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UNDERGROUND STORAGE TANK SYSTENPECEIVED DESIGNATED UST OPERATOR MONTHLY INSPECTION REIM 2014 Facility Name: Manteca Kwik Sery Inspection Date: July 15, Facility Address: 824 E Yosemite Ave City: Manteca DEPART LTkf Name of Designated UST Operator Conducting Inspection: Alex Jabbari International Code Council Certification No.: 5243897-UC Expiration Date: 10/6/2014 Signature: O Phone: (925) 389-1262 N/A=Not Applicable Item MONITORING PANEL/ALARM HISTORY Yesi No I N/A 1. Is the monitoring stem powered on and in proper operating mode? 0 L1 Li 2. Is the monitoring stem not currently showing any leak alarms? 3. Is the Alarm History Report/log for the previous month available,and has it been reviewed by the Designated UST Operator? (Attach a copy of the alarm history report/logreport1log to this ins ection ora) 4. Has each alarm for the previous month been res onded to appip riatel ? ® ❑ ❑ UST SYSTEM INSPECTION 5. Are tank-top containment sumps free of water,debris, and hazardous substance? Note:If the answer to Item 4 was "Yes,"or "NA"skip to Item 6 Sumps where an alarm has occurred in the past month must be inspected if a qualified service technician has not responded to,and properly addressed,the cause ofthe alarm.Documentation g nappropriate service should be attached to this re rt. L7: UDC 314 fuel alarm Yes No __,;� F No Sumps alarm Yes No Sum Location: ate: Sum Location: Sump Location: Li El - I Sump Location: 10 1 Li 6. Ares ill buckets(containment structures)free of water,debris,and hazardous substance? Yes No NJA Yes No N/A Tank 1 ID—Regular ❑ Tank 3 ID—Premium El El Tank 2 ID—Plus I ® I U I Lj I Tank 4 ID— 7. Are under-di enser containment areas free of water,debris,and hazardous substance? Yes I No I N/A I a No N/A -Dispenser— 1/2 1 El I El I Dispenser—9/10 0 1 ❑ -Dispenser—3/4L)i user-11/12 ❑ Di ser—5/6 ® EJIH Dispenser— 13/14 Dispenser—7/8 N Ll I LJ I Dispenser—15/16 8. Leak detection is properly located within under-dispenser containment Yes No N/A Yes No I N/A Dispenser—1/2 1 Lj I Dispenser-9/10 Di ser-3/4 D nser-11/12 Dispenser—5/6 M L1 0 1 Dispenser— 13/14 Dispenser—7/8 ® I ❑ I ❑ I Dispenser— 15/16 ❑ ❑ PAPERWORK INSPECTION Yes No N/Al Date Done 9. Monitoring System Certification was completed within the past 12 months? ® ❑ ❑ 6/30/204 10. Secondary containment tests completed within the required time frame? ❑ 10117/20113 11. Spill bucket(containment structure)testing completed within the past 12 months? 6/30/2014 12. Tank tightness testing completed within the required time frame? L1 Z 13. Line tightness testing completed within the required time frame? = ❑ 15. Other required testis maintenance was completed within required time frame? List test/maintenance items below) Describe Test/Maintenance: TP 201.3&TP201.6 Describe Test/Maintenance: I Li I ❑ FACILITY EMPLOYEE TRAINING Yes No UNIA16. Have all facIli em to ees received the re uired on-the-nob trainin within the ast ear? 17. Have all facili em to ees hired within the 2ast 30 d s received the re uired on-the-nob training.? I Ll 1 ❑ Note: Explain any"No"answers in the"Comments"section on the following page. Those issues require corrective action from the UST owner/operator.