 Gilbarco MPD Im <br /> Dispenser 3/4 Gilbarco MPD ® Di.c►enser 11/12 Gilbarco MPD <br /> Dis►eraser S/h Gilbarco MPD ® Dis tenser 13/14 Gilbarco MPD <br /> Dispenser 7/8 Gilbarco MPI) ® Dispenser 15/16 Gilbarco MPD <br /> PAPERWORK INSPECTION Y N INA I DATE DONE <br /> 9 Monitoring system certification has been completed within past 12 months. IBI 12/22/2009 <br /> 10 Secondary containment tests have been completed within the required timeframe. ® 12/22/2009 <br /> I I Spill containment structure(bucket)testing was completed within the past year. ® 12/22/2009 <br /> 12 Tank tightness tcstin►was completed within required timeframe. <br /> 13 Line tightness testing was completed within required timeframe. 191 <br /> 14 Other required testing/maintenance was completed within required timeframe. (List test/nuiintenance items he/ow.) <br /> Test/A/aintenance: Air Quality ® 3/05/2010 <br /> Te.stl1laintenance: <br /> Test/Maintenance: <br /> FACILITY EMPLOYEE TRAINING Y N NA <br /> 15 All facility employees have received the required on-the-job training within the past year. IBI <br /> 16 All facility employees hired within the past 30 days have received the required on-the-job training. <br /> Note: Any answer or"N"should be explained in the comment section on the following page.and will require <br /> follow-up action. <br /> Pagc I of 2 <br />