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Apr.08.2016 09:39 AM Af--rda Test — Galt Offic 209744"116 PAGE. 6/ 11 <br />Site ID: 1010.1 <br />Afforda-Test Designated Operator <br />416 2nd Street <br />Galt, Ca 95632 Monthly Inspection Checklist <br />209-744-0112 Fox 209-7440116 <br />Site: CD&R - TRACY TRUCK STOP <br />3940 N TRACY BLVD <br />TRACY, CA 95304 <br />Zane A. Nimmo <br />#5263322 <br />David A. Winkler <br />x#5263373 <br />W, <br />F% -_V DATE: 1-15-16 <br />9017 <br />❑ Felix G. Ramirez ❑ Edward Stearns <br />#5213934 #5250492 <br />!(= es N = no NA — not 2POCA <br />MiO TTORING PANEL / ALARM ERSTORY v 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 />•,1�,;.a k�istory reportllog for the previous month is available, and has been reviewed by the Designated UST X <br />O erator, Attach a co o the alarm history report/logreport/log to this orm tf available. X <br />Each alarm for the previous month has been responded to appropriately <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: <br />service technician resp., d and properly <br />Note: Sumps whero an alarm has occurre to the past mm <br />olt' ust be tnspecte unless a quali led re <br />addressed, the cause of the alarm, Attach documentation verifying appropriate service to this report, tjf sump inspection is required record results <br />in item 6, below. <br />UST SYSTEM 1N5rJfU ttvlx <br />_ AUTO Y <br />Tank -top containment sumps are free of water, debt <br />Note; Visual inspection ofsumps is on rs Wred in s s where m <br />Auto Sump location: 87 X <br />Auto Sump Location:: 91 X <br />Auto Sump Location: Diesel East X <br />Auto Sump Location: Diesel West X <br />Auto Tank 1 - Regular <br />Auto Tank 2 — Premium <br />Auto Tank 3 — Diesel East <br />e ; r Tank 4 Diesel West <br />Auto Dispenser 1/2 <br />Auto Dispenser 3/4 <br />Auto Dispenser 5/6 <br />Auto Dispenser 7/8 <br />eontainxnent structures are <br />X <br />X' <br />X <br />X <br />containment free of water. <br />X <br />X <br />X <br />,AST SYSTEM INSI'.LU'llUiv <br />ANA__ TRUCK Y N NA <br />and hazardous substance. Sensors are located properly. <br />rrm has occurred in the st month or which there is no service record. <br />Truck Sump Location: Diesel East X <br />Truck Sump Location: Diesel West X <br />Truck Sump Location: <br />water debris�Tank <br />& hazardous substance. <br />iiiTruck— Diesel East X <br />Truck -Diesel West X <br />& hazardous substance. Sensors located <br />properly, <br />9-10 <br />Out of Service <br />spenser 11-12 <br />X <br />spenser 13-14 <br />rau,ckpenser <br />Xspenser <br />15-16 <br />X <br />spenser 17-18 <br />X <br />