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.. <br /> 0 <br /> > AT <br /> o (Q0- <br /> IC Ort REPO <br /> Y i <br /> 1''ANNSPECf <br /> (D f <br /> is N 0 81C UNI)F.RCRt)UND 11 n <br /> `< O �° ti nG, NATBU UST OPFRA'l(W 'V1 6/10 <br /> Urlik'y^a 1 Mnrcn a nunrfu chenrron 7 9 g2��taaow Pr(/� <br /> .L __ <br /> C 1 NVIY urfh fnln Me cn len! laa'' ix '•"t A N /r���� <br /> � � � rnh�Wl.nu « mal lihl l4r.mn.rarAocilna ingr<hra, as:.a'I ,.ire: ( Y� YL <br /> N I r'•.fc __ i <br /> 3 �: al�furc n 1..minn No GO•a <br /> N O ` _.== RV <br /> Co r, 1 I. <br /> _ M NI� by <br /> 1. Is WR�j W <br /> n) ? 2. is monnlxl MOYITORING P��IiAO pq�� <br /> SCD 3. monllrxin ye4m p.werc I amt In pi.Pc'r eslsrms'- ho.0 pif f� �Ya>'•' <br /> y " fe the AI°rm Ilia Y"km nw carr ny (wwi4 eny k ,`- I, to <br /> 1 Ipwr -id 1^, <br /> D41 Y Repm/l nn rhe ioos munch a rl'/I �r r^ ar'°•� <br /> Q 1. -I JIM <br /> rtY..Chiiermr �Arluchu _u/'Ih�alarm_-� !We n ,dr.i//yr pr No <br /> 3 n <br /> (D s• Aft Vnk. °� bw fnomk SVST M INSPF yrhs�e✓i%ro.rcP°rc' y <br /> ru rnm..•top containment wm free of watcT.aeixie.end hsrs d dM }( <br /> (n Ya c <br /> Yes No Sum I.a�pn: ? <br /> Lxatlon:PREMIUM X Srfnl Lo�tJ �sn <br /> (C)- Aft s f11 yatuckas�LDED X yrd Irei'- <br /> contaimm�fl gnfcttfra free ofwamr• <br /> Q) Tank 11D- <br /> PREMIUM Y No WA •r+nkp[D' ya ND p/A <br /> Tank 2 ID-UNLEADED Tank 5 ID' <br /> Tank 3rD--DIESEL Tank 6 t. D,.r1iVS subsls°U• O <br /> Are under-dis ser wnminment!utas!roe of wawN ^s' her••'-_q/10 X <br /> Dis nser- r2 Yes No <br /> N Di ser=11/12 X <br /> O Dis <br /> nser-3/4 I nur�13/14 <br /> s ser-5/6 <br /> o 15!16 <br /> � Dis riser-7/8 Di _ yes No NIA <br /> 8. Leak detection is rotainment• <br /> rl located within under-di con <br /> Dis W- 112 Ya No NIA Dis ser-9/10 X <br /> X m <br /> Dis nxDis _11/12r-3/4 r_13114 I r l <br /> Dis enser-5/6 Dis ria <br /> Dis nser- 7/S is riser-15/16 <br /> yes No NIA Date Done <br /> PAPERWORK INSPF.('I JONx 1111$12014 <br /> Monitorin S stem Certification was completed within the ast 12 months? 1111$12014 <br /> Line Leak Deteclors were tested/certified within the t 12 months? X 1111$12014 <br /> 'p I Spill bucket containment structure testing co m feted within the ast 12 months? X X VPH (j <br /> 00 Line tightness testing completed within the required time frame? X VPH <br /> o Secon containment tests completed within the required time frame? <br /> I Enhanced I-cak Detection completed within the required time frame? X r <br /> m Other required testin maintenance was com leted within required time frame? (List test/maintenance items below. <br /> o Describe Test/Maintenance:Air Quality/Vapor X 10181 <br /> z <br /> z Describe Test/Maintenatrce: <br /> 0 <br /> < FACILITY EMPLOYEE TRAINING yes p <br /> m <br /> 3 have all facilit employees received the required on-the=ob trainingwithin the ast ear? X (� <br /> 6 <br /> lave all facili em to ees hired within the ast 30 da s received the re uired on-the=ob trainin ? X (Jl <br /> c^'„ :xplain any "No•answers In the"Comments"section on the following page.Those issues require corrective a N <br /> N le UST owner/opcrator. <br /> CD wr w.unidncs.olR <br />