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r <br /> UST OPERATOR MONTHLY INSPECTION t <br /> Facility Name:RAMOS OIL-FRECH CAMP <br /> Facility Address:10842 S HARLAN RD <br /> City/State/Lip:FRENCH CAMPlCA <br /> Phone:916-371-2570 <br /> Designated UST 0 mue lgado <br /> JCC Certiftcat Nu er:l 203 c <br /> Expiration 0 e:March 3,20J 4 <br /> Date: <br /> Signature: ' <br /> MONITORING PANEL/ALARM HISTORY Y N/A <br /> Item <br /> I Monitoring system is powered on and in proper operating mode. <br /> 2 Monitoring system is not currently showing any alarms or warnings. <br /> 3 Alarm history report/log for the previous month is available,and has been revieFved by the Designated UST Operator. ❑ <br /> 4 Each alarm for the previous month has been responded to appropriately. ❑ ❑ <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. <br /> Note Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician respond to,and properly addressed,the cause of the <br /> alarm Attach documentation wri in appropriate service to this report. !£sum Stu ion is aired,record resutis in kem 6 below. <br /> loll mffil� <br /> tIST SYSTEM INSPECTION <br /> 6 Tank-top containment sumpsare free of water,debris,and hazardous substance. Sensors are located properly. <br /> Note. Visual ins iron orsum s is on•re wired in sum s where an alrmY occurred in to ast momh for which there is no sernee record Y <br /> Fl <br /> Sump Location: Sump Location: <br /> Sump Location: Sump Location: <br /> Sump Location: Sump Location: <br /> Sump Location: Sump location: <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N N/A <br /> N/A <br /> Tank I-Contents: DFC Tank 6-Contents: <br /> Tank 2-Contents: Tank 7-Contents: ❑ <br /> Tank 3-Contents: Tank 8-Contents: <br /> Tank 4-Contents: Li I Lj I Li Tank 9-Contents: ❑ <br /> Tank 5_Contents: [] Tank 10-Contents: <br /> 8 Under-dispenser containment ,as are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Y N NWA <br /> Y N N/A <br /> Dispenser# 1 ❑ Dispenser# <br /> Dispenser# L k44- 1 4 Z Dispenser# <br /> Dispenser# 2A&3A Dispenser# <br /> Dispenser# 311!`&4 Dispenser# <br /> Dispenser# 4A&5J► Dispenser# <br /> Dispenser#5Ap Dispenser# <br /> Dispenser# Dispenser# <br /> 0111111 <br /> (800)477-7266 <br /> P.O.60X 401.W SACRAMF.:NI'O,CA 95091 <br />