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West Marina, 6649 Embarcadero Dr, Stockton, cA <br />Desii;natcd Underground Storage Tank (UST) Operator r <br />Monthly visual Inspection Checklist <br />�Ira�ilinNamc. VILLAue_I-tel nrl+nrnA I <br />6669EMBARCADERODRIVE <br />6 <br />Date: <br />I'a.ilm-:\ddnss- <br />STOCKTOCm>� N I <br />� <br />yin Code' 952'19 <br />_ .. _ <br />tt—nulyd l!S I'(�cntorConductm the Ins cctwn: GREG KAISER <br />rinrrmm nal Cola ci rtilicrrtion �; 5252318 <br />[x imtion fate: 10/15!2015 <br />ti�mr,uurr /`r <br />✓_� <br />Phone' 209 <br />( )887-2639 <br />Y = Yee. I <br />Ifotn MONITORING PANEL I ALARNI IIISTORY <br />1 %lonitorin¢ system is 12owered on and in'Ji . ; -- <br />lode. <br />_ <br />Ali+nitoring system is not currently showing anv aI"­";... <br />_ Alarnt hi<ton repon/Iog For the previous month - <br /><viewcd by the <br />IDesignated UST Operator. (Attach u , •�/ lhr <br />+c form ifavailable. <br />4 L:ach alarm for the previous month has bca. ronded u.: <br />I Sensors located in tank -top containment sump—, _---,past <br />rnonth. - <br />5a _ List ull lame( -top sumps where alav*, in the <br />- -- <br />Sam S—y" +. hero ml alarm h o afro the post month may i <br />proper/r nti,h esseJ rhe can x J I �i.rm..tlloeJr daealRenfafion + .. <br />6. h,1- <br />. r . , oris "p- <br />ponQh,1— <br />G 1 Tank -top canta,nmc I sumps are tree ofwater, debHs,andit0k dOtUs substance. Sensors are Located pra <br />:\'are 1'r nurl uesprrnal olsum/?s lS anh'reUurrr:�... .r Js nJrr. rc.,alarm hos pCcy stn rk, rcrr , s nG <br />Sump Lncarion: �_ arp Lvealion: <br />Sump Location: i Sump Locolin_n <br />Sum Location., _ __ ~. Sum,.•+ -- ----- A <br />7 Spill containment structures are - r, r .iris, and haze 1 <br />_ ?' N NA 1 <br />I Tank I-Cr»Ilents: Tank 3 <br />VD <br />onsents: 'I'ank 4 - Cr:;,t-nts: <br />enser containment areas are e of water, debris, and h.; .ions sub'- sensor <br />Y N NA <br />3 / l r )I v: enser 30 / 31 <br />Dispenser / 5 _ Dislrenser 37 / 35 - <br />3 i 2I ti Dis er <br />Dis enser 27125 Dis enser a <br />PAPERWORK INSPECTION Y <br />9 Monitoring system certification has been completed within past 12 month. �' 1 <br />10 Secondary containment tests have been completed within the required Lir, <br />I I Spill containment structure (bucket) teslinrg, s completed within chic J-1 <br />12 Tank tighttess testing was completed widir quired timeframe. _- <br />13 Line tightness testing was completed within required timefratne. <br />Fes- 14 Other required testi, maintenance was completed within required timeframe. _(List ._nance items h+' <br />TesilAfaintenance: <br />TestlMaintenance: �-l-QAY T y <br />Test/Maintenance: <br />FACILITY EMPLOYEE TRAINING <br />15 All facility employees have received the r uired on-the-job training within the ast ear. _ <br />116 , All thcility employees hired within the past 30 days have received the required on -the -yob trainin17. <br />Note: Any answer of "N" sh a comrsQp the fog and will require <br />December 2014 monthly D.O report with incorrect secondary containment test date <br />Page 4 of 28 Photo taken on March 16, 2015 <br />