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Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name:ConocoPhilli s Site#2705445 1 Date:3/21//06 <br /> Facility Address: 1206 E.March Lane <br /> City: Stockton Zip Code: 95210 <br /> Designated UST Operator Conducting the Inspection:Julie Lee <br /> International Code Council Certification#: 5248777-UC Expiration Date: 12/14/2006 <br /> Signature: <br /> Phone: (510)245-5218 <br /> �°` <br /> Y=Yes,N=No, A=NotAppllcable <br /> Item MONITORING PANEL/ALARM HISTORY Y 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 report/log for the previous month is available,and has been reviewed by the x <br /> Designated UST Operator. (Attach a copy of the alarm history report/logreport/log 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 sums have not alarmed in the past month. x <br /> 5a List all tank-top sumps where alarms occurred in the past month: <br /> N/A <br /> Note:Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to,and <br /> properly addressed, the cause oJlhe alarm.Attach documentation verifying appropriate service to this report <br /> If sump inspection is req aired,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 /> Nole:Visual inspection o sums is only required in sum s where an alarm has occurred in thepast month or which there is no service record. <br /> Y N Y 1properly.Sum Location: Sum Location: <br /> Sum Location: Sum Location: <br /> Sum Location: Sum Location: <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N NA YTank 1 —Contents: 87 x Tank 3—Contents:91 x <br /> Tank 2—Contents:Diesel x Tank 4—Contents: <br /> 8 Under-dis enser containment areas are free of water,debris, and hazardous substance. Sensors are located <br /> Y N NA Y N NA <br /> Dispenser 112 x Dispenser 7/8 x <br /> Dispenser 3/4 x Dispenser 9/10 x <br /> Dispenser S x Dispenser 13/14 <br /> Dispenser G x Dis enser 15 116 <br /> PAPERWORK INSPECTION Y N NA DATE DONE <br /> 9 Monitoring system certification has been completed within past 12 months. x 5/12/05 <br /> 10 Secondary containment tests have been completed within the required timeframe. x 12/29/04 <br /> 11 Spill containment structure bucket testing was completed within the past year. x 5/12/05 <br /> 12 Tank tightness testing was completed within required timeframe. x <br /> 13 Line tightness testing was completed within required timeframe. x <br /> 14 Other required testing/maintenance was completed within required timeframe. (List test/maintenance items below.) <br /> Test/Maintenance: <br /> Test/Maintenance: <br /> Test/Maintenance. <br /> _. ... <br /> FACILITY EMPLOYEE TRAINING YV NA <br /> 15 All facilityemployees have received the required on-the-job trainingwithin the past year. x <br /> 16 All facilityemployees hired within the past 30 days have received the required on-the-job training. x <br /> Note: Any answer of should be explained in the comment section on the following page,and will require <br /> follow-up action. <br /> Page 1 of 2 <br />