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Nov 19 07 04: 37p Affnrda Test (2091 744-0116 p. 9 <br /> Aflorda-Te,� <br /> Designated ��fi�eo Operator <br /> 416 2nd Street Galt, Ca. 95632 Montbly Inspection Checklist <br /> 209744-0112 - 800 524-9087 - ax 209744-01.16 <br /> Site: J 1. don Date: <br /> Designated O era 4 r: Davi A_ `VVijulder ICC #- 5263373-UC Expiation.- 313108 <br /> Signature Y-yes Nino NA'-notapplicablc <br /> MONII()RING PANEL/ALARM,HISTORY V N NA <br /> -Monitoring Systcm is powered on and in proper o gratin mode. <br /> Monitoring system is not currently showing an alarms or warnings. <br /> Alarm history report for the previous month is available and has been reviewed by D.O. <br /> (Artach alarm history,if available) x <br /> Fach alarm for the previou.s month has been res ondcd to appropriatcly. <br /> Sensors located in tank-to containment sum s have not alarmed in the past month.. <br /> List all lank-top suntps where alarms occurred in the past month l <br /> 3J <br /> Nate:,tiumps where an alarm has occurred in the past month must be inspected unless a yualiftcd servlcr: technician responded <br /> to, and properly addressed, the cause of the alarm. Attach documentation vertrying appropriate service to this rrport. <br /> I .rum lns peetlon 1s re ulrrd rrcord results In Item 46 ho-law- <br /> UST <br /> elawUST SYSTEM INSPECTIONY I N Y J,N N <br /> Tank-top contaimncnt stamps ate free of water,debris, and hazardous substance. Sensors located properly. <br /> Note, Visual inspection orsumps only required in sumps where an alarm has occurred in the past month for which there is no service record. <br /> J.-SumpJ.-Surnp location: Sump location: <br /> Suri location: surnp location: <br /> '-sump location: Sump location: <br /> Spill containment structures are free of water, debris, & hazardous substance. <br /> Tank 1 -Rc ular Tank 4-Diesel. <br /> 'yank 2-flus Tank 5 - <br /> Y'ank 3-Premium `rank 6 - <br /> Under-dispenser containzrlent free of water deb riti &:},azardous substance. Sensors located Vro erly. <br /> Dispenser 1/2 Dis cnscr 19/20 <br /> Dispenser 3/4 Dispcnser 2l ix <br /> Dis cnscr 516 Dispenser 22/21 Satellite x <br /> Dispenser 7/8 Dis cnscr 23/22 Satellite <br /> Dis cnscr 9/10 'Dispenser 24/23 Satellite <br /> Dispenser 11/12 X --Dispenser 25/24 Satcllitc <br /> Dispenser 1.3/14 17is cnscr 26/25 Satcllitc <br /> Dispenser 15/16 Dispenscr 27/26 Satcllitc X <br /> Dispenser_17/181 Dis Lcnscr 27 Satellite <br /> Facility Employee Training <br /> All facility cm Ice ccs leave received the rcc uired on-the-job training within the past year. <br /> All Cacili( • cm.lo ccs hired within (lie last 30 clays have received the rcc uirccI on the job training. <br />