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RECEIVED <br /> Designated Underground Storage Tank(UST)Operator 0 C T 0 3 2017 <br /> Monthly Visual Inspection Checklist <br /> Facility Name:953 TRACY FED EX GROUND Date:7-28-2017 <br /> Facility Address:5655 HOODWAY H <br /> City:TRACY,CALIFORNIA Zi Code:95377 nFPABTAdFNT <br /> Designated UST Operator Conducting the Inspection:DAVID L.TURNER <br /> International Cod ouncil Cenificat' n#:8788650-UC Expiration Date: 07-06-2019 <br /> Si lure: Phone:559-688-2977 <br /> Y—Yet,N—No,NA—Not plicable <br /> Item MONITORING PANEL/ALARM HISTORY YI N NA <br /> 1 Monitoring system is powered on and in proper operating mode. X <br /> 2 Monitoring system is not currently showing any alarms or warnings. X <br /> 3 Alarm history reporVlog for the previous month is available,and has been reviewed by the X <br /> Designated UST Operator. (Attach a copy o the alarm history report/logreporillog to thisform i available. <br /> 4 Each alarm for the previous month has been responded to appropriately. X <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. X <br /> 5a List all tank-top sumps where alarms occurred in the past month: SEE <br /> COMMENTS <br /> Note:Sumps where an alarm has occurred in the past month must be inspected unless a quaked service technician responded to,and <br /> properly addressed the cause ofthe alarm.Anach documentation verfNng appropriate service to this report <br /> Ifsump inspection is required,record results in item 6,below. <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Note:Visual m7actum ofrumps is on re ired in sum s where an alarm has occurredin thepast month or which there is no service record, <br /> Y I N Y N <br /> Sump Location:DSL SUMP#1 Sum Location:B-99 SUMP <br /> Sum Location:DSL SUMP#2 Sum Location:B10 BLENDER <br /> Sum Location:DEF SUMP ��P Sum Location: VENTSUA P <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N NA Y N NA <br /> Tank 1—Contents:DSL SUMP#1 X Tank 3—Contents:B-99 SUMP X <br /> Tank 2—Contents:DSL SUMP#2 Ix I I I Tank 4—Contents:BR-99SUA& X <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located proo I . <br /> Y N NA I Y I N NA <br /> Dispenser 1 MASTER X Dispenser4VT X <br /> Dispenser 1 SAT12M4STER X Dispenser 5MASTER16AIASTER X <br /> Dispenser 2 SATWL4STER X D' enser7MASTEPRAMSTER X <br /> Dispenser 3 SAT14MASTER X Dispenser <br /> PAPERWORK INSPECTION Y N NA DATE DONE <br /> 9 Monitoring system certification has been completed within past 12 months. X 8-17-2016 <br /> 10 Secondary containment tests have been completed within the required timeframe. X <br /> 11 Spill containment structure(bucket)testing was completed within the past year. X 8-17-2016 <br /> 12 Tank tightness testing was completed within required timeframe. <br /> 13 Line tightness testing was completed within required timeframe. <br /> 14 Other required testinWinaintemmoe was completed within required timeframe. (List test/maintenance items below. <br /> Test/Maintenance: <br /> Test/Maintenance: <br /> Test/Maintenance: <br /> FACILITY EMPLOYEE TRAINING Y N NA <br /> 15 All facility employees have received the required on-the-job training within the past year, I X <br /> 16 All facility employees hived within the Last 30 da Ls have received the required on-the-job training. I I X <br /> Note: Any answer of"N"should be explained in the comment section on the following page,and will require '.. <br /> follow-up action. <br />