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AUG/17/2021/TUE 02:24 PM Has each follow Attach documen, _ f�9alJi vvfiliinu J Attach a coDV of aMon of Tracy Truck Stop on III from the previous roPrieto service to this f Is the monitoring system powered or Has each leak detection alarm since rt/log fo this report__ and in proper o eratirn he previous inspection riate service to this rePLP FAX No,209832 2312 n been completed appropriately? model een responded to P, 015 ❑ ❑ ❑p Have all contelnment sumps that have had a leak detection alarm since the previous inspection been responded to by a ❑ ❑ 0 uallfled UST Service Technician? List below in Section IX all containment sumps that have had a leak detection alarm since the previous inspection and have not been responded to by a qualified UST Service Technlelan, Containment sumps listed below require a visual Inspection for damage, water, debr/s, hazardous substance and Proper sensor location. ( of file visual ins ��a anon The rasul s inspection must ba rec N S I ,ulphnlA 1 i y rarunalJ enrm,n7nsn S 1irT�"r� .ten orded/n Section A: Is the containment sum free of dame e, water debris and hazardous s. b.... r , _ u Stance? Containment Sump ID ff' 9'°I° ntarnme , ,,.d>g;94F1 M ❑ ❑ ❑ ❑ ❑ ❑ Are all sensors in containment sumps inspected located to detect a leak at the earliest opportunity? Is the spill container free of damage, water, debris, and hazardous substance? Tank ID 87 ❑D ❑ Tank ID DIESEL Tank ID 91 X❑ ❑ Tank 10 Is the fill pipe free of obstructions? Tank ID 87 p ❑ TanklD DIESEL Tank ID 91 ❑ ❑ TanklD Is the fill cap free on the fill i e? Tank Ib 87 d ❑ Tank it DIESEL Tank ID 91 p ❑ Tank ID Is the under -dispenser containment free of damage, water, debris, and hazardous substance? Under-Dis enser Containment ID ��ot'M.ry"('�R°""" r n. �u,JiH•.J�s�fy, Under-Dis enser Containment ID Dis enser 1/2 ❑D 17 ❑ Dispenser 3/4 Dis enser 5/6 ❑ ❑Dis enser 7/8 ❑ ❑ ❑ ❑ ❑ ❑ El ❑ ❑ ❑ ❑ ❑ ❑ Are all sensors in undertli® enser p containment located to detect a leak at the earliest opportunity? Ritti4 VlUn Irimwn SRW JINi Iv,o, fI i UTAI+�MM EIANIRIUIwh r 7 �1�171�Un INh M114fIVRI��mW�l Iklq� riuisUln�ul li II�;rt;IIIUIU UTI 61 +11In Idly 1p�unnl� Vi btl II�lNN19uia,I I��INYII y '�i�(iY ri {iiiNU!'Fln U �R ggyne Jiiirn'Ju��s�lel utJi,J,.imai imi .JiPm pp�Im"e arL�'m µ��mibli4 tllrtav vr' .in n eM1 vi ,✓vlp� yy..�� iia a d l irk � i 4 1 II+� 4f�i i7� 8 vi Nl4 vmi �IV\R gJ,yi ��nvmG ��m aiiW mri "�`�mll`I'i�m� mi�Ai�. �i4� �:iµµl a mm VrI Al'i� ,nm�nm�m��w 1 m n,°i�i 'fi n.n �'la P°�w a. mnm m ,J. . n��Jr�mNm.�mPL�m. nmS'!_�'U"� Su 1 L9m L�JIt�n ��n;aa�ew� �IaI .S��"I'aunl n,n Tai"Im �M l m o.i. mia"�Mf m mwn ^nI�V° 'r,a�wint�lm1a lr°Wool°u r5�11 $u pop mw IRa:n� cin ern nw ry�tml9mall is ml4i P1 imeu namyy((W��lal ul dr rf�n+4epU,AJ' a.�rnll_.�y Malinuiai{iA uIHM •nnN� Has the monitoring system certification been completed within the past 12 months? ❑x q...,� Has the spill container testing been completed within the past 12 months? ❑ (] Has the overfill prevention equipment inspection been completed within the past 36 months? ❑ ❑ N Has the secondary containment testing been completed within the pest 36 months? ❑ ❑ t] Has the tank tightness testing been completed within m uired timeframes? ❑ ❑ 0 Has the line tightness testing been completed within the required timeframes? ❑ ❑ O Other required testing / maintenance was completed within required timeframe. (List tesUmaintonance items below. Test / Maintenance: ❑ n / Maintenance: 1-.i u / Maintenance- � ❑ ntenance: '�' `-' Have all individuals performing facility employes duties received the re quired facility employee training within the past 12 months? /the facility has more components than Phis fomt accommodatos, additional ovpies eifhis page maybe atiac/led. Y = Yes, N = No, NA = Not Appllcable, ID = IdPnf 7mflnn Received Time Aug,17, 2021 3119PM No,6863 Cl D ❑ ❑ D an ren 12/412018