Laserfiche WebLink
.A <br /> Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Facility Name: Express Market Date: August 28,2013 <br /> Facility Address:410 S.' ain St <br /> City: D ima CA Zi Code: 95337 <br /> Designated UST( is or Conducting the Inspection with Lyle I deeks Franzen-HillCorp. <br /> International Code Council Certification#: 8188753-UC E iration Date: 1-18-2015 <br /> Signature: jjXzty4 Phone:(559)805-3367 <br /> Y—Yea,N=No,NA=Not A licable <br /> Item MONITORING PANEL ALARM HISTORY I YJ N INA <br /> 1 Monitoring stem is powered on and in proper o eratin mode. X <br /> 2 Monitorin system is not currently showing any alarms o s. X <br /> 3 Alarm history report/log for the previous month is availat le,and has been r <br /> Designated UST r. Attach a co o the alatm h to re rt h i,avai <br /> 4 Each alarm for the previous month has been responded to appropriately. X <br /> 5 Sensors located in tank-top containment sumps have not armed in the p2st month. X <br /> 5a _ List all tank-top sumps where alarms occurred in the past month: JUN 19 2014 <br /> Note_Sumps Aere an alarm has occurred in the post month must inspected unless a q[A ri r�rpoxdarl rQ.,a j <br /> properly addressed,the cause of the alarm.Attach documentation vr6ing appropriate service tortr <br /> Irequired, <br /> /1L t 1 CHL't t <br /> sum ins tiott is re uired,record results in item 6,below. <br /> UST SYSTEM SPECTION <br /> L- 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Note:Visual inspection o sum s is only requi In sum s where an 41arm has occurred in the post month or which there is no service record. <br /> Y N Y N <br /> Sump Locatio-, _ Sump Location: <br /> Sump Locah Sump Location: <br /> Sump Loca. on: Sump Location: <br /> .7.----Spill containment structures are free of water,debris,and iazardous substance:__. _.__.._..._........_._. .... <br /> Y N NA Y N NA <br /> Tank 1—Contents:Premium I X Tank 3—Contents:Diesel X <br /> Tank 2—Contents: Unleaded Ix I I Tank 4—Contents.Vapor buckets X +_ <br /> 8 Under-dispenser containment areas are free of water,debr s,and hazardous substance. Sensors are located proWVperl . <br /> Y N INA Y N NA <br /> Dispenser 1/2 X I Dispenser 9110 <br /> Dispenser 3/4 X Dis.penser 11/12 <br /> Dispenser S/6 Dis nser 13/14 <br /> Dispenser 718 Dis nser 15/16 <br /> PAPERWORK INSPE TION Y N NA DATE DONE <br /> 9 Monitoring system certification has been completed wi i past 12 months. X 05-30-12 <br /> 10 Secondary containment tests have been completed within e required timeframe. X 05-21-12 <br /> 11 Spill containment structure(bucket)testing was complete( within the past yW. X 05-30-12 <br /> 12 Tank tightness testing was completed within required tinit aame. <br /> 13 Line ti mess testing was completed within required time <br /> 14 Other required testis maintenance was completed within uired timeframe. (List testbnaintenance items below) <br /> Test/Maintenance: <br /> Test/Mainienrwv: <br /> Test/M,-' evaace: <br /> FACILITY EMPLOYEE TRAINING Y N NA <br /> 15 All facility employees have received the required on-the training within the past year. 5-22-12 X <br /> 16 All facility employees hired within the at 30 days have ri=ived the r d on-the-' training. X <br /> Note: Any answer of"N"should be explained in the comment section on the following page,and will require <br /> follow-up action. <br /> INnnA <br />