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I <br /> i <br /> 1 <br /> Designated Underground Storage T (UST) Operator 1 <br /> Monthly Visual Inspection Checklist <br /> Facili Name:City of Stockton CORP YARD Date:04/26/18 <br /> Facility Address: 1465 S.Lincoln St <br /> City:Stockton Zi Code:95203 <br /> Des!anated UST Operator Conducting the Inspection:Karen R Arnaiz <br /> Intema*mWode Council CerAjfication#:8356759 Expiration Date: 03/30/19 <br /> Si a re: Phone:(209) 5184836 <br /> Y A Yes N s No,NA=Not A Plicable <br /> Item MONt G PANEL/ALARM HISTORY Y N NA <br /> 1 Monitoring system is powered on and in pTjjtkgatin&mode. X <br /> 2 Monitoring system is not currently s owing any ala-rlh4 or warnings. X <br /> i <br /> 3 Alarm history report/log for the previous month is available,and has been reviewed by the X <br /> Designated UST Pperator. (Attach a cqU of the alarm history re ortllo to his j* i 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. I X <br /> 5a _ List all tank-top sumps where alarms occurred in the past month:04123 due to testing. <br /> Note:Sumps where an alarm has occurred in the past month must be Inspected unless a quaked service technician responded to,and <br /> properly addressed,the cause of the alarm.Attach documentation verifying appropriate service to this report. <br /> 1 sump in etion u required record results in item 6,below. <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 2 ction o sum sis on re iced in sum s where an alarm has occurred in the past month or which there is no service record <br /> Y N Y N <br /> Sump Location:Diesel X <br /> Sum Location:87 X <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N NA Y N NA <br /> Tank 1—Contents:Diesel X <br /> Tank 2—Contents:87 X <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Y N NA Y N INA <br /> Dispenser 1/2 X <br /> Dispenser 3!4 X <br /> Dispenser 5/6 X <br /> Dispenser 7/8 X <br /> PAPERWORK INSPECTION Y N NA DATE DONE <br /> 9 Monitoring system certification has been completed within past 12 months. X 04/23/18 <br /> 10 Secondary containment tests have been completed within the required timeframe. X 04/20/18 <br /> 11 Spill containment structure(buclTo testing was completed within the past year. X 04/23/18 <br /> 12 Tank#&hmess testing was completed within required timeframe. <br /> 13 Line tightness testing was completed within Muired timeframe. <br /> 14 Other required testing/maintenance was completed within required timeframe. List testlmaintenance items below. <br /> TestlMaintenance: <br /> TestlMaintenance: <br /> TestlMaintenance: <br /> i <br /> FACILITY EMPLOYEE TR G Y N NA <br /> 15 All facility em to ees have received therequired on-the-job training within the past year.03/21/18 X <br /> 16 All facili em to ees hired within the past 30!Lays have received the required on-the-'ob tratmL . X <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 2 November 2004 <br />