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a <br /> Designated Underground Storage Tank (UST) Operator <br /> Facili Name:CoDocoPhilli s sate Mo ly. Visual Inspection Checklist <br /> Facilit Address: 1206 <br /> C; :SE.March Lane Date:7/28//06 <br /> tockton <br /> Desi i UST erator Conductin the Ins coon:Tulle Lee Zt Code:95210 <br /> International Code Council Certification#:52gg777_. C <br /> Signature, �'' Ex iration Date: 12/14/2006 <br /> Phone:(510)245-5218 <br /> Item <br /> MONITORING PANEL/ALARM Y�Yes N"' NA <br /> I Momtorin s stem is HISTORY NoeA acorns <br /> 2 Monnorm s stem is notcurrentlashowinin oao alarms <br /> leratin mode. <br /> Y N NA <br /> 3 Alarm history report/Iog for the previous month is available,s andt has been reviewed by[he x <br /> Desi arm UST erator Attach a s o the alarm histo report/1a to this orm i available. x <br /> 4 Each alarm for the previous month has been res nded to a ro riatel x <br /> 5 Sensors located in tank-to containment sum sthe ast have not alarmed in month. <br /> Sa _ <br /> List all tank-top sumps where alarms occurred in the past month: x <br /> x <br /> Note:Sumps where an alarm has occurred in the N/A <br /> praperfy addressed,the cause ofthe alarm.A[tacicum h�ont 6e tnscred artless a uali <br /> I sum in salon is r 9 fled service technician responded to,nr,d <br /> ave I record results in item 6,below. 8 Pp pante service to this report. <br /> UST <br /> 6 Tank-top containment sumps are free of waters del and haz.rd iOsubstance. Sensors are located properly. <br /> Note:Pisua(ins cion o sum s is oral re iced in sums where an alarm has occurred in <br /> Y the l month or which thereis no service record. <br /> Sum Location: N <br /> Sum Location: Sum Location: Y N <br /> Sum Location: Sum Location: <br /> Ion Location: <br /> 7 S ill containment structures are free of water,debris,and hazardous substance. <br /> Tank 1—Contents:87 Y N NA <br /> tents:91 Y N NA <br /> Tank 3— <br /> x Con <br /> an 2—Contents:Diesel xf _ x <br /> 8 Under-di eraser containment areas are free of water,debris,and hazardous substance. Sensors are located to <br /> Div enser 1/2 Y N NA <br /> A is eraser 7/8 Y N NA <br /> Dis eraser 3/4 x x <br /> Dis eraser S Div eraser 9/10 <br /> x Dis enser 13/14 x <br /> Dis eraser 6 x Dis eraser 15/16 <br /> PAPERWORK INSPECTION <br /> 9 Monitorin em certification has been com leted within ast 12 months. x N NA DATE DONE <br /> 10 Second containment tests have been com leted within the re aired timeframe. x 5/5/06 <br /> 11 Spill containment structure(bucket)testin 2/29/04 <br /> was com leted within the ast ear, x 1 <br /> 12 1 Tank tightness testing was completed within required timeframe. 5/5/06 <br /> 13 Line tightness testing was completed within required timeframe. x <br /> x <br /> 14 1 Other required testine Liamtenance was completed within required timeframe. List test/maintenance items below. <br /> Test/Maintenance: <br /> 7bml"I amlenance: <br /> Test/Maintenance: <br /> FACILITY EMPLOYEE TRAINING Y N NA <br /> 15 All facility em to ees have received the re uired on-the-'ob trainin within the ast ear. x <br /> 16 All facility employees hired within the past 30 days have received the required on-the-'ob trainin . 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 /> Page 1 of 2 <br />