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C <br />Designated Underground Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />Facility Name: Ryder Stockton <br />[Jere: 1Z/27112 <br />Facility Address: 3633 Duck Creek Drive <br />City: Stockton <br />Zi Code: 45215 <br />Desi d UST Opemtor Conducting the Inspection: Rolando Urbina <br />International Code Council Cettification ft: 8009631 -UC <br />Expiration Date: 10/242014 <br />Signature: / <br />Phone: 408-942-8686 <br />Nor A""sole <br />Iters. 111)\1111K1\(: P 1\k:l 1l_ SRM 1111T1►K1 _ ; 1 � \ i \ � <br />_ <br />�1.mtt.annil .Y.tem r.�..%crrd on ruin to pn.lttr 2rj2ng nwlk. <br />%lonuonn . stem is mot cuttrntiv +hwA trig any alarms or warns ... <br />Alum hra.try teptttt kryl for the pnn wus nul•nrh is aYatLabk, enol has hurt m tcweti 1iY the <br />Desr tad UST Operakw (.1n+a h u c„ n ul the ,tkwm huts„t ry %*r 1 • u, this /:fnw r u,wluhlr 1 <br />i <br />_ <br />Fach alarm for t!x_Pre. iuus mumth has h.ett to tel x <br />S <br />Sends located in tank- &:tmtatnmcnt %umps hate ta” mimed in the pam month K <br />Sa <br />_ <br />- list all humor top sumlyl u ht-ty ,tlaami .h , mrrr,/ to, rk. /past mr,nth _L IX V --- - -- - <br />�aK+• S„rrM rAittir .If ,rit..rar haf to . W►+1t w Ihr p4flf too odh 41"1 t4- :a*" srj 4NW6 is a yw/rjn/ .." aur p. Ma falx rvvk v 4.+J M .art <br />1�"YKh' .rih'...d Mr . rotor •✓,hr .,rrrr loom � .M• �lrr.rmrrt .mral+t y�M"rtlr .ret a -r r. M,. •. �. rt <br />r • Mt ff.w ,) r. Val r.t rrJ /.'.rth N+ Mrs A hA_ <br />UST S1 STEM INSPECTK)N <br />6 <br />t .top contamnmu camps arm free of water. dcbn•. and harardotu +ul►rtance Sens,ws are k ea�ed pruparty. <br />.Yule 1 urfi rw t Ir.�.,/ • ft .•Mil aM'.•rt ri .4~. . owr .r..+brw hy..� .,mmol �� rhe lnr .wrrMA r .lr N rhrnr f. a, vnr r r.. ,.mal <br />N <br />Y <br />Susepl,le +mi armor Dteitem 1( <br />C Lrt utu,n l'.mli 11t1 X <br />Suoqp tin wwn. Dwsci Re er-.e x <br />vufflp IJr(-6001" <br />Skrmr Lon armors %v%t hi X <br />Nanp Lot aaiur <br />7Spit <br />containment Vructures are fres of water, debris, and hazardous triibetance. <br />---1 N NA Y N NA <br />Tank 1 - C'fmttenrs Dicaei Main x Tank 3 C•rutrev, New Od x <br />rank 2 - (•t;_tentan <br />_ , there, Resenr X tk 4 C rWents • ,:sod lAl — x <br />K <br />Under containnmt areas are free of water. debris. and hauankaus substance Sensors are kt - ted <br />'%A <br />_ <br />YZ1%-Ant, <br />_ <br />tfr 1 2 Oil 'Jl tl'r;Ihr <br />rter <br />x <br />nil tiler 2 x nil h'nla•/ - — -- - <br />_ <br />`t <br />_ PAPERNORK INSMTION <br />WMttortnll .Y.tent ccrtdicatrlm has heron tomQktcd %rt m past 1: rno-M s <br />,1 \ NAI DATE DONE <br />\ 19 12 <br />In <br />Smonciary conLunnsent tests haYc been conVicud %+thin the requtted ttmcfrtnk <br />\ I Irl II <br />II <br />12 <br />Splicantainment -Anx-ture (hucketl te-Aing was cjimpictcd wtthrn the past .ear <br />Tank N s texu Mil ctxrgmktc,i w tthm Mlluired Ilmeframc <br />13 <br />Lute tilghwwss Inst %as cLwMlejej %thin requirLd timeframe <br />14 <br />Other reqwmd tc-simt ntaintciunL:c w as cuffMlc d ,atthin rcquircd hmeftume rLw tett err irmrerwi, r cent, Ar(r+N r <br />-- <br />_ <br />reu%S/utmr&Ns` e <br />TetyikuntemAr+t - -- --_- -- — <br />Tr+t, lilrnt: nrlrt � <br />S <br />FAC -111.1 TV EYIPLOI I I I c 11\ING VA <br />aylo --I <br />I <br />All facility en have recital the m4wred ,m :. : �nQ cants the pzit Ycnr_ <br />Ir. <br />It facility c IuYee. hard within the a til dati. hal. ;:l cd the tcquited un -rhe -job trainmit x <br />:.uac: nuy nunrrCr vs r. snoutu ire expntnea in tae comment section on the following page, and will require <br />follow-up action. <br />Page I of 2 September 2004 <br />