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Afforda-Te$t <br />416 2n, Street <br />Galt, Ca 95632 <br />209-744-0112 Fax 209-744-0116 <br />Site: CD&R - TRACV TRITCIC QTnn <br />3940 N TRACY BLVD <br />TRACY, CA 95304 <br />❑ Zane A. Nimmo <br />#5263322 <br />® David A. Winkler <br />#5263373 <br />1 <br />af <br />Site ID: 1010-1 <br />Designated Operator <br />Monthly Inspection Checklist <br />ilk► DATE: 9-9-15 <br />CC T 2017 <br />1=�'IIIROPlfItz: ;iL <br />HEALTH <br />PFR "'TP3ER 1 CF' <br />❑ Felix G. Ramirez <br />#5273934 <br />er__�7- <br />❑ Edward Stearns <br />#5250492 <br />— yub 1. <br />MONITORING PANEL / ALARM HISTORY <br />= no, i.n <br />Y <br />= not <br />N <br />appicame <br />NA <br />Monitoring system is powered on and in proper operating mode. <br />X <br />Monitoring system is not currently showing any alarms or warnings. <br />X <br />Alarm history report/log for the previous month is available, and has been reviewed by the Designated UST <br />Operator. Attach a copy o the alarm history reporqog to thisform if available.) <br />X <br />Each alarm for the previous month has been responded to appropriately <br />X <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />X <br />List all tank -top sumps where alarms occurred in the past month: <br />e: Sumps where an alarm has occurred in the past month 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 />in item 6, below. <br />UST SYSTEM INSPECTION AST SYSTEM INSPECTION <br />AUTO Y N NA TRUCK I <br />Y I N NA <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection of sumps is only required in sum 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 <br />ump Location: 91 X Truck Sump Location: Diesel West <br />Mump 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 />X <br />X <br />Auto Tank ] -Regular X <br />Truck Tank 1 — Diesel East <br />X <br />Auto Tank 2 —Premium X <br />Truck Tank 1 — Diesel West <br />X <br />Auto Tank 3 — Diesel East X <br />Auto Tank 4 — Diesel West X <br />Under -dispenser containment free of water, debris, & hazardous substance. Sensors located properly. <br />Auto Dispenser 1/2 X Truck Dispenser 9-10 <br />Auto Dispenser 3/4 X Truck Dispenser 11-12 <br />Out of Service <br />X <br />Auto Dispenser 5/6 X Truck Dispenser 13-14 <br />X <br />Auto Dispenser 7/8 X Truck Dispenser 15-16 <br />X <br />Truck Dispenser 17-18 <br />X <br />