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AUG/17/2021/TUE 02,23 PM Tracy Truck Stop FAX No,209832 2312 P,013
<br />Has each follow-up action of Section III from the previous inspection been completed appropriately?
<br />Arttach documentation ver 'I a ropriate service to this re o
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<br />Attach a co of the 1 C• ,'" ° '' L'�"
<br />e a arm histo roport/lo to this report.
<br />Is the monitoring system powered on and in proper operating mode?
<br />Has each leak detection alarm since the previous inspection been responded to appropriately?
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<br />Hu Ilfisd UST Service Technician? ave had a leak detection alarm since the previous inspection been responded to by a ❑ ❑
<br />hist below in SeCtion IX all containment sumps that have had a leak detection alarm since the previous inspection and have not been
<br />responded to by a qual/tled UST Service TeChnician. Contalnmentsumps listed below require a v/sual lnspection for damage, water, debris,
<br />hazardous substance, and roper sensorlocatlon The r Ylts ofthe visual Inspection must be recorded In sacrinn lY
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<br />s t e containment sump free of dama e, water, debris, and hazardous substance.
<br />Containmant Sump ID Containment Stimp ID 7L]
<br />❑ ❑ ❑ ❑ ❑ ❑
<br />Are All sensors in containment sumps inspected located to detect a leak at the earliest opportunity? ❑ ❑
<br />Is the, s III contalner free of dama e, water, debris, and hazardous substance?
<br />L
<br />k ID 87 p Cl TanklD DSL. ❑
<br />k ID 91 ❑ Tank ID ❑ ❑
<br />Is the fill pl a free of obstructions?
<br />T ® ❑ Tank ID 87 Tank ID DSL
<br />Tank ID 91 0 ❑
<br />❑ Tank ID q ❑
<br />Is the fill ca secure) on the fill pipe?
<br />Tank ID 87 Q [] Tank ID bsl.
<br />Is
<br />91 [] ❑ TanklD ❑ ❑
<br />❑ ❑
<br />Is the under -dispenser containment free of dama e, water, debris, and hazardous substance?
<br />Under-dispens®r Containment ID Uig J yl�n9 l 11 M Under -Dispenser Containment ID # .W
<br />Dispenser 1/2 T[id`�;"s•
<br />0 ❑ ❑Dis enser 3/4 n © ❑ ❑
<br />bis enser 5/6 p ❑ ❑ Dis enser 7/8 0 ❑ ❑
<br />❑ El ❑ ❑ ❑
<br />❑ ❑ ❑ 10 ❑ ED]❑ ❑ ❑ ❑ ❑ ❑
<br />F1 F1
<br />Are all sensors in under- ese detect a•leak at the ?
<br />dispn` r containment located to earliest lest opportunity [a ❑ ❑
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<br />Was the monitoring system certification been completed within the past 1Q months�d�w'.,,,......au�Jlnp101M1�pl;uiIl���1 014�rTVjPij VItlA"'p`��f�m��� � ��it
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<br />Has the spill contalner testing been completed within the past 12 months? © ❑ 12/4/2018
<br />❑ ❑ AST
<br />Has the overfill prevention equipment inspection been completed within the past 36 months? ❑ p ❑ AST
<br />Has the secondary containment testing been completed within the past 36 months? ❑ ❑ q AST
<br />Has the tank tightness testing been completed within required timeframes? ❑ ❑ q
<br />Has the line tightness testing been completed within the required timeframes? 11 ❑
<br />Other required testis /maintenance was completed within required timeframe. (List testilmaintenance items bolow.)
<br />Test / Maintenance: 1—u
<br />Test / Maintenance:
<br />Test / Maintenance: Test / Maintenance:Test / Maintenance:
<br />Test / Maintenance
<br />/the faculty has move components than th/s farm accommodates, additional co res of tin's y a e may be attachedpasf , nJm,h�; --rs -J;;m idPl��;,�
<br />Have all individuals performing facility employee duties received Use re cared ("a iii
<br />em to ae train' 12 months? p ❑
<br />Y = Yes, N = No, NA = Not Applicable, ID = Iden ffieatlon
<br />Received Time Aug, 17. 2021 3119PM No, 6863
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