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6226 <br /> \ Designated Underground Storage Tank(B.JST) Operator <br /> Monthly Visual Inspection Checklist <br /> ,Facility Name- <br /> �c-.� d>_riity Address: - <br /> Valiey Undergtotutd Tank Mond"ng <br /> Mailiizg and Remittance Address: Valley Undergfound Tank (illonitonng <br /> P-CI-Box 33 <br /> Stockton,GA 95241 <br /> 0 i noted UST(Dperatar Conducting the Ins an II.rattt <br /> - — - - Date. 5/12/13 - <br /> S ndTt ire= - - Pham 2fJQ� ' <br /> Y=Yes.I-NLo,NA=toot APPrWaUle <br /> !tern MonitoringPansilAlwm Hist Y N NA <br /> c -1 ondonng systeni+s Bower on a in zPeta . <br /> 1 urutoruLg s3rsterrt is not currently y any . mis of ucarruni <br /> 3 m gory re a previous UW <br /> is a rem <br /> ed <br /> by!!�e Designai tJST Operator_(Attarl,a copy at the alarm histaY r o >f ava7ab�e)- <br /> a a or a Previous tnont as to ap <br /> 5 risors --tan #op con sttm� no in <br /> List to -top surnt3 w rrs °' Past <br /> - mmigh�be s>�9ed miless a quaWied service <br /> worn_.Siurtt�S where an al-a"has olx� Y► ePast <br /> tchr4cian r � to,and p W.4y dde lire Cause of Ih2 ararm. t lWh <br /> r docurnentatinrt-M#Ying <br /> ,OPMpna►e service to this tsporL tf sump tnspt rr is rcquued,M-0 reruns in gem S,betas+._ <br /> UST System Ins <br /> -top Cort nment sumps are Of;rater, <br /> y Sensors are locates P�dY- �-�t e�Df stumps are only4eill.rsed <br /> wItarx--an all bas ocsarlrad in i-pan rrwnm rorwfr nlar�is rio service record _ <br /> urnp_ oratxxt: P batt <br /> um ocatrott_ <br /> Limp cation: \ <br /> �p C�cnntainrrtent structures ata ee w-1 11--r. <br /> nce_ <br /> an - nt8nts: Contents: <br /> tents: 4 onten#s: <br /> er- penser Coil snment areas ata water, our su lance. ensors <br /> afe Located roperty- <br /> tspenser V <br /> tspenser 1spenSer 4 <br /> tspenser is <br /> pertser <br /> Paperwork inspection Y N NA <br /> ortttonng <br /> system ce ca NIS i root! <br /> Ilaa" containment tie: ts a <br /> containmerit Structure t testi ig was w1um,Past yew- <br /> r - <br /> � lrit?s� t�estirt oras t:a Te <br /> ane lig tness testing was comp re4 <br /> e_ (Lisf:rnainL items below)- <br /> 4. <br /> Other fequjreij festingimaniW11— <br /> es, maintenance: _ <br /> es MairlterLartGB= L d" <br /> es maintenance: — Y N NA <br /> _ <br /> FacilityEm to ee Trainin <br /> ac,rty emp oyees ave recent requlr ed t9 in past year- <br /> Dill <br /> eO <br /> emp oyees err w-, in past ys a received fequir <br /> ori--its ob �airsuig. <br /> Note-Any aer of"N"should be explained in the comment seCtion on the foilgA ing)aw,_ <br /> and wilt rt q1i f*Uow-UP acbOil <br /> _. Pglof2 <br />