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Apr.08.2016 09:39 AM Af" rda Test — Galt Offic 20979-~116 PAGE. 5/ 11 <br />Facility Employee Training P e 2 of 2 <br />All facility employees have received the required on-the-job training within the past year. X <br />All facility employees hired within the past 30 days have received the required on the job training, <br />X <br />Monthly Inspection - - <br />Y N NA Datc Done <br />Monitoring system certification (within past 12 months) X 4-29-15 <br />Spill Bucket testing completed (within past 12 months) X 4-29-15 <br />Leak Detector-mechanical/electronic for most sites (within past 12 months) X 4-29-15 <br />The above are usually done together on an annual basis for local regulator. <br />Line Tightness (usually upon Construction or when no positive shutdown) x <br />Tank Tightness (Usually only after construction or when using SIR) X <br />Secondary containment (SB989) tests have been completed (usually every 3 years) X 2-12-15 <br />Other testing or maintenance completed as required. List them below: <br />'Fest/Maintenance: AQ Testing X <br />Test/Maintenance: <br />Test/Maintenance: <br />PRINTOUT INCLUDED Yes No NA <br />Comments: <br />[0,T ?J'1% <br />Items Requiring Follow-up Actions: <br />. <br />' L <br />Q— PPeT� <br />Monthly inspection must be conducted by an JCC licensed Designated Operator. <br />A copy of this checklist must be provided to UST owner or operator, but not to State Water P esources. <br />Designator Operator must alert the UST owner or operator of any condition discovered during the monthly <br />inspection that may require that may require follow-up action. <br />UST owner or operator must maintain a copy of this monthly inspection and any attachments for the previous <br />12 months, Records must be maintained on-site or, if approved by the local agency, off-site at a readily <br />available location, <br />99/79 <br />10/ <br />