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PAGE. 2/ 11 <br />Site ID: 1010-1 <br />Afforda-Te$t Designated Operator G <br />416 2nd Street <br />Galt, Ca 95632 Monthly Inspection Checklist <br />209-744-0112 Fax 209-744-0116 <br />Site: CD&R - TRACY TRUCK STOPF s DATE: 11-3-15 <br />1:� ..u_ <br />3940 N TRACY BLVD 2017 <br />TRACY, CA 95304 =P VIRO� ,: HEALTF <br />❑ Zane A. Nimmo ❑ David A. Winkler ® Felix G. Ramirez Edward Stearins <br />#5263322 95263373 #5273934 #5250492 <br />r <br />Y yes N = no. NA = not applicabli <br />MONITOIUNG 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 co o 'the alarm histo re ort/lo to thisform r 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: <br />Note: Sumps where nt <br />an alarm as occurred in the past ont inspected must be unless a quali te <br />ed service e nician responded to, and properly <br />addressed the cause of the alarm, Attach documentation verifying appropriate semice to this report, Ifsump inspection 14 required, record results <br />in item 6, below. <br />UST SYSTEM INSPECTION AST SYSTEM INSPECTION <br />AUTON LNA TRUCK Y N NA <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection Dumps is on!y re rued in su s where an alarm has occurred in the past month or which there is no service record. <br />Auto Sump Location: 87 X Truck Sump Location: Diesel East X <br />,Auto Sump Location: 91 X Truck Sump Location: Diesel West X <br />Auto Sump Location: Diesel East X Truck Sump Location: <br />Auto Sump Location: Diesel West X <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 1 — Diesel West X <br />Auto Tank 3 — Diesel East X <br />Auto Wank 4 — Diesel Nest X <br />I Under dispenser containment free of water debris &hazardous substance. Sensors located ro erl . <br />Auto Dispenser 1/2 X Truck Dispenser 9-10 _ Out of Service <br />Auto Dispenser 3/4 X Truck Dispenser 11-12 X <br />Auto Dispenser 516 X Truck Dispenser 13-14 X <br />.Auto Dispenser 7/8 X Truck Dispenser 15-16 X <br />Truck Dispenser 17-18 X <br />