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Site ID: 1576-I <br /> - - Afforda-Te$t rl <br /> 416 2nd Street Ag 2D Designated Operator <br /> Gait,Ca Monthly Inspection Checklist <br /> 209-744-0112 Fax x 209 249-744-0116 <br /> E <br /> Site: J&L MARKET DEPARTMENT <br /> Date:3-6-17 <br /> 8125 S EL DORADO STREET <br /> FRENCH GC-1-1 1 <br /> ❑ Zane A.Nimmo ❑David A.Winkler ® Felix G.Ramirez <br /> ❑ Edward Stearns <br /> #5263322 #5263373 #5273934 #5250492 <br /> Y= es 1!=no NA=oot a licabte <br /> MONITORING PANEL I ALARM HISTORY Y N NA <br /> Monitoring system is powered on and in proper operating mode. - X <br /> Monitoring system is not currently showing any alarms or warnings. X <br /> Alarm history report/log for the previous month is available,and has been reviewed by the Designated UST X <br /> Operator. Attach a=o the alarm histaFy report/logreportlog to thisform i available. <br /> Each alarm for the previous month has been responded to appropriately X <br /> Sensors located in tank-top containment sumps have not alarmed in the past month. X <br /> List all tank-top sumps where alarms occurred in the past month: <br /> eNote:Sumps where an alarm has occurred in the past month must be inspected unless a qua!fed service technician responded tq andproperly <br /> addressed, the cause of the alarm Attach doeumetuarion verifying appropriate service to this report.If sump inspection is required,record results in <br /> item b,below. <br /> LST SYSTEM INSPECTION <br /> Y N NA Y N NA <br /> Tank-top containment sumps are free of water,debris,and hazardous substance.Sensors are located properly. <br /> Note: i'tsual in eetiort ofsum <br /> Ps iso mquiredin news where an alarm has occurred in the Past month or which there is noservice record. <br /> Sump Location: 87 STP X " '''>': Sump Location: <br /> Sump Location:91 STP X Sump Location: <br /> Sump Location:DIESEL STP X ` , Sump Location: <br /> tr <br /> Spill containment structures are free of water,debris,&hazardous substance. <br /> Tank 1 -Regular X Tank 5- X <br /> Tank 2—Plus X Tank 6- X <br /> Tank 3-Premium X Tank 7- X <br /> Tank 4-Diesel . X Tank s- X <br /> Underdi eraser containment free of water,debris,&hazardous substance. Sensors located properly. <br /> Dispenser 1/2 X Dispenser 19/20 X <br /> Dispenser 314 X Dispenser 21 X <br /> Dispenser 5/6 X Dispenser 22121 X <br /> Dispenser 7/8 X Dispenser 23122 X <br /> Dispenser 9/10 X Dispenser 24/23 X <br /> Dispenser 11!12 X Dispenser 2824 X <br /> Dispenser 13!14 X Dispenser26/25 LXX Dispenser 15,116 X Dispenser 27126 Satellite Dispenser 17118 Dispenser 27 <br /> L'd dtit,:Zl LI. 8ZInf <br />