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ri <br />4. 0 0 <br />Designated Underground Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />Facility Name: V. P, <br />PANEL/ ALARM HISTORY <br />Monitoring system is powered on and in proper operating mode. <br />Moni!2�_ !� currently showinl� any alarms or wamjnrs. <br />larm history report/log for the previous month is available, and has been reviewed by the <br />: 2A� <br />I signated UST Operator. (Attach a copy ofthe alarm history reporollog to 1hisA=T yavailable.) <br />Wo <br />List all tank -top sumps where alarms occurred in the past month: <br />product Alarm <br />I �Vote.-&&?Vsivhereanalamhavtxxwredinthepwtmowhnutstbebispwtedwz6maquaViedservicelechnkianreWondedto, and <br />aroper�v addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. <br />Vs-mp inspection is required, record results in item -6, below. <br />---------- ON <br />UST SYSTEM INSPECTION <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sen�ors are located - pf�perly. <br />VE <br />Sump Location: 87 turbine <br />SuTp Location: 89turbine <br />k,!�iunp Location: 91 turbine <br />MMURRIMM40 CWIRM11 <br />EER <br />Tank I Contents: UnleadedConlents:Plus <br />Tank 4 — Contents:--- <br />1 2 <br />o :, <br />Lit <br />ispemer 11 12 <br />lawmildra "N"111111 R 13 1 t <br />11 S ill containment structure (bucket) testing was completed withinthepast_year. <br />D. Jan 18,2011 <br />Facili!y AddresLs: 23_75_IT'racy Blvd- <br />CityLEr.acy_._, <br />Code: 9537&� <br />_L4�p <br />;T Operator Conductin� the Inspection: Terri Un.,erman <br />Designated US <br />de tififa4on #:526�655-(JC <br />qW, <br />(209)271-8588 <br />WON WW <br />-VVW" <br />PANEL/ ALARM HISTORY <br />Monitoring system is powered on and in proper operating mode. <br />Moni!2�_ !� currently showinl� any alarms or wamjnrs. <br />larm history report/log for the previous month is available, and has been reviewed by the <br />: 2A� <br />I signated UST Operator. (Attach a copy ofthe alarm history reporollog to 1hisA=T yavailable.) <br />Wo <br />List all tank -top sumps where alarms occurred in the past month: <br />product Alarm <br />I �Vote.-&&?Vsivhereanalamhavtxxwredinthepwtmowhnutstbebispwtedwz6maquaViedservicelechnkianreWondedto, and <br />aroper�v addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. <br />Vs-mp inspection is required, record results in item -6, below. <br />---------- ON <br />UST SYSTEM INSPECTION <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sen�ors are located - pf�perly. <br />VE <br />Sump Location: 87 turbine <br />SuTp Location: 89turbine <br />k,!�iunp Location: 91 turbine <br />MMURRIMM40 CWIRM11 <br />EER <br />Tank I Contents: UnleadedConlents:Plus <br />Tank 4 — Contents:--- <br />1 2 <br />o :, <br />Lit <br />ispemer 11 12 <br />lawmildra "N"111111 R 13 1 t <br />11 S ill containment structure (bucket) testing was completed withinthepast_year. <br />12 Tank ti tress testing.was completed within required timeframe. <br />x <br />13 Line ti tress testing was completed within required timeframe. <br />x <br />14 Other required testinmaintenance was completed within requiredtimeftame. (List testlmaintenance items below.) <br />—TestIMaintenance: <br />TestlMaintenance: <br />Page 1 of 2 <br />September 2004 <br />