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Designated Underground Storage Tank(UST)Operator Monthly Visual Inspection Checklist Facility Name: 7 Eleven Inc Date: 12/08/2008 Facility Address: 1399 N MAIN ST Station: 19976 City: MANTECA,CA Zip Code: 95336 Designated UST Operator Conducting the Inspection: Ryan Wyatt International Code Council Certification#: 5315333—UC Expiration Date: 07/23/2009 Signature: Phone: 559-999-2301 Y=Yes,N=No,NA=Not Applicable Item MONITORING PANEL/ALARM HISTORY Y N NA 1 Monitoring system is powered on and in proper operating mode. X 2 Monitoring system is NOT currently showing any alarms or warnings. X 3 Alarm history report/log for the previous month is available,and has been reviewed by the Designated UST Operator. (Attach a copy of the alarm history X report/log to this form if available.) 4 Each alarm for the previous month has been responded to appropriately. X 5 Sensors located in tank—top containment sumps have NOT alarmed in the past month. X 5a — List all tank—top sumps where alarms occurred in the past month:Ll—L8 Note:Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to;and properly addressed,the cause of the alarm. Attach documentation verifying appropriate service to this report. If sump inspection is required,record results in item 6,below. UST SYSTEM INSPECTION 6 Tank—top containment sumps are free of water,debris,and hazardous substance. Sensors are located properly. Note:Visual inspection of sumps is only required in sumps where an alarm has occurred in the past month for which there is no service record. Y N NA Y I N NA Sump Location: RUL X Sump Location: UNLEADED X Sump Location: PREM UNL X Sump Location: PREMIUM X 7 Spill containment structures are free of water,debris,and hazardous substance. Y N NA Y N NA Tank 1—Contents: RUL X Tank 4—Contents: UNLEADED X Tank 2—Contents: PREM UNI, X Tank 5—Contents: PREMIUM X 8 Under—dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located properly. Y N NA Y N NA Dispenser 1/2 X Dispenser 9/10 X Dispenser 3/4 X Dispenser 11/12 X Dispenser 5/6 X Dispenser 13/14 X Dispenser 7/8 X Dispenser 15/16 X PAPERWORK INSPECTION Y N NA DATE DONE 9 Monitoring system certification has been completed within past 12 months. X 01/02/2008 10 Secondary containment tests have been completed within the required timeframe. X 01/08/2007 11 Spill containment structure(bucket)testing was completed within the past year. X 01/02/2008 12 Tank tightness testing was completed within required timeframe. X 13 Other required testing/maintenance was completed within required timeframe. X 01/02/2008 14 Other required testing/maintenance was completed within required timeframe. (List test/maintenance items below.) Test/Maintenance: Test/Maintenance: Test/Maintenance: Note: Any answer of'N"should be explained in the comment section on the following page,and will require follow—up action. Page 1 of 2 January 2009