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4 <br /> UST OPERATOR MONTHLY INSPECTION ' <br /> PAPERWORK HISTORY Y N N/A DATE <br /> Monitoring system certification has been completed within the past 12 months. <br /> 10 Secondary containment tests have been completed within the past 36 months. ]0-31.2012 <br /> 12-16-2011 <br /> ['9 <br /> 1 Spill containment buckets have been tested within the past 12 months. <br /> ® ❑ ❑ 10-31-2012 <br /> 12 Tank tightness testing was completed within the past 12 months <br /> 13 Line tightness testing was completed within the past 12 months. <br /> 14 Other required testing/maintenance was completed ❑ Liwithin the required timeframe. <br /> Test/Maintenance: <br /> Test/Maintenance: <br /> ❑ ❑ ❑ <br /> Test/Maintenance: <br /> ❑ ❑ ❑ <br /> L ❑ ❑ ❑ <br /> FACILITY EMPLOYEE TRAINING <br /> Y N N/A <br /> 15 All facility employees have received the required on-the-job training within the past year. <br /> 16 All facility employees hired within the past 30 days have received the required on-the-job training. ❑ ❑ <br /> Vote: Any answer of"N"should be espl»fined in the cornment section El C)on Inc following page,and will require follow-up action. ® <br /> Comments: �Q <br /> r. 3 <br /> 777777 <br /> i� tii .fp' <br /> Qom. ��/ -�e�•,�" ' .. � ,.,... 1 ....ai <br /> Hems Requiring Follow-Up Action: t <br /> ALARM PRINT OUTS <br /> I L <br /> g F <br /> P.O. BOX 401,W SACRAMENTO,CA 95691 <br /> (800)477-7266 <br />