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2010-09-15 15:33 <br />Facility Name; COST# <br />Facility .Address: 2440 <br />City: Manteca <br />DesignatedUST Operate <br />International Code Coun <br />Signatuw: 41"L <br />Costco #1031 2048258204 >> 2094683433 P 7/17 <br />Desi ed Underground &,,rag, Tank (T 1#) <br />Monthly Visual Inspection Chc.Ailst operator <br />1031 <br />noeIs St. Date: 10/2912OO9 <br />Zip Code: 95331 <br />Conducting the inspection: Justin Downs <br />1 Certifica- tion #E: g(f2.1990-UC <br />Expiration Date: <br />,. .}'�t14 e {94 Q <br />4's Yes, N = No, NA= hunt Applicable <br />1 Monitoring System iris o� _ _ �`b``1 1 <br />Y _ 1" <br />p crud oa and in proper operating mode <br />2 Moxtitorit� system is not currently showint, <br />3 ory anal <br />reportllog for t}ie prtviaus month is available, and has been reviewed by the �st`t�i T7�"[' x <br />Operator. (Attach a copy of the ttlarrn history repoitllog to this form if available.) <br />4 Each alarm for the previous month has been riately. <br />S Sensors located in tank -top containment SUMPS havve not responded to appropx <br />Sa - hist all tank -top sumps where alarms ed alarmed i.n the past month. <br />We x <br />past month:-- <br />Note: ,Sumps where an alarm hos ocr+crred in rhe parr moarh muss hE inspected unless a gtraGfted service tool7ntcirn3 responded to, p>rd prt�perZy <br />addressed, the crease nfthe alarm. Attach darurnentatiarr ve ifj Fng approprtare servlca to this report. Ifsump lrrsp0i es Fs required, record results <br />sir item 6, belrt <br />b Tank -top contanunent sumps are <br />pfre <br />NoaYrua!nettnf e of waaater,ordeembrralasr, mahadr PhccaazuraerddtoorhesnmNsnoty :gnard stpswusubstante. Sensors are locaProperly. <br />f^a%monthfor.vlrlrh there:r xp rervYca nca+rd <br />Y N <br />Sump L-Oca ion: N/A <br />Sump Location: N/A ti Sump LOCati0iT ' NIA <br />Sump Location; NlA gyp': Sump Location: NIA <br />r} , <br />7 Spial aonSump Lot:ation, NIA <br />ta s <br />ituttent truGiures are free of water, debris, and hazardous substance. <br />Tank -87W Y/ N NA -- -- -� <br />lank -67E x 1 Quk-3?I Y N <br />x x <br />$ tinder dispenser contauurient areas are flee ot'water, debris, and. hazardous. substance. Sensors <br />are located properly. <br />!X# <br />ispenser-.11✓11Xispe>rser--13119x ispeeuer-13/16EEX <br />l0 <br />system certification has been Completed A, I' past. i 2 months. <br />Secondary containment <br />Y N NA <br />DATE DONT <br />! l <br />tests have been corn leed wit] ame. <br />Spill containment stricture <br />past <br />�r <br />12 <br />{bucket) testing was completed within the <br />Tank i 111! ess testing was completed 4vi£itin Amt yam' <br />y <br />x <br />x <br />Cont. mopitoret! <br />anR/fsg <br />13 <br />Line tightness testing was completed within required timeframe_ <br />timeframe. <br />x <br />NIA <br />14 <br />Other required testi --wed <br />ngfmamtenance was completed within re AWA <br />T'est✓Maintenanee; quired timeframe. (I ist testimaintenance <br />items below) <br />TestlLldaintenance: <br />x <br />Nit# <br />7'es&Mamtenance: <br />x <br />NIA <br />-z��....� r cmri,UYEE TRAININ43 <br />L&1621tacility <br />fcilty employees have received the recluirec! on -the job training wit}un the art Y N ^N, <br />employees .Mired within the past 34 days }3ave received there on theejob x <br />Note: Any answer of "N" should be expiaineri In ttte camatent section nn tl�e ft►llawin x <br />action. g !sage, and will require follow -Up <br />r Page I of 2 <br />