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Apr.08.2016 09:39 AM Aft rda Test - Galt Offic 20974-116 PAGE. 4/ 11 <br />Site ID: 1010-1 <br />Afforda-Te$t Designated Operator <br />41.6 2nd Street p <br />Galt, Ca 95632 Monthly Inspection Checklist <br />209-744-0112 Fax 209-744-01.16 <br />Site: CD&R - TRACY TRUCK STOP_ DATE: 12-1615 <br />ECFV' VEL. <br />3940 N TRACY BLVD 0 WPO T 2017 <br />TRACY, CA 95304 E-h'l/IROIN; <br />EALTF <br />S <br />Fj Zane A. Nimmo Z David A. Winkler Felix G: Raimir4i'E" Q Edward Stearns <br />#5263322 #5263373 #5273934 95250492 <br />V .. N — nn. NA o tint anntirahle <br />MONITORING PANEL / ALARM 141STORY <br />Monitoring system is powered on and in proper operating mode. <br />Monitoring system is not currently showing any alarms or warnings. <br />X I N NA <br />X <br />x <br />hi -,tory report/log for the previous month is available, and has been reviewed by the Designated U51I x <br />Operator. if (Attach a copy of the alarm history report/log to this Form available,) <br />Each alarm for the previous month has been responded to appropriately T 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, <br />No -to: Sumps where an aarm has occurred in the past most must be inspected unless a qualified service technician responded to, and properly <br />addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report, if sump inspection is required, record results <br />INSPECTION <br />AUTO v 1 N <br />Tank -top containment sumps are free of water, debt <br />to • O'Cual insngclinn of sumps is oniy required in sumps where CL <br />Auto Sump Location: 87 <br />X <br />Auto Sump Location: 91 <br />� <br />Auto Sump Location: Diesel East <br />x <br />- <br />Auto Sump Location: Diesel West <br />`X <br />Auto Tank 1 - Regular <br />Auto Tank 2 - Premium <br />Auto Tank 3 - Diesel East <br />Auto Tank 4 - Diesel West <br />Auto Dispenser 1/2 <br />Auto Dispensor 3/4 <br />Auto Dispenser S/t <br />Auto Dispenser 7/8 <br />It containment structures are <br />X <br />X <br />-r containment free of water, <br />AST SYSTEM INSPECTION <br />NA TRUCK v N <br />and hazardous substance. Sensors are located properly. <br />vm has occurred in the east month er which there is no service rscOn <br />Truck Sump Location: Diesel East <br />Truck Sump Location: Diesel Vilest X <br />Truck Sump Location: <br />water, debris 8c hazardous substance. _ <br />'Nuck Wank 1 - Diesel East x <br />Truck Tank 1 -- Diesel West X <br />hazardous substance. Sensors located properly. <br />er 9-10 <br />Out <br />er <br />WTruckDispenser <br />er <br />"17,18x <br />er <br />ser <br />NA <br />