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0[n <br />= v <br />O mCD <br />—I O > <br />O �' CLQ <br />NA --d W N tD <br />Ep LINOERG�a C <br />U oEn <br />�� <br />stop MTyRY y�sUq a STORAGE q o `� <br />3555 W.rket arts2 - NSpECTIpN NK (i15T) pp <br />stockto er t -ane CHECKLIST <br />,. ", >� ss ERATp 0 <br />-?'e Carpenter; Cu 219 N <br />r tr <br />8167865itis o <br />-UC No, <br />r ,ember 7 tot v eD <br />D <br />_ O v <br />:3 <br />m <br />March is, m 2011 <br />s - 91f1g O <br />q a <br />O <br />.., _ N 77 <br />report a Y stv ng a mode � <br />�Y of the al rm for the Prevmus mon h a or warn s. _ .. Y O � <br />-Eat alarm far the rm h aro y rePwt t ava kable ami pray N <br />1 pre' irs min tank-toponth has to this tOrm? been rec d by the ❑ <br />_ — <br />_ � � <,p r <br />_ aN <br />-for su contarnrrrer;t sumpsespOnded to appropriately 11- <br />mPs there elms ave NOT ala (O <br />-� '� occumsdr'n rm�. w N <br />past _ <br />N <br />tt W m , eM cause Of the � � Aaat month mast be ins .:�. O <br />ra stamp Attach doeurrrNatron 7 <br />.�� - ua�pN record resuHs in sem 8 bekw *i r8 aPPropnateI to this repo4 <br />rehn�yn rss <br />Darted fo, .. <br />O <br />Tank -top COntainment sum UST SYSTEM INSPECTION <br />N <br />Note' <br />visualonsInme n draup$ are tree nl wakes, deb, <br />Is,E14 and p <br />mPS is 0, Y Iridial in sum hazardous substance 8ensOrs are .p ce <br />Ps vhere an alarm has sled ro rl.y " <br />_ xarred In the ast " . � <br />Sump Location. Y N D norm ror yh;�ry there is no <br />.. Sump Location y_�`--- <br />Sump Location _ — ❑ . , <br />7 Spdt ContainmentStr-' ii <br />lures are fr ❑ ❑ 1 <br />ee of water, debris. and hazardous substance <br />6nk 1 - Gasoline 87 Y N NA <br />k2 - Gasolina 89 ■ ❑ ❑ Tank 3 - Gasoline 91 Y N NA <br />r -dispenser containment areas are free Of water, debris, and hazardous substance. Sensors are located properly • ❑ C]Dispenser 112 Y N NA <br />Dispenser 319 <br />■ ❑ ❑ <br />Dispenser 516 ■ ❑ ❑ <br />■ ❑ ❑ �! <br />Dispenser 718 <br />PAPERWORK INSPECTION Date Y _N �ql <br />Monitoring system Certification has been completed within the past 12 months. <br />04!16116 ■ Li <br />1; Secondary containment tests have been completed within the required timeframe. 04123115 ■ ❑ <br />ill containment structure (bucket) testing was completed within the past year <br />04116116 ■ ❑ ❑{� <br />nk tightness testing was Completed within the required timeframe ❑ ■ " <br />e tightness testing was completed within the required timeframe. ❑ ❑ ■ i <br />er required testing / maintenance was completed within the required timeframe (list items below) <br />r <br />Test/Maintenan` Alr Quality Test 03110116 ■ - ❑ ❑ <br />_ . <br />Test /Marntenan ❑ ❑ ■ ' al CD <br />__ <br />O <br />C1 <br />15 All facility employees have received the required on-the-job training within the past year <br />❑ ❑ ■ o <br />All facility employees hired within the Past 30 days have recswed the required on <br />lob tralnmg <br />checklist lit y <br />Page 1 W0 <br />