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Nov 19 07 04 : 36p Afforda Test ( 209) 744-0116 p. 5 <br /> 416 2nd Street Galt, Ca. 95632 MOnthly hiSpection Checklist <br /> 209 744-0112 - 800 524-9087 •- Fax 209 744-0116 <br /> Date: 07 <br /> Foo t^y:2P_, .f <br /> Acsignatcd Operator: yid A. Winkler ICC 5263373-UC Lrpirulinn, 313108 <br /> Signature <br /> Y-ycs N=no Nth=not npplicahlc <br /> Monitorin Sy-tem is owel'ed on and in proper o erltin mode, Y N <br /> Monitoring wstcni is not OLir ntly showilig an alarms or warnin:s. X <br /> Alarm history report for the rcvious month is available and has been reviewed by D-O. <br /> (Attach alums history, if available) <br /> Each alarm for the revious month has been res onded to a ro riatcl , <br /> Sensors locatcd in tank-top containment sumps have not alarmed in the past month. )r <br /> Lisl rill tank-top sumps where alarms occurred in the pact month: <br /> --_.1>(�22_.A ,•mss_ .� <br /> Note• yz17nps where an alarm has occurred in fhe past month mtrst be inspected unless a gual fed service technician rye ponded <br /> to,and properly addressed the cause of the alarm. Attach documenlotion verijvirrg apprvpricite service to thi.v report, <br /> 1 sum Insecrfon iv reutrrc! record results in f�em 116 below <br /> UST SYSTEM INSPECTION <br /> _JyN Y N N <br /> Tank-top containmeztt sumps arc free of water, debris,and hazardous substance. Sensors located properly, <br /> ir'otc: Visual inspection of sumps oily required in sumps where an alarm hos occurred in the past month for which titre is no service record. <br /> Sunt location; btES <br /> um lot tion; <br /> �j <br /> um location: ump location: <br /> ""Sum location: ) butra location: <br /> Spill containment structures are free of water, debris, &hazardous substance. <br /> Tank I •- Regular NO Tank 4- Dicscl <br /> Tank 2 -Plus K <br /> Tank 5 •- � <br /> Tank 3 - Prcmium <br /> Under-dis enscr contai.tunerzt free of water debris & hazardous substanee. Sensors <br /> Dis cnlocated ro eel <br /> Dispenser 1/2 a, scr 19/20 <br /> Dis eraser 3/4 b Dispcnser 21 <br /> Dispcnser 5/6 Dis cnscr 22/21 Satellite <br /> Dis cnscr 7/8 fi Dispenser 23/22 Satellite <br /> Dis cnscr 9/10 Dispcnser Dis cnser 24/23 Satellite <br /> 1 <br /> -Dispenser 25/24 Satellite <br /> Dis enscr 13/14 i7.is cnscr 26/25 Satellite <br /> Dispenser I5/16 J>ispcnscr 27/26 Satellite <br /> Dispe�ffsrcr 17/1b Dis cnscr 27 Satellite <br /> Facility E"11310yee Training <br /> All facilit em lovees have received the re aired on-the-joU tr,tinin within the post vear. Y <br /> All facilit em to ccs hirccl within the past 3(? days I»avc received the re aired nn the joh trai:ninp. <br />