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AUG/17/2021/TUE 02:25 PM Tracy Truck Stop FAX No,209832 2312 P1018 <br />Site On 1010-6 <br />A.fforda-Telt <br />416 211d Street Designated Operator <br />Galt, Ca 95632 MrIbIvIn a *+ Recklist <br />209-7440112 Fax 209444-0116 i ` T. <br />Site: C D& R- C i S CHEVRON <br />7501 W. 1 1 rx STREET <br />TRACX , CA 95304 <br />®2;ane A. Niiriwo <br />#8883064 <br />❑ bavld A. Winkler <br />#8883059 <br />W <br />AUG 17 2021 <br />ENV1RnNMENTAL HEALTH <br />DEPARTMENT <br />❑ �+elix Gr. ffi.4mirez <br />#8883072 <br />batee 6/14/16 <br />❑ Edward Stearns <br />#8883080 <br />Y=yes N=no.NA=i <br />MONiTORTNG PANEL / AI..,1��M 1iIST01i'Y Y N N,A. <br />Monitoring systern is powered on and in proper operating mode. X <br />Monitoring system is not currently showing any alarms or warnings. X <br />Alarm history report/log for the previous month is available, and has been reviewed by the Designated UST X <br />Operator. Attach a co o the alarm histo Me ort/lo to this orm i available_ <br />Each alat'txi for the previous month has been responded to appropriately <br />Sensors located in tank -top containnimt sumps have not alarmed mi the past month_ X <br />List all tank -top sumps where alarim occurred in the past month; <br />Bruce: ournps tivnere an alarm has occurred irr the past month must be inspected unless a quald service technician responded ao, and properly <br />addressed, the ca:tse of rhe alarm. Attach doc:�mentation ver <br />in item 6. below_ trtg appropriate service to thus report. 4T sump inspection is required, record results <br />iJST SYSTEM 1NSPECTTON <br />4—A N NA <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located <br />Note; Visual iris edion p sun s is onlyrequired in siuA s whsre an alarm has occurred in the asi month or wh <br />Sump Location. VAPOR POT SUMP X Sump Location: <br />Sump Location: X Sump Location: <br />Sump Location: X Sump Location: <br />Sump Location: Sump Location_ <br />Sump Location: Sump Location: <br />zti contaznrnent structures are free of war®r debris &hazardous substance. <br />Tank 1 — 8 <br />7 OCTANE X Tank S - <br />Tank 2 — 91 OCTANE X Tank 6 - <br />Tank 3 — DZESYM X Tank 7 - <br />Tank 4 - <br />X Tank 8- <br />Under-dis eraser containment flee of water debris &hazardous substance. Sensors located <br />Dispenser 1/2 X Dispenser <br />Dispenser 3/4 X Dispenser <br />Dispenser 5/6 X Dispenser <br />Dispenser 7/8 Dispenser <br />Dispenser 9/10 X Dispenser <br />Dispenser 11/12 g Dispenser <br />Dispenser 13/14 X Dispenser <br />Dispenser 15/16 Dispenser <br />Dispenser 17/1$ X Dispenser <br />Received Time Aug,17. 2021 3119PM No,6863 <br />f►T1 <br />X <br />X <br />X <br />