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-win <br /> Designated Underground Storage Tank (UST) Operator <br /> Monthly Visual Inspection Checklist <br /> Date: May 27, 2009 <br /> Facility Name: Hammer/1-5 Arco — <br /> Facility Address: 3250 West Hammer Land <br /> Zip Code: 95209 <br /> City: Stockton - --�---- <br /> Designated UST Operator Conducting the lection: Wesle Parkinson <br /> iration bate. July 24 <br /> International Code Council Certification #, <br /> Phone: (209)_474-9125 _ <br /> Sinature "" _. _� _. <br /> __:. re� �° ��cs ' yc�,�t� = dot ?. licable <br /> _ _ <br /> y N NA <br /> —� MONITORING PANEL / ALARM HISTORY <br /> Item __ ---� X <br /> i Monitoringsystem is powered on and in proper operating mode. <br /> h <br /> Monitoring system is not currently showing any alarms or warnings. X <br /> Alarm history report/log for the previous month is available, and has been reviewed by the <br /> Designated UST Operator. (.Attach a c y o fthe alarm history report/log report/logto this corm if available.) X <br /> 4 ; Each alarm for the previous month has been responded to appropriately. X <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. <br /> List all tank-top sumps where alarms occurred in the past month: <br /> vote:Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to. and <br /> properly addressed, the cause of the alarm,Attach documentation verifying appropriate service to this report. <br /> ! swn ins ection is required. record results in item 6, below <br /> UST SYSTEM INSPECTION �. <br /> 6 Tank-top containment sumps are free of water, debris, and hazardous substance. Sensors are located property. <br /> n <br /> Note: Visual ins coon ired in.turn s where an alarm has occurred in the )ast tit <br /> unth for which there is no <br /> �sy)erv'' <br /> Sum Location: Tank 1 .Sum Location: <br /> ,-Sump Location: Tank 2 Sump Location: <br /> Sump Location: Tank 3 'V Sump Location: <br /> 5 ilI containment strut free of water, debris, and hazardous substance. <br /> Y <br /> 6a y tJ <br />