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`rH 0 Y <br /> Designated Underground Storage Tank(UST) Operator <br /> Monthly Visual Inspection Checklist JUN 17 2010 <br /> Faci I i!X Name:Super Stop Date:0886109 J-'D O'JNTI V <br /> Facil'V Address:290 N,Main 77 77 7 T7777—7 <br /> I- i'. - <br /> City:Manteca E <br /> De-signated UST 9perator Conducting the Inspection; Karen R Arnniz <br /> International C-6de-Councg Certification#.8032295.UC Expiration Date: 06/20/11 <br /> SignatuW--V^"i'l Ae A Phone:(209 2 519-4836 <br /> Y-RYAN=NiNA-Nat A leabie <br /> Item• :2RONITOWNG PANEL/ALARM HISTORY Y N I NA <br /> I Monitoring system is 22wered on and in.proper opeting mnde. X <br /> 2 Monito!jng system is not currentIX showing any alarms or warnin . X <br /> 3 Alarm history report/log for the previous month is available,and has been reviewed by the X <br /> — <br /> Desi matedUST!2esrator. (Attach a cnlVnf the alarm Nrt Meeq/la <br /> 4 Each alarm for the previous month has been resE2nded to Wprogri <br /> !iml -- X <br /> 5 Sensors located in tank-Locontainment sumps have not alarmed in tho past month. <br /> 50 - List all tank-tap sumps where alurms occurred in the past month., <br /> Now;bWoW where an alarm has occurred In the pan month must be inspected unless a qualffled service technician respoaddd to,and <br /> PrqP-IY addremeit the cause of rhe akwot Mac*documentation veroqng appropriate serviev to this report. <br /> YMM LnSWelion is required mWd rendis in item 6,below <br /> UST SYSTEM INSPECTION <br /> 6 1 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors an located properly, <br /> Note. Visual Iris arae 2LTUM <br /> JAV is on re irrd in sumps where an alarm has occurred in jivLmyj month or which thereis no wr.ics accord <br /> rd <br /> Y N —Y N <br /> Sum <br /> 2 Location.,91 Turbine X <br /> Sum E Location:Diesel Turbine X <br /> Sum p_Location:87 Turbine X <br /> 7 S2ill containment structures are tree of water,debris,and hazardous substance. <br /> ... ....- I Y I N NA Y N NA <br /> Tank 1-Contents! 91 Ix I Tank 3-Contents:87 X <br /> Tank 2-Contents: Diesel X <br /> 8 Under-dispenser containment area are free of water,debrisand hazardous substance. Sensors arc located -)mly. <br /> Y N I N'A V N' NA <br /> DMnser 112 X Diypenser 9 10 X <br /> qteraser 3/4 X Dispenser 11 12 X <br /> :41spserer 516 X <br /> I Dispepwor 718 X I <br /> PAPERWORK INSPECTION V N KA DATE DONE <br /> 9 Monitoring system certification has been completed within,post 12 months. X 05(27/09 <br /> Ito Secondary containment tests,have been completed within the M. guired timeframe. X 07/21/09 <br /> 11 was 22MIeted within the Last year. X 05/27/09 <br /> 12 Tank ightness testing was cam feted within required timeframe. X <br /> 9 <br /> 0 <br /> 12 <br /> 13 Line tightness testing was completed within reguired timeframe. <br /> 14 1 Other Mggired-testis maintenance was comeleted within E2guired timeframe. (Uvt t r1maintenance items below.) <br /> r&WHaintenance., <br /> TestlMaintenance., <br /> FACTLI.TY EMPLOYEE TRAINING Y N NA <br /> 1.5 <br /> All facility e!n /2 /09 <br /> ployces have received the required on-the training within the past ftr.05 7 ..-.N <br /> f6 All fac'ilt eT212yees hired within the Egt 30 days have received the Muired on-thejob��n 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 /> Page I of 2 November 2004 <br /> t7/ti'd M7289t7602T:01 :WOaA 9t7:8T 6002-2-Nnf <br />