Laserfiche WebLink
Monthly Ins ection - Page 2 of 2 <br />PAPERWORK INSPECTION771--- <br />Tank <br />Date Do e <br />Monitorin system certification within past 12 months b 6 <br />Spill Bucket testingcom leted within past 12 months b (- <br />Leak Detector-mechanical/electronic f r m sites (within12 1610116(, <br />The above are usually done together on an annual basis for local re <br />Line Tightness (usuallyupon construction or when no positive shutdown <br />Tightness (usually only after construction or when using SIR) <br />14 <br />secondary containment (SB989) tests have been com leted(usually every 3 yrs X <br />Other testin or maintenance com leted as re uired. List them below: <br />Test/Maintenance: <br />Test/Maintenance: <br />Test/Maintenance: <br />Comments: V, % I LA— IEC>tAL-ED <br />Items Requiring Follow-up Actions: <br />Monthly inspection must be conducted by an ICC licensed Designated Operator. <br />A copy of this checklist must be provided to UST owner or operator, but not to State Water Resources. <br />Designated Operator must alert the UST owner or operator of any condition discovered during the <br />monthly inspection that may require follow-up action. <br />UST owner or operator must maintain a copy of this monthly inspection and any attachments for the <br />previous 12 months. Records must be maintained on-site or, if approved by the local agency, off-site at <br />a readily available location. <br />