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West Valley Auto Service LLC 2615 West Grant Line Road, Tracy, California <br /> -- rx uanon 1 ate: 07 2016 <br /> j' <br /> Rick Brayi Phone:(925)699-1396 <br /> Itet•j MONITORING PANEL/ 'ti'ef _�o "s=Not a tinbte <br /> a _ ALARM HISTORY Y N NA <br /> 1 <br /> Sionitcriine system is powered on and irk proper o mode. aaijz <br /> Monitoring system is not current!y showing any alarms or warnin2s. X <br /> 3 Alarm history reportloe for the previous month is available,and has been reviewed by the I X f <br /> Desi¢rtated VST razor. fArtach a co o the alarm histo r or/lo ro this orm' available. <br /> 4 Each alarm for the previous month has been resp2nded to appropriately. <br /> 5 Sensors located in tank-to containment sum shave not alarmed m the X <br /> c month. X . <br /> a List all tank-top sumps where alarms occurred in the past month: See notra page 2 <br /> j %ore.Sumps'-,here an alarm has ocewred in the past month must be inspected unleu a gwhfwd eedmieian responded to.and <br /> properh addressed the cause of rhe alarm.Attach donrmemarion verifying appropriate wrr/ce to this epm <br /> /su,w inspecrion is required,record results m item 6.below. <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Vote Visual r cnon ofsum s is o,i ,re rred in sum s where an alarm has occurred in the month or which dwre u w some recd d 1 <br /> Y N Y N <br /> Sum Location: 87 ��'A Sum Location: <br /> .Sum Locarion: 91 N"A Sum Location: <br /> .Sum Location: Diese! A'!4 Sum Location: <br /> 7 Spill containment structures are free of water.debris,and hazardous substance. <br /> Y N NA Y N NA <br /> Tank I -Contents: X Tank 3-Contents: X I <br /> Tank 2-Contents: X Tank 4-Contents: <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located properly.. <br /> Y I N NA Y N NA <br /> Dispenser 112 X Dispenser 9/10 X <br /> Dispenser 3/4 X Dispenser 11/12 X <br /> Dispenser 5 16 X Dispenser 13/14 X <br /> Dispenser 7/8 X Dispenser 15/16 X <br /> PAPERWORK INSPECTION Y N .NA DATE DONE <br /> 9 Monitoring system certification has been com leted within past 12 months. X 3!25!2015 <br /> 10 Secondary containment tests have been completed within the required timeframe. X 3!27/2015 <br /> I I Spill containment structure(bucket)testing was completed within the ast ear. X 3/25/2015 <br /> 12 Tank of htness testing was completed within required timeframe. X <br /> k 3'>>'_015 <br /> R 13 Line tightness testingwas completed within required timeframe.Line Leak Detector X <br /> 14 Other re uired testintJmaintenance was com !tied within required timeframe. (List test maintenance items behm.l <br /> Tes't/,Mainlenance:.58989 follow up testin 12-17-15 hr'UST Cohn li <br /> TestAkfaintenance.' <br /> I Test/Maintenance: <br /> (• FACILITY EMPLOYEE TRAINING Y N \A <br /> I S X <br /> All facility employees have received the re uired on-the-job training within the pa5t year. <br /> 16 All facili em to ees hired within the ast 30 da shave received the re uired on-the-job trainiiX <br /> q <br /> Note: Any answer of"N^should be explained im the comment section on the follortiin page,and"ill require <br /> follow-up action. <br /> page I oft November 2004 <br /> Incorrect date for secondary containment test <br /> Photo taken on- 3/14/2016 <br />