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WEST LANE CHEVRON 4747 WEST LANE, STOCKTON, CA UNDERGROUND STORAGE TANK SYSTEM DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT farilit, Name: West Lane Chevron I Inspection Date: 9/29/16 Faeui;. Wdresr 4747 West Lane City: Stockton Manic of Designated LIST Operator Conducting hxpection: Alex Jabbari International Code Council Cenilication No.: 5243897 -UC Expiration Date: 10/3/2016 Signanrm: , /1 t, ys. Phone: (925) 389-1262 \I y = Not Item MONITORING PANEL / ALARM HISTORY Yes No N/A I. I Is the monitoring system ow ered on and in proper Operating mode" _ Is the moninoring system not currently sho„ ine any leak alarm,^. _. Is the Alarm Hision Report log for the precious month available. and has it been reviewed by the ST Operator? i.4n ha : ov+ of the alarm hisiorr reportylot; to this inspection orin.l Designmed Um t�E�1[01 4. fids each alamh for the precious month been responded to appropriately? UST SYSTEM INSPECTION _. Are tank -top containment sumps free of water, debris, and hazardous substance? Note If the a>uwer to Item a was "'t'es nr skip rn 1iem 6. S otpt where an afar, has —.,-d m the past month most he o peered Jo q-11fied sconce rechnraton has ..tmspnrxlyd I tn, and rwx•h �r.hfre csrd the tmur of the alarm. Ga'umenlonan rerifi,rn npprpryne ten•ree shmdd hr orurehed ro this re n. No Sumps alarm I Yes I No Yes No Sump Locition: Sump Location: Sump Location: Sump Location: I ti. Arms ill buckets containment structures) free of water• debris, and hazardous substance? Yes No N/AYes No l N/A Tank 1 ID - Diesel Tank 3 ID - Regular Tank 2 ID - Supreme Tank 4 ID - ?. Are under -dispenser containment areas free of waxer, debris. and hazardous substance'.' Yes I No I NIA I I Yes No I NIA Dispenser -- 1 C Dispenser - 9; 10 Dispenser -_ 3 4 Dispenser - 1 P 12 _ _ _EFF0_ i Dispenser 5 6 Dis enser - 13 la TT I Dispenser - 7 S M I Li I Li I Dispenser - 15 16 - S. Leak detection i, properlv located within under-dis enser containment. - Yes No I N/A Yes No NIA I Dispenser - 1 -p Dis enser L) 10 Dis enser- 7 4 Dispenser - I I I_ Dis enser -;-6 - Dispenser -- L_t 14 Dispenser -' R Dispenser I>_16 I PAPER\YORK INSPECTION I 1 es I N_o N/A Date Done 9 '`lonitoring Sc stem Certification was completed within the past 12 months? j ❑ ❑ 9/29/2015 10. Sccundary containment tests completed within the required time frame? I 9/26!2014 11. Spill bucker jcontainment -structure ) resting completed within the past 12 months:' 9/29/2015 12. E Tank rightness testing completed „ithin the required time frame". --- I3. I Line [iehmes, testing completed within the required time frame? I I 11. Oilier re uired iesrin>;hnaintenance was completed within required time frame? rl.ist rasrmtrintrrnuter i+, nr..^::: j Describe I r,t Maintenance ST 27 and S'I'30 9/29/2015 I Describe TcslMaintenancr. FACILITY EMPLOYEE TRAINING T'rs,o NrA 6. 1 Have all facility em btees received the required on-the-job training within the put }car" 17. 1 Ila,e all fitcilitN ent loyees hired within the Is 30 days received the re uired on-the-job trarmne' -n....� :.: .... LJ LJ 1 M Note' Explain anN ..Nei' ansv,ers in the "Comment, section on the nnu...... Na the LIST ou tier operator. Designated operator did not answer item #4 23 24 26 2c Tri 291J0'1t =uA Photo taken on- 9/29/16