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RW/-O—#: 16MI3M. <br /> �j 1, <br /> 7"­ <br /> Designated Underground Storage Tank (UST) Operandi ID <br /> Monthly Visual Inspection Checklist <br /> Facility Name: I(INGCA—Mid City CaFO Regen Date: 2016-07-07 17 <br /> Facility Address: 13850 Devrin Read <br /> City: Lodi Code- 95242 <br /> Designated UST Operator Conducting the inspection: David SmithEALTO <br /> International Code Council Certification#: 8260473 iration Date:201 VRW <br /> S' tore:t)avid Smith Phone: (SM 588-8737 <br /> Y-Yes,N-N*,, =Not AmAtable <br /> Item MONITORING PANEL/ALARM HISTORY Y N NA <br /> ism 1111111 ljjljj� 111 GERM <br /> I Monitoring system is powered on and in proper operating mode. le <br /> 2 Monitiod <br /> _!qrig s)T!em is not currently showing any ahmns or w!2!!jp. we <br /> 3 Alarm history repoi for t previous month is available,and has reviewed by the ✓ <br /> Desi ted UST OpEn!!or.(Attach ap_ r <br /> a if the alarm lusts ryMe��I%to 1his&rm!ZT2Lab1e_ <br /> , p <br /> 4- Each alarm for the previous month has been responded to appropnately. <br /> Sensors located in tank-top containment!!p <br /> _a have not alarmed in the p!d month. ✓ <br /> Ss List all tank-top sumps whaw alarms occun-ed in the past month: <br /> Note.swi 14*0M an alarm has o4warwitif in the Paw month mi be Inspected wiles a qualyWse2vite terkuklain responded to.and <br /> praperlj ada*sws,the came of the alarm.Affewh doemmostai sert6ilng appvpriate s6"Iry to this nvom <br /> aIon 1j zZ rLvard vaults in Own 6.below. MOMN asimamagnom <br /> 6 _T1 -top con�entfsumps are ffee ofwaluWn <br /> , s,and fiiiiffl6us s_ubRin_c_e7Scwrs are locatcdproper ly._ <br /> 1106-- <br /> OlAi 17stial Inipwdom qj'xini is only rLVivirrdinjunii whom an alarm has ocrurred In the past month ich"there Is no senice re-card. <br /> N <br /> Sump Location. <br /> Stang Location. <br /> YU �Olv—MP zo� Sump Location: <br /> t p <br /> Sump Location: i n Location: E 11 <br /> 7 Sill containment structures are free of water. a ' and hazardous substance. <br /> 11 <br /> 1 Y N NA Y I N <br /> Tank I -Contents: diesel f VP i 1 Tank 3-Contents: <br /> _ <br /> Tank Tank 2-Contents: 4-Contents: <br /> 8 Under­diMnser containment am are five of water,debris,and hazardous substance.Sensors are locatedTri <br /> I Y N NAAIA <br /> DLipenser 112 Dispenser 9/10 <br /> Dfsleraser 3/4Dispenser 11 12 <br /> Dis user 516 718 Dispenser 13 14 <br /> D user Dispenser 15 16 <br /> PAPERWORK INSPECTION Y I N NA I DATE DONE <br /> 9 Monitoring system ceHic0on has been 22!!5!lei within post U—mi be._ 20154111 <br /> 10 secondary containment tests have been 22m within the Suired time e. le 201349-12 <br /> 11 Spill containment structure(bucket)testing was completed within the pat year. V 201549-03 <br /> 12 Tank ti#tness tesft was c2MIeted within reguired timeframe. ✓ <br /> — <br /> 13 -Lfine tighmess testing was completed within required Gun�ee. <br /> 14 1 Other rega <br /> *d testinLmtcnance was co ted within Enwired timeftame.(List testIntaintenance items below. <br /> Test/Maintenance. <br /> Test/Maintenance. <br /> Tesi/Maintenance: <br /> I= I Ism <br /> FACILITY EMPLOYEE TRAINING Y N NA <br /> 5 All facili!y Em <br /> 219yees have received the Lajw�red within the Rast year. be <br /> 16 All facility employees hired within the past 30 days have received the required on-the-Job training ✓ <br /> Note:Any answer of'IN"she re expErM G the comment section,on'tre"Ma"oMng page,an ;M ji4fu`E0. <br /> follow-up action. <br /> QA/QC APPROVED <br /> 7/8120168:07AMBrandon Bo <br /> Page I of 2 November 2004 <br /> REV:5.0 <br />