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Site ID:122: Afforda-Test 416 2a°Street Designated-Operator Facility Employee Training P o Galt,Ca 95632 MonthlyInspection Checklist :Ali aem layce3 f have received the requited on-tho-jjob Naming within the past year. ' 209-7440112 Fax 209-744-0116 AII fact7Sty errmloyees'Hiiedlvitbinthe past 30 days have received the required an the jab training. X Monthly Inspection— Site::MANIECA,13"RESS Date:8/2/12 Y -N NA' Date Done 419 S. MAIN ST. Mom-mg system certification(within past 12 months) X 5/30/12 Spill Bucket testing completed(within past 12 months) X 5/30/12 M?a19T CA, CA Leak Detector-machanicaVelectronic for most sites(within past 12 months) X 5/30/12 The above are usually done together on an annuat-basis for local regulator. ❑Lyle D.Nimmo ®Zane A.Nimmo ❑David A.Winkler ❑Felix G.Ramirez Line Ugbtness(usually upon construction when no positive shutdown) . X #5249115 #5263322 #5263373 #5273934 Tank Tightens(Usually only after or when using SIR) X seeonaaty containment(SB989)tests ha been completed(usually etry'3 y—) X 5-21-12 Y= N= NA -t*Mffi.bl .,., ....- .. Other testing or mausarance completed as ., _ MOIVIIC{�R•INCs�PANEL/-ALARM HISTORY, .- ,.X .N. NA required Fist them below: Mouitoringsystem-i*powei edea-anti-in-proper operatingmode: X- - Test/Mamtensoce:A Q MD X 5/30/12 -Monitoring-system-iti not cmrreullpsbowlng any alarm --Knings. - Test/Maintenance: - Alarm-historyreport/log Aw-the previous m-th is available;and-bas been reviewed by the Dedgnated'UST X Test/Maintenance: . _.. -- or,_Attachaco o the al—history.r. ora to.this armi available. .. . Pt3rD1 INQ UDED, Each alarm for the previous month hasbeen'responded to appropriately X Yes No,. ,;NA Sensors located in tank-lop containment sumps have not alarmed m the past mouth. X Commeafs ALL NICE AND CLF,A)tI. r. :.. 'caaU-tank4op'sumps-where alarms occurred in the past month: - .... - Noh:Sumps where mi alarm has ocaared m rhe past month must be.iwpected unless a qual fudservirx technician rrspondedto,. addressed the cause of the alarm Attach documentation verjfying approprk ie service to this report lfsump ingmction is required retard ranula . UST SYSTEM INSPECT-ION Y I N NA Y N NA Taut-top containment sumps are five of water,dam{dndlh�Qa dqus suk tante.Sgnsotigrl;jt p 4Y•w Items Follow- Actitms:Print bd Attached bb ion P rt --xab;.Voml it �'' hereowvWmhararaared NtM vrhldrdtae nMasrrvtn reootFt"�'� SumpLucation:-87 STP __.X_. SampLocatioa ._�_ 1 Sump Location:91 STP-. . Location;- _5ump—LocanRa._-_ ._..._s ..»_ .:Step Locanwt.-- S ilYcontaininert sitiitiTides"eYe°Ofe Fifer'? s& ce. Tank I-Regular X Tank 5- Tank 2-Plus Tank(r ;, WTAWy inspection must be conducted by.an3CC licensed.Designated Operator. Tank 3=Premium X Tank 7- r� 'Taok4-Diesel._ .X,.. ..,EankB-_ { ` Under-dispenserconlair>mentfree ofwater, &hazardous substance.Seosaslocated — A copy of this chec list,must be proviticd to LIST owner or operator.but not to State Water.Iteso, es- r.> :Disq>caset,l2 .. X Dispenser 1920 Y ti r. X.; rt flee l IS'I owner..pc:nlx:ralor u1 auty wndition discovereddtlting4 evD,ta�t . nispencer3l4'" X Dispenser 21 --- D.eSignatorOperatormust �1� -. a 5,.. c X insplxtion that may requtrc that may reyucn w up action_ Dispenser 5/6 X Dispenser 27121 - X ��+-� l$!.: X.,;Dispenser23fL2,;,, ti t irwtx:i ni ops:airor mnst.Inanuain a c,opyAhis mondily inslx°�trn andEny attachm 11 ispeaur 91,1[t,. X- Dispenser 2423.. :x 12 nit+milts.ktarAiLti mm1,he'r tatntau ed oust "'or,tf approvcdby'thc:louil.agenCy,off-site:. w r'�y Dispenser 11/12 X Dispenser 2524 - Xrt"T i Dispensed 3/14- - X Dispenser 2625 'Dispmscr 15/16 c,Dispenser22- _ j{. W 47 LL • '-