Laserfiche WebLink
Afforda-Te$t Designated Operator <br />416 2nd Street Galt, Ca. 95632 Monthly Inspection Checklist <br />209 744-0112 - 800 524-9087 - Fax 209 744-0116 <br />Site:��© 7, Date: /D /o/ /6 ee <br />( <br />1r. , <br />Designateda ator-_.Zone A. Nimmo ICC # 5263322 -UC Expiration: 2/3/08 <br />i <br />Signature ; Y=yes N=no NA= not applicable <br />Q <br />Monitoring System is powered on and in proper operating mode. I X <br />Monitoring system is not currently showing any alarms or warnings. <br />Alarm nrP 7;t ,, -4, : n:1..1.1.. ..-A L__ I---- <br />(Attach alarm history, if available) y <br />Each alarm for the previous month has been responded to appropriately. J� <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />List all tank -top sumps where alarms occurred in the past month: <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded <br />to, andproperly addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. <br />Ifsump inspection is required, record results in item #6 below. <br />111 111101111 111111 <br />UST SYSTEM INSPECTION <br />Y <br />N <br />Y <br />NN <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors located properly. <br />Note: Visual inspection of sumps only required in sumps where an alarm has occurred in the past month for which there is no service record. <br />Sump location: eF>`j Sump location: C <br />Sump location: eFlX Sump location: <br />Sump location: ENSump location: <br />Spill containment structures are free of water, debris, & hazardous substance. <br />Tank 1 - Regular X Tank 4 -Diesel <br />Tank 2 - Plus X,..++Tank 5 - �( <br />Tank 3 - Premium Tank 6 - K <br />Under -dispenser containment free of water debris & hazardous substance. Sensors located vro erl . <br />Dispenser 1/2 )C Dispenser 19/20 <br />1C <br />Dispenser 3/4 X, Dispenser 21 <br />Dispenser 5/6 X Dispenser 000 Satellite ® ?r <br />Dispenser 7/8 7XC Dispenser 23/22 Satellite <br />!C <br />Dispenser 9/10 Dispenser 24/23 Satellite <br />iC <br />Dispenser 11/12 Dispenser 25/24 Satellite <br />?( <br />Dispenser 13/14 X Dispenser 26/25 Satellite <br />X <br />Dispenser 15/16 x. Dispenser 27/26 Satellite tel( <br />Dispenser 17/18 jC I Dispenser 27 Satellite ly, <br />REWEEMWE <br />Facility Employee Training <br />All facility employees have received the required on-the-job training within the past year. <br />X <br />All facility employees hired within the past 30 days have received the required on the job training. I <br />>t_ <br />