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Village West Marina, 6649 Embarcadero Dr, Stockton, CA <br />- Designated Underground Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />Facility 1Vame: VILLAGE WEST MARINA Date: <br />Facility Address: 6649 EMBARCADERO DRIVE <br />City: STOCKTON Zip Code: 95219 <br />Designated UST Operator Conducting the Inspection: GREG KAISER <br />International Codeci itification 9: 5252318 tix station Date: 10/15[2015 <br />Sienature: �' Photic: 209 ) 887-2639 <br />Y = Ytv. N = No, tit, = Not APplteaRle <br />Item I /MONITORING PANEL / ALARM HiSTORY I v I N 1 1-4' <br />1 \Tonitorine <br />system is powered on and in proper operating mode. <br />t9onitorin� system is not currently showing any alarms or warnings. <br />3 Alamt history report/log for the previous month is available, and has been reviewed by the ><I <br />Designated UST O orator. (Attach a co of the alarm histol re ort/lo to this• form if available.) <br />4 Each ularm for the previous month has been responded to appropriately. <br />X <br />5 Sensors located in tank -top containment sumps have not alarmed in the past month. v I <br />Sa List all tank -top sumps where alarms occurred in the past month: <br />Note. S+mtps where art alarm has occurred in the past month must be inspected tmless a qualified service technician responded to. aril <br />property addressed the cause of the alarm. Attach documentation verifying appropriate service to this report. <br />lf.sunrn insnecrion is reouired. 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 arc located properly. <br />Ir N'or visual inspection of sumps is only required in sum s where an alarm has Occurred tit the past month for xduch there is no wmca <br />I 1 T: N <br />Stun Location: <br />Sump Location: <br />Sum Location: <br />Sump Location: <br />Sun? Location: <br />Sinn Location: <br />7 S ill containment structures are free of water, debris, and hazardous substance. <br />N <br />a, <br />N NA <br />�— <br />Tank 1 - Conten". <br />Tank 3 - Contents: <br />Tank 2 - Contents: <br />I <br />Tank 4 - Contents: <br />water, debris, and hazardous substance. Sensors are located <br />- <br />rk) ccl y <br />8 Under-dis enser containment area,; are <br />e of <br />a <br />Y N NA <br />- <br />Dis enser 3 / l <br />Dispenser 30 / 31 <br />l Dis censer 715 ,� <br />Dis enser 3 7 / 3 5 _ — <br />Disunser 23 i ?I j <br />Dis enser <br />- <br />Disenser?7/ 25 <br />— <br />Dispenser <br />PAPERWORK INSPECTION Y N NA DANL DOIVr. <br />9 Monitoring system certification has been cornleted within est 12 months. X <br />10 Secondary containment tests have been completed within the ret tired umelrante. - <br />1 1 Spill containment structure (bucket) testing was completed within the past car, - <br />12 Tank tightfiess.testlflg was completed within required timeframe. <br />13 1 Line tightness testing was completed within required timeframe. <br />December 2014 monthly D.O report with correct secondary containment test date <br />Page 18 of 28 Photo taken on March 16, 2015 <br />