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Village West Marina, 6649 Embarcadero Dr, Stockton, CA <br />UWU UrluGrg'11Ju11u OLUI "5- i -111, tv.a 1) vY� tawr <br />Monthly Visual Inspection Checklist <br />Fecilitc Name: VILLAGE WEST MARINA Date: <br />Facility Address: 6649 EMBARCADERO DRIVE I <br />CM: STOCKTON Zip Code: 95219 <br />I Desisnated U5T Operator Conducting the Ins ection: GREG KAISER <br />International Code Council Ce ti t n i, 5252318 Expiration Date: 10/15/2015 <br />OK "SiLnawre: Phone: { 209 ) 887.2639 <br />Y= Yes, N= No. ',A=NofA licable <br />item MONITORING PANEL / ALARM HISTORY Y N' NA <br />jitoring system is powered on and in proper operating mode. }1 <br />itorings stem is not currently showing any alarms or warnings. <br />m history report/log for the previous month is available, and has been reviewed by the X ` <br />gnated UST O orator(Attach a co v o%the alarm histot�t re ordlo to thisform ijavailable.) alarm for the previous month has been responded to appropriately. X <br />Sensors located in tank -to containment sumps have not alarmed in the past month.Ix I <br />Sa _ List all tank -top sumps inhere alarms accurr d in the past mon .O&'= 3 C 1 ✓h <br />e A e11 t <br />Note: Sumps where an alarm Inas occurred in the past month Lust be inspected unless a qualifkd service technician responded to, and <br />--�properly addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. <br />Ifsmnp inspection is required record results in item 6. below. <br />UST SYSTEM INSPECTION <br />6 Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />.tote: Visual inspection o sump s is onh required in sunt s inhere an alarm has occurred in the past month or lvhich there is no service recon3. <br />Y I N I I I_Y_T_N1_T_ <br />Stunt Location: <br />I Sump Location: <br />Sunt Location: <br />Sum Location: <br />Sump Location: <br />Sump Location: <br />7 Spill containment structures are free of water, debris, and hazardous substance. <br />Y N NA Y N NA <br />Tank i - Contents. <br />Tank 3 - Contents: <br />Tank 2 - Contents: <br />Tank 4 - Contents: <br />8 Under -dispenser containment areas are free of water, debris, and hazardous substance. Sensors are located property. <br />Y N NA Y N NA <br />Dis ensei�iLL <br />Dispenser 30 / 31 <br />Dispenser Z45- 3- <br />Dispenser 37 / 3.i <br />Dis enser 23_1_X- <br />Dispenser 27/25 <br />u Dispenser _ <br />DisDenser <br />PAPERWORK INSPECTION Y I N I NA I DATE DONE <br />9 Monitoring system certification has been completed within past 12 months. � _ <br />10 SecondM containment tests have been completed within the required timeframe. _ _1 'z - <br />-N&S was completed within the Past year. <br />January 2015 monthly D.O report with incorrect secondary containment test date. Also the C2 Diesel <br />Annular Space Sensor Out Alarm/ Fuel Alarm not documented <br />Page 13 of 28 Photo taken on March 16, 2015 <br />