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West Marina, 6649 Embarcadero Dr, Stockton, UA <br />1� Designated Underground Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />Facility Name: VILLAGE WEST MARINA Date: <br />Facility Address. 6649EMBARGADERODRIVE <br />11IJ Gl:II VII. VRCV f�MIJCR <br />International Code Cou I cation #: 5252318 1 Expiration Date: 10/1s12015 <br />siernamre: Phone: ( 209 887-2639 <br />= Item MONITORING PANEL / ALARM HISTORY y <br />1 Monitorin¢ system is powered on and in proper operating mode. ',-/- <br />2 Monitor- 2 s stem is not current) showin an alarms or warnin s. jc <br />3 Alarm history report log for the previous month is available, and has been reviewed by the <br />Designated UST Operator. (Attach a copy o the alarm history =ortfiog to this form if available.) <br />4 Each alarm for the previous month has been responded to appropriately, y� <br />5 I Sensors located in tank -top containment sumps have not alarmed in the past month. k <br />5a - List all tank -top sumps where alarms occurred in the past month: <br />J Note: Sumps inhere an alarm has occtared in the past month must be inspected tmless a qualified service technician responded to, and <br />t( properly addressed the cause ojthe alarm. Attach docvmenmtion verifying appropriate service to this report- <br />/%smn ins,pection is required record resTdts in item 6, below. <br />UST SYSTEM INSPECTION <br />M6Ta�nk--top containment sumps are free of water, debris, and hazardous substance. Sensors are loted properly. <br />e: Vrstral in ection gfstan s is only re uired in stare s where on alarm has occurred in the ost month or which there is no service <br />Y N y <br />Location: Sum Location: <br />Location: Sum Location: <br />Location: Sump Location: l <br />7 LspM containment structures are free of water, debris, and hazardous substance. <br />Y N NA y <br />NJDi:vpemser-z1j7 <br />1 — Contents.• Tank 3 — Contents: <br />Z — Contents: >C Tank 4 —Contents: <br />-dispenser containment areas are free of water, debris, and hazardous substance. Sensors are located <br />Y N NA y <br />Dis enser 30 / 31 <br />er-z,,- Dis enser 37/35 <br />Fj 2 t�,..,: , i I x I I I <br />2712i <br />NA <br />PAPERWORK INSPECTION Y N NA DATE DONE <br />9 Monitorin system certification has been completed within past 12 months. <br />10 Secon containment tests have been completed within the required timeframe. <br />I 1 S ill containment structure (bucket) testingwas completed within the past year. >C —1 <br />12 Tank ti tness testingwas completed within required timeframe. <br />I3 Line ti to <br />testing was completed within required timeframe. <br />August 2014 monthly D.O report with incorrect secondary containment test date <br />Page 8 of 28 Photo taken on March 16, 2015 <br />