COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

INSPECTION H11SfiORY Has each follow-up action of Section III from the previous inspection been completed appropriately? Y Al_ Attach documentation verifying appropriate service to this report ❑ V1111. ALARM MSTORY Attach a cou of the alarm history reporillogto this report. Y LN., KA Is the monitoring system powered on and in proper operating mode? ❑ ❑ Has each leak detection alarm since the previous inspection been responded to appropriately? :11 ❑ Attach documentation it a roruts service to this re ort Have all containment sumps that have had a leak detection alarm since the previous inspection been responded to by a qualified UST Service Technician? ❑ ❑ List below in Section a all containment sumps that have had a leak detection alarm :ante the previous inspection and have not been responded to by a qualified UST Service Technician.Containment sumps listed below require a visual inspection for damage,water,debris, hazardous substance,and proper sensor location. The results of the visual inspection must be recorded in Section DC DLUNDERGROUND STORAGE TANK SYSTEMINSPECTION Is the containment ump free of damage,water, debris, and hazardous substance? Containment Sump ID Y N Containment Sump ID Y ,'N ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Are all sensors in containment sumps inspected located to detect a leak at the earliest opportunity? Ell ❑ Is the spill container free of damage,water. debris; and hazardous substance? Tank ID 1-87 ❑I TanklD 2-91 ❑ Tank ID 3-DSL ❑ITank ID F 131 ❑ Is the fill pipe free of obstructions? Tank ID 1-87 ❑ Tank ID 2-91 ❑ Tank ID 3-DSL ja I ❑ Tank 1D I I ❑1 ❑ Is the till cap securely on the fill pipe? Tank ID 11-87 ❑1 Tank IQ 2-91 ❑ Tank ID 3-DSL ❑ Tank ID ❑ Is the under-dispenser containment free of damage,water,debris, and hazardous substance? Under-Dispenser Containment ID Y 14 1 NAI Under-Dispenser Containment ID Y N RA Dispenser 1/2 ❑ ❑ Dispenser 3/4 ❑ ❑ Dispenser 5/6 ❑ ❑ Dispenser 7/8 ❑ ❑ Dispenser 9/10 ❑ ❑ Dispenser 11/12 ❑ ❑ Dispenser 13/14 ❑ ❑ Dispenser 15/16 ❑ ❑ ❑ ❑ X 0 1 Elij Ell ❑ ❑ ❑ Are all sensors in under-dispenser containment located to detect a leak at the earliest opportunity? ❑ ❑ )L TESTING AND MAINTENANCE Y N. Date Last Performed Has the monitoring system certification been completed within the past 12 months? ❑ 10/16/2019 Has the spill container testing been completed within the past 12 months? ❑ 10/16/20191 Has the overfill prevention equipment inspection been completed within the past 36 months? ❑ ❑ 12/27/2018 Has the secondary containment testing been completed within the past 36 months? , ❑ ❑ Has the tank tightness testing been completed within required timeframes? j ❑ ❑ Has the line tightness testing been completed within the required timeframes? ❑ ❑ Other required testing/maintenance was completed within required timeframe. (List fest/mainfenance items below.) Test 1 Maintenance:Vapor Recovery © 'l ii26/2019 Test/Maintenance: ❑ ❑ Test/Maintenance: ❑ ❑ Test/Maintenance: Test/Maintenance: ❑ ❑ Test/Maintenance: ❑ Y❑_ Xi. FACILITY EMPLOYEE TRAWNh N Have all individuals performing facility employee duties received the required facility employee training wthin the past 12 months? I the faer7ity has more components than this form accommodates,additional copies of this page maybe attached. ❑ Y=Yes,N =Na,NA=NotAppRable,IC=Identifir6on