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0 <br /> UST OPERATOR MONTHLY INSPECTION <br /> 3 V <br /> , <br /> Facility Name:RAMOS OIL-FRECH CAMP <br /> Facility Address:10842 S I[ARLAN RD <br /> City/State/Zip:FRENCH CAMP/CA <br /> DesigDesignated US*'Operator,,,, clgad <br /> e* <br /> nated UST Operator:.', clga�v Phonc:916-371-2570— <br /> C -Cert.fi N <br /> ICC Certifica(ion N cr:166 3-u f-Expiration Dipe:2- -2013 <br /> 'i 'ure. <br /> gna <br /> Signature: <br /> D. C <br /> Z_NR/FA <br /> Item MONITORING IANEIJALARM HISTORY V N <br /> I Monitoring system is powered on and in proper operating mode. <br /> Monitoring <br /> op <br /> 2 Monitoring <br /> g system <br /> not <br /> currently <br /> ow <br /> Monitoring system is not currently showing any alarms or warnings. <br /> 0 <br /> 1 Alarm El 0 <br /> 0 <br /> 3 history report/log for the previous month is available,and has been reviewed 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. El 0 <br /> Note: Sumps where an alarm has occurred in the Past month most tv inspected unless qualified service technician rcspomd it),and properly addrcssed,the cause of Itic <br /> alarm. Attach docuniLmation vcrifvin L a 101riateservice to this re m. 11'sunip insricuion is raired,record results in item 6,h0ow, <br /> UST SYSTEM INSPECTION <br /> 6 Tank-top containment sumps are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Note: Visual insnect ion(,,'sumps is only.required in sum ps where an;trin has occurred In lk ; I month for which there s an service record. <br /> Sump Location: ❑Y N N/A —Y N N/A <br /> Sump Location: El Sump I ocation: -0- <br /> Sump Location: ❑ <br /> 0 C3 Sump Location: ❑ 0 <br /> Sump Location: I Cl Cl Sump Location: Ear CEII 0 <br /> I❑ �;❑� Sump Location: El 0 0 <br /> 7 Spill containment structures are free of water,debris,and hazardous substance. <br /> Y N N/A Y N N/A <br /> Tank I–Contents: DF-C iacal ❑ Tank 6–Contents: _0 <br /> Tank 2–Contents: ❑ <br /> ... ...... m' a",month <br /> for <br /> �h"a"c Is 111,scrvcc record. <br /> on. <br /> SUMP I "I <br /> SUMP location: <br /> 0 Sump -i <br /> 0 'Sump Loc' <br /> Tank 3–Contents: -0 Tank 7–Contents: <br /> ET Tank 8–Contents: ❑ <br /> Tank 4–Contents: 0 <br /> ❑ Tank 9–Contents: Ell <br /> Tank 5–Contents: ❑ k 10 <br /> () C_ <br /> 0 <br /> ❑ Tank k 10–Contents: I Ej 1 01 F-1 <br /> 8 Under-dispenser'containment areas arc free of water, <br /> debris,and hazardous substance. Sensors are located properly. <br /> h N N/A Y N <br /> W ❑ Dispenser# Li U Li <br /> Dispenser# 6444,2 -2- 'K ❑ —0-- Dispenser# ❑ El 0 <br /> Dispenser# 2A&3 14% Dispenser# El <br /> 44 <br /> Dispenser# 3A. -4- ❑ Dispenser# 0 <br /> Dispenser# 4A&5 Dispenser# <br /> Dispenser#,." ❑— <br /> Dispenser# 11 101 <br /> 6 Dispenser# Dispenser#= 1:1 ED] <br /> P.O. BOX 401,W SACRAMENTO,CA 95691 (800)477-7266 <br />