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1? RAIRip Underground flank( 3. C = 39-PFJ 6 <br /> F SOUTHERN rnuFoaw Operator Monthly Vmml Inspection Cl [WQ <br /> Monthly Designated Operator Inspections _ Rev. 11118120 t. <br /> (949)458-usro(8786) ---�— <br /> `Month: DECEMBER 2013 <br /> CUPA Facility ID#: PTO Exp.Data DIrspec6on Date: Designated UST Ope dL ip• Fe Inspection: <br /> FA0006672 12/31/2s i 3L q ,Zo 13 _ ANCE YORK <br /> Facility Name: !ntemahoral Code Cct --�'itfi -�c-. k and Expiration Date: <br /> PILOT/ FLYING J - RIPON #618 5296385-iJu SE.PTEEMBER 1, 2014 <br /> Facility UST Owner/operator. Facility Contact DO Stamp and Slcnai -- <br /> PILOT /FLYING J LBRIAN CAIRNS <br /> Facility A dress: _ <br /> 1501 JACK TONE RD- <br /> RIPON, CA 95366 <br /> Contact Phone#: --- —'--- -- <br /> (209) 599-4141 <br /> Checklist lnstruebons: - --- <br /> A UST Designated Operator(DO),who poszesses a current"California UST _ <br /> System Operator"certification issued by the international Code Council(CC) <br /> must conduct a monthly visual inspection of-he UST system. <br /> The DO must provide a copy of this rr th . ✓isual inspection checklist to the <br /> UST Owner or Operator. <br /> The DO must alert the UST Owner or Ooe!r or of any condiiion discovered ' <br /> during the monthly visual inspection tha rn � require follow-up actions. ) <br /> The UST Owner or Operator must main am a copy of this monthly visual <br /> inspection checklist and all attachments for 'ie previous 12 months.The records ,n ec Operator <br /> must be maintained on-site,or, 'd approt d y the local Certified Unified Program �/ ,+ rr tec,CPer <br /> Agency CUPA or their desi nate,off sse at a readily available!-cation. <br /> t r <br /> avow • <br /> 1. Is the monitoring system powered on�-nd in the proper operating mode(i.e_.functional and not t -;ed) El <br /> 2. Does the monitoring system show nc current alarms or warnings(i.e.,"all functions not`nal")% X ❑ ❑ <br /> 3. Is an alarm history report or log ter th-previous month available and has it been rewev,e a oy the _ � )-� ❑ <br /> -Attach e copy of the Alarm History Repo,,,00 e rhe VIC d available.v not a✓ailable,explain why not m General c,mmants se . _ <br /> 4. Has each environmental alarm for the orevious month bees responded to appropriately,ac ordir <br /> response log and/or maintenance rP -rds?(NOTE:Non-anvironmentat alarms such as mr pepe,,sm an of or, ,ow ❑ ❑ <br /> product,fuel delivery needed,and invalid fed: evf F antlered to low product in the tank,do not need a be logged A! others 'o). <br /> 0 IF clr umil 1, rs=:c a e0 inspection on t t 7i5 <br /> 5. Have no tank-top containment sur np tensor alarms been f iggered within the past Mon-,-i> [' ❑ ❑ <br /> 5a. List all tank-top sump alarms trigg,dec-in the past month below (i,eob sit,mo re acs for ea- sp: ;;_ �. <br /> - - <br /> ❑ Norecord <br /> _ \ ❑ No record <br /> ❑ No record <br /> CA, C9k <br /> ❑ No record <br /> ❑ No record <br /> ❑ No record <br /> DEPAW <br /> For any sump alarms noted in 5a above with no record of a qualdled service techoirian resp- ,e. snsw rlcr; - d 6a below. NlA/Kl <br /> 6. Are tank-top sumps presently free of eater,debris, and 6a. Are tank-top sump orobF �r ; 17,-dy located (i.e., at <br /> hazardous substances? lowest point in .urnp)? <br /> (Use General Comments sectcn to sole additional details as needed) (Use Genera,Cr emLen ,--additional details as needed) <br /> ,� ❑ ❑ ❑ Li ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> �- <br /> -- ❑ ❑ ❑ CI ❑ ❑ - -- - <br /> --- ❑ r C; --: n_ -- <br /> -- <br /> El El �I, �: ❑ 7 C - <br /> — - - -- - <br /> ol <br /> G <br />