Laserfiche WebLink
Designated Underground Storage Tank (UST)Operator <br /> montwy Visual Inspection Checklist <br /> Facility Name: Date: <br /> Facility Address: 1�e,6,0 ;k2 Zi <br /> City: -7�tIzeZ <br /> Designated US Con theInspectign: John Dal <br /> Inten:aliojW Code uncfl 3 UC Exoirazion Date: Nwcmber 24,2011 <br /> Phone:( 916 )217-1373 <br /> Signature: Y-,YMN-rN%. A-NotAPPBc"k <br /> Item WOMTORING PAML/ALARM HISTORY Y N NA <br /> 1 Monitaxing SyStga is I!D -I—and in vroper mode.. <br /> 2 Monitoring is yact 9EE?PY Showing any alarms or <br /> 3 Alarm history TqxffWog for The pnmons month is available,and bas been reviewed by the <br /> Desi UST qFrAw, (.Attach a the alarm hist,VY-reporOgg to this ®rm i available.) <br /> —4 Each alarm ford=previ-ous month has been to <br /> 5 J Sensors located in tank-top oontammmt wraps have not alarmed m the Vast month. <br /> 5aA��List aft tank-top szoW where alarms oommed in the <br /> Mote:SWAPS where an alarm has Oc=ryedAhePjfM"Wpoh~be"upmCfed unkm a quabfied serpke fechrdejon responded to.and <br /> pippowly**&T=ed,the cause x#'the alam AMC*dommagafton VmWffg&PPVPrMe s6rWar to Ovs rapam <br /> &sump!2SMoren isreqx&W.record results to low 4 help- <br /> OST SYSTEM INSPECTION <br /> 6 ITank tag conv&ment sumps are free Of water,debris,and hsmdm subsm=. Sm-%m are located properly. <br /> -- - . i- an Jim oceurmd in dw vast moah for which there is N rword. <br /> Note.-V11=1 n 4'mumps is OWY in <br /> sump <br /> Swnp Location 91 87 <br /> Sum 89 Location: Location: <br /> �K%M <br /> Location- Ihesel <br /> Sump Location: <br /> 7 Spill containment WOW=are fine of water.debris,and hazardous substance. NA <br /> Tank 1-—Conte-n-f-S.- 91 Tanis 3-Contents: <br /> Tank 2-Contents: Tank 4-COMM&: Diesel <br /> and hazardous sub0ance, Sensors are located 8 Under-dispenser containment areas are free water, A <br /> I.-I y N— NA <br /> ispenser 1/2 Di 91,10 <br /> Dis user y <br /> 314 Di riser <br /> 516 Dispewer 13 T-14 <br /> Dispenser 7 8 Dispenser 15/16 <br /> PAPE - ---A-J�DATE KWORK W3N <br /> SPECTIUN y E DOME <br /> mrtgaWw has been cx)nVieted within vast 12 montIm- <br /> 9 mc"togna e- <br /> 10 SwoRdary containment tests hbeen conudeted vntlnu the nredBCIrm <br /> I I Spill containment mam Onwket)Lc!!tiM was <br /> 12 Tank tightnew testing was within IVUUUW timeflanle. <br /> -- uired timeframe <br /> 13 Une fivjtness IestftK was,oompleted wjithTin <br /> �dv�d --- .cc Items below. <br /> !RnrA co rogwred fust <br /> 14 Other req[Wtell testim Was _p!eted within <br /> Test;Malntenanw: Leak Detection <br /> test/ cc"'ems O,�,O"W, <br /> —TesWaintenance: <br /> FestlMaInkmance., <br /> FAcmrry rmrLOYRE TRARm ear. <br /> received the aired on-the-'Ob ymn <br /> '�mwj"the past year <br /> 15 All facility ke�iot,traumv, <br /> ;�L days have the mquired.2R:!h2;j2j!2!Lm4. <br /> 1U All facility em loyees hired within the <br /> Note- Any answer of"N"SbOuld be explained in the emment wed"on the following page,and will require <br /> follow-up action. <br /> page 1 of 2 November 2004 <br /> t,,d VZZC-LCC-M UqOf IBZ V O 60 90 qac <br />