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Site ID: 1010-1 <br /> Afforda-Te$t <br /> 416 2"d Street Designated Operator <br /> Galt,Ca 95632 Monthly Inspection Checklist <br /> 209-744-0112 Fax 209-744-0116 <br /> CEN D <br /> Site: CD&R—TRACY TRUCK STOP Date: 12/20/16 <br /> 3940 N TRACY BLVD <br /> OCT 1 " 2017 <br /> EWIRONMEK,AL HEALTH <br /> TRACY, CA 95304 PERk"T/SERVCES <br /> ❑Zane A.Nimmo ❑David A.Winkler ❑Felix G.Ramirez ® Edward Stearns <br /> #5263322 #5263373 #5273934 #5250492 <br /> LAI <br /> Y=Yes N=no,NA=not applicable <br /> MONITORING PANEL/ALARM HISTORY Y N NA <br /> Monitoring system 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 copy of the alarm history report/logreporillog to thisform if available. <br /> Each alarm for the previous month has been responded to appropriately X <br /> Sensors located in tank-top containment sumps have not alarmed in the past month. X <br /> List all tank-top sumps where alarms occurred in the past month:L-12 DSL STP <br /> Note:Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to,andproperly <br /> addressed,the cause of the alarm.Attach documentation verifying appropriate service to this report.if sump inspection is requireri,record results in <br /> item 6,below. <br /> UST SYSTEM INSPECTION AST SYSTEM INSPECTION <br /> AUTO Y N NA TRUCK I Y N NA <br /> Tank-top containment sumps are free of water,debris,and hazardous substance.Sensors are located properly. <br /> Note:Visual inspection o sums is only required in su s where an alarm has occurred in the past month or which there is no service record. <br /> Auto Sump Location:87 <br /> X , Truck Sump Location:Diesel East X <br /> Auto Sump Location:91 X N .. Truck Sump Location:Diesel West X <br /> Auto Sump Location:Diesel East XTruck Sump Location: X <br /> x <br /> Auto Sump Location:L-12 DIE STP WEST X Truck <br /> Su Location: X <br /> 1! r <br /> Spill containment structures are free of water,debris,&hazardous substance. <br /> Auto Tank 1 -Regular X Truck Tank 1 —Diesel East X <br /> Auto Tank 2—Premium X Truck Tank 2—Diesel West X <br /> Auto Tank 3—Diesel East X Truck Tank 3— X <br /> Auto Tank 4—Diesel West X Truck Tank 4— X <br /> Under-dispenser containment free of water,debris,&hazardous substance.Sensors located properly. <br /> Auto Dispenser 1/2 XJXT' <br /> ruck Dispenser 9a X <br /> Auto Dispenser 3/4 Xruck Dispenser 9/10a X <br /> Auto Dispenser 5/6 Xruck Dispenser 10/11a X <br /> Auto Dispenser 7/8 Xruck Dispenser ]1/12a X <br /> Auto Dispenser 9/10 ruck Dispenser 12/13a X <br /> Auto Dispenser 11/12 ruck Dispenser 13/14a X <br /> Auto Dispenser 13/14 ck Dispenser 14/15a X <br />