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Village West Marina, 6649 Embarcadero Dr, Stockton, CA <br />Y Designated Underoround Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />Facility' VILLAGE WEST MARINA Date' l <br />I� <br />Fa;ilin AAd ress: bb49EMBARCADERODRIVE <br />tlt STOCKTON Zi Code: 95219 <br />l� i_na[cd 1'ST Operator Conducting the Inspection: GREG KAISER <br />Imcniational Code Cotflacil Certification --: 5252318 Ex iration Date: 10/15/2015 <br />Si_natnre: Phone: ( 209 ) 887-2639 <br />N'= 1'es. N N \ — Not.%pplicable <br />[ten a MONITORING PANEL / ALARM HISTORY <br />I Monitoring stem is pottered on and in properoperating mode. l <br />\ oni[orine sN stem is not currently showing any alarms or warnings. <br />Alarm histon reporulog for the previous month is available, and has been reviewed by the J I <br />Desi_nated UST Operator. (Attach a copy of the alarm history report/logreportllog to this orni i available.) 1 I� <br />4 Each alarm for the previous month has been responded to appropriately. <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />;a - List alt tank -top sumps where alarms occurred in the past month: <br />:Vote: Surmps it here an alarm leas occurred it: the past month must be inspected unless a qualified service technician responded to. and <br />properfr addressed the cause oldie alarm. ,4tmch documentation venfwng appropriate service to this report. <br />— — —� !f sunup inspection is required. record results in trent 6. below. <br />UST SYSTEM INSPECTION <br />6 l Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />—T0. \'ort thsual insnection ofsumos is only reouired in swims where an alarm has occurred in the oast month for which there is no service <br />I Sump Locations <br />Sump Location: <br />I St Location: <br />Stun Location: <br />Sum Location: <br />Sutra Location: <br />7 Spill containment structures are free of water, debris, and hazardous substance. <br />Y N NA Y <br />Tank 1 — Contents: <br />Tank 3 — Contents: <br />Tank ? — Contents: <br />Y Tank 4 — Contents: <br />8 Under -dispenser containment areas are free of water, debris, and hazardous substance. Sensors are located <br />Y N NA Y <br />Dis ensu j <br />\ Dispenser 30 / 31 <br />Dispense -9'-/7- 7 jV (� <br />Dispenser 37 / 35 <br />Dispenser l i <br />y' Dispenser <br />Disnenser 27/25 <br />Dispenser <br />NA <br />PAPERWORK INSPECTION I Y I N NA DATE DONE <br />9 Monitoring system certification has been completed within past 12 months. \ - <br />10 Secon containment tests have been completed within the required timeframe. \ - - <br />11 S ill containment stricture bucket testing was completed within the past year. <br />12 Tank tightness testingwas completed within required timeframe. <br />bhi.aw <br />July 2014 monthly D.O report with incorrect secondary containment test date <br />Page 9 of 28 Photo taken on March 16, 2015 <br />