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ARCO AM/PM NO. 83230 1340 W. COLONY ROAD, RIPON, CA <br /> UNDERGROUND sTo - -rANI< S-VS-VU <br /> I)ESIGNATED UST OPERATOR MONTHLY INSPEC-F ON R> rc�rZ�C <br /> i <br /> F Inspection Date: <br /> acility Name: r?C Q Z <br /> Focilit city. <br /> Address: ��,� � (� �a� � <br /> Name of Designated UST Operator Cond ting Inspection: Guadalupe Sanchez <br /> International Code Council Certification No.: 5250451-UC Expiration Date: 113112017 <br /> Signature: {' 7 Phone: (925) 470-0803 ext. <br /> NIA=Not Applicable <br /> F <br /> MONITORING PANEL/ALARM HISTORY Yes No NIA <br /> Is the monitorinti s-stem owered on and in ro er operating mode? ❑ ❑ ❑ <br /> 2. Is the rnonitorin�system not currently showing an leak alarms? ❑ ❑ ❑ ` <br /> 3. 1s the Alarm History Report/log for the previous month available, and has it been reviewed by the ❑ ❑ ❑ <br /> L)esi-nated UST O erator'? /Attach a co y of the alann l�is'ory re nrU7og to this ins eciion fbl.l.) <br /> 4. Has each afarm for the ievious month been res onded to appro riately? --- -- �[] ❑ ❑ <br /> UST SYSTEM INSPECTION <br /> a. Are tank-top containment sumps free of water, debris, and hazardous substance? Note .r, <<.: ;-. ;;, ?,n 4 it-as ' Yes."skip <br /> to Item G. Sumps rhere an atarrn has occurred in the post month mull he inspected if a qualified service frac oui responded to, and <br /> pro,erty addressed. the cause o%the alarm. Docunrentation rel-141 n a ro priate service sheneld be allache4 io this report, <br /> Yes No _ Yes No <br /> Sum Location: ❑ ❑ 5un�p Location: ---- �_ ❑ ❑ <br /> Sum Location: ❑ [] Sutrt Location: _� [I ❑ <br /> Are s ill buckets(containment structures) free of water, debris, and hazardous substajtce? _ <br /> Tank 11D— r Yes No NIA Yes No NIA <br /> Tank 2 ID— <br /> l E ❑ ❑ Tank 4 ID— ❑ ❑ <br /> Tank 3 ID— ❑ ❑ Tank 5 ID— ❑ ❑ ❑ <br /> Are under- is enser containment areas free od'w❑ater, d❑ehrisTand ank 6 !D— ❑ ❑ ❑ <br /> hazardous substance' <br /> Dis enser- 112 Yes No N/A Yes No N/A <br /> Dis enser-314 ❑ ❑ Dis enser-9/10 ❑ ❑ <br /> Dis enser-5/6 ❑ ❑ Dis enser- I I/l2 ❑ <br /> Dispenser-718E ❑ ❑ Dis enser� ]3114 � � n <br /> Items 1 through 4 have not been completed on the 9128116 designated operator monthly inspection report <br /> Photo taken on: 10/20/2016 <br />