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'CST OPERATOR MONTHLY INSPECTION <br /> v , <br /> Facility Name:RAMOS 017 FRECH CAMP 'i�51 il; 14 01 <br /> Facility Address:10842 S HARLAN RD <br /> City/State/Zip:FRENCH CAM <br /> Designated USTOpera : annue elgad Phone:916-371-2570 <br /> ICC Certification mber:10 03-uc Expiration_pa/:2-25- 13 <br /> Signature'. <br /> Date: <br /> Item MONITORING PANEL/ALARM HISTORY Y N/A <br /> I Monitoring system is powered on and in proper operating mode. <br /> g <br /> 2 Monitoring system is not currently showing any alarms or warnings. ❑ <br /> Y <br /> Alarm <br /> h. t.,y <br /> report/tog <br /> f. <br /> Item MONITORING <br /> history Teport/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. El <br /> 5 Sensors located in tank-top containment sumps have not alarmed in the past month. El 13 <br /> 0 C3 <br /> Note: Sumps where an alarm has occurred in the past month must he inspected unless a qualified service technician respond to,and properly addressed,the cause of the <br /> Malarm. Attach d-jeumentation verifying a�) rtau;service to this re if sumi inspection is rciuired,11record results I 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 properly. <br /> Note: Visual inspection of sums is only required in sum s where an;dim has occurred in[tic asi month for which there is nose-rvice record. <br /> Y N N/A Y N N/A <br /> Sump Location: 11 0 El Sump Location: El El EJ <br /> Sump Location: ❑ 11 [Ell Sump Location: 0 <br /> a-❑ _EElF <br /> 0 <br /> Sump Location: [Ell Sump Location: ❑ 0 ❑ <br /> Sump Location: U I U U I Sump Location: ❑ El 103 <br /> 7 Spill containment structures are free of water,debris,and hazar us substance. <br /> Y Y N N/A <br /> Tank I-Contents: DFC M ❑ Tank 6-Contents: —a_E1 -11 . <br /> Tank 2-Contents: El El ❑ Tank 7-Contents: 13 11 11 <br /> Tank 3-Contents: ❑ 0 El Tank 8-Contents: —0--a 11 <br /> Tank 4-Contents: Tank 9-Contents: 11 E] 0 <br /> Tank 5-Contents: Tank 10-contents: El 1:1 0 <br /> 8 Under-dispenser containment areas are free of water,debris,and hazardous substance. Sensors are located properly. <br /> Y �N N/A Y N N/A <br /> Dispenser# Ift <br /> E] ❑ Dispenser# 0 E] El <br /> Dispenser# 1A-.&--2 El El Dispenser# <br /> 0­19 El <br /> Dispenser# 2A&3 V* El [I Dispenser# = El <br /> Dispenser# a1-&.4 J Dispenser# 1:3 El El <br /> Dispenser# 4A&5 Dispenser# 1:1 ❑ 11 <br /> Dispenser#&A- Dispenser# 0 <br /> Dispenser# ❑ 0 0 Dispenser# <br /> P.O.BOX 401,W SACRAMENTO,CA 95691 (800)477-7266 <br />