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<br /> Designated Underground Storage Tani: (UST) Opiormul.
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<br /> y Nan,c. 7-1132190 1)atc. 41('512014
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<br /> Address: 4943 S.STATE RT.49--- - _. � - m Y
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<br /> TOCKTON C'r7cic: 95215 - -- O_ �
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<br /> rh.,igtm1cd l of C111u star Con rlu,(i ig(lie Irr>lirlhr,ii JII,611-601i 111; - -- _-- O
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<br /> � In(cmatiuntlCmict: 11cerrit:catiorl 423222 Y U Q
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<br /> Signature: 1hurry 1')49)4hfl- 2i{){I - -- - - ._-
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<br /> ltcm MONITORING I ANF l 1 Al.AR8111 I.ORY
<br /> ! A]t 'iitoring S stem is oraerrdsot;(rrd ra ,r[ — Y n J \.1� N
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<br /> ��lonrtonng systi cn,is nut currcutly vlu-win':mV,al rrn.tit u•,rraaing . -
<br /> Allnn ltrvinr'rclalrr[Jr1,fiat[Ttc pray inu.s rn pit 1 tti�s t l 1111u and ha. hccn IL:v �°ed by the r)csrgn;ttcrl l"ti"i I x 107
<br /> Uperatur (:1t[sch a ulpy of the lsrrrr Ills?r n rtl,nrl.In to this Ibmi if a°,nil,tf,lc I x C
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<br /> Each Alarrra liar,the previous moltth h1s hour cvl,rin 1rd to appropt iatek O
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<br /> 4cnst)ra loea(ctl in tarok-tela onl:uirrnctl[sumlx hati o nu[talarmed in tlra I,.r.l rIr„ilia
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<br /> �a List all tank-trap suulp,,uficrc ainrtn ut�atrr:•_i gra he hast ntnnllr O
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<br /> b is11k- rp�r ra(_unnr nr 4nr I,, ���ire.. I . ri debris. and julz Irdoll,>uFwt.Inrr ti,,-,tiurs are lui:rrsd f•r�.�t,rils O
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<br /> 7 Spill contarlinicnt slrticu r s irc t'rcc of r::[tcr,dib,i;,::ndha;.ir, —� --
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<br /> 1 !IndLr di+pcarser conutinmual urc:l,uc cur ts,rter,dc6nv,and hxrardous suhsl trice. 5cn,ora are located pr�iperly.
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<br /> i Dispenser-111 X 1 Y N NA t3 d'
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<br /> Dispenser-314 x - - - _ x v Q
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<br /> - 1 APERMOiik INSPECTION y CL �
<br /> _ NA DATE DONE: p
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<br /> 11.J y Manitnm ring systecertification has been COMplctcd within past 12 months. -f Y cZt t�
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<br /> °� ]() ° $ectmd.uy containment te;;Lv have been cwnTllctcd st�illtin tT,r required[iine!'rr.me.—_-- x 12-IR-12 C
<br /> ,y T I Spill containment structure(buckct)testing was completed within the past ychr. _ ){
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<br /> _ 1 a Tank[igh[ne+c testing war;complctcd within required umcrramc. XC
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<br /> Uj13 Line riglttncss testing complctcd within required tamcfnrnte. 4 X
<br /> 14 Other rr quircd testing/maintcnance was complctcd within required timeframe_(List test/maintenance items below) 4 t3
<br /> Tc.tUMaintenance.' X MA It 0
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<br /> FAGILITY EMPLOYEE TRAI)VING �
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<br /> rUt facility r mployees have received t)tc rcquircd on-the-job training within the past year. X - T- N
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<br /> Ili All(aPlltty G1111'alOyt:eS hired w,Cllln 111C post 3U drays Tauti'C rCCCIVe(t tTlc rcyulred on-tttC=j06 tra,11+R�, x .` (T)
<br /> „should be cxplaincd#n the comment scc[Ton an the ialTnw#ne ppgc,and wi#1 rcqulre follow-up - �-
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