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Village West Marina, 6649 Embarcadero Dr, Stockton, CA <br />llestgnatect Uruuct 6� <br />Monthly Visual Inspection Checklist <br />^,-' <br />Ftyj ya(t 21P tj Date: - k4' <br />Facili Name: <br />> FaciIity Address Zi Code: — 1 <br />r Ci <br />! Designated UST Operator Conducting the Inspection: GREG KAISER nnA J� _Z S <br />International Codp, Z c cemficahon 5252398 LnY <br />I Phone (209 ) 827 2639 <br />PANEL / ALA -RM HISTORY <br />yMONITORING <br />L Item <br />t I ,Monitoring system is powered on and in proper Operating mode. <br />arning _ i <br />Monitoring system is not curr ­Tly showing any alarms or warnings- <br />is available, and has been reviewed by the <br />and <br />Alarm history report/log for the previous month <br />Designated UST O erator. (Attach a co o the alarm history repot r/lo to this orm i available.) !x <br />4 Each alarm for the revious month has been res onded to a ro nately. <br />5 Sensors located in tan] -to containment sumps have not alarmed in the past month. <br />6 5a List o11 tank -top sumps where alarms occurred in the past month: <br />Sumps inhere an clans has occurred in the past mondr must be inspected unless a qua! fed service (ed mitran responded to. and i <br />:fore: <br />properly addressed the cause of the o/arnt. Attach documentation verify g appropriate service to this report. <br />Y <br />Ifsum 'nsuection is require record results in nein 6. below. <br />UST SYSTEM INSPECTION <br />I <br />are free of water, debris, and hazardous substance. Sensors are located Qroperl-s . <br />6 Tank -top containment sumps <br />Note: Visual iection ofsum s is onl , required in sant s where an olorm has occurred in the past month for ,rh;ch rheic is noY i acNrecord. <br />Nns <br />Y N I <br />i <br />Sum Location Stun Location: I I I I <br />Stem Location: Sum Loeatiat: <br />Sura Location. Stvn Location: <br />7 1 Spill containment structures are free of water, debris, and hazardous substance. <br />NA 1 <br />qI <br />Y N NAI Y N <br />n <br />� <br />Tank ] - Contents: Tank 3 - Contents: <br />Tank 2 - Contents: 'e Tank 4 - Contents: <br />8 Under -dispenser containment areas are free of water, debris, and hazardous substance. Sensors are tocamd to tire. <br />Y I N INA Y N NA <br />Dis enser -JO!r 1 UJIJ I Dispenser 30131 <br />Dis enser J%0:7 a1 U Dis enser 37 / 35 <br />�k <br />Dis enser G7 Dispenser <br />Dispenser 27 / 25 Dispenser <br />PAPERWORK INSPECTION IY N NA DATE DONE <br />9 <br />1 Monitoring system certification has been completed within past 12 months. — l <br />10 <br />Secondary containment_ tests have been completed within the required timefiatne. <br />I I <br />Spill containment structure (bucket) testing was completed within the past - <br />12 <br />Tank tightness testing was completed within required timeframe. <br />13 <br />1 Line tightness testing was completed within required timeframe. <br />14 <br />Other required testis maintenance was completed within rued timeframe. (List testhnaintenance itelns below.) <br />Tesi/_Maintenance.- <br />TesdMaintenance: <br />tenance: <br />May 2014 monthly D.O report with incorrect secondary containment test date <br />Page 11 of 28 Photo taken on March 16, 2015 <br />