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Afforda-Te$t <br />416 2"d Street <br />Galt, Ca 95632 <br />209-744-0112 Fax 209-744-0116 <br />Site: CD&R - TRACV TRITE W cTnp <br />3940 N TRACY BLVD <br />TRACY, CA 95304 <br />® Zane A. Nimmo ❑ David A. Winkler <br />#5263322 #5263373 <br />Site ID: 1010-1 <br />Designated Operator <br />Monthly Inspection Checklist <br />EC E DATE: 6-18-15 <br />CCa 2017 <br />ENVIRON,- -._' -aL HEALTi•1 <br />❑ Felix G. Ramirez ❑ Edward Stearns <br />#5273934 #5250492 <br />V = ve% N = nn_ NA =not snnlino Gln <br />MONITORING PANEL / ALARM HISTORY <br />Y <br />N <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 of the alarm history report/logreport/log 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. lfsump inspection is required, record results <br />in item 6, below. <br />UST SYSTEM INSPECTION AST SYSTEM INSPECTION <br />AUTO I Y I N NA I TRUCK <br />I 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 />Auto Sump Location: 91 X Truck Sump Location: Diesel West <br />Auto Sump Location: Diesel East X Truck Sump Location: <br />Auto Sump Location: Diesel West X <br />X <br />X <br />Spill containment structures are free of water, debris, & hazardous substance. <br />Auto Tank 1 - 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 />Out of Service <br />Auto Dispenser 3/4 X Truck Dispenser 11-12 <br />X <br />Auto Dispenser 5/6 X Truck Dispenser 13-14 <br />X 4 <br />Auto Dispenser 7/8 X Truck Dispenser 15-16 <br />X <br />Truck Dispenser 17-18 <br />X <br />