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s <br /> O <br /> + 00 <br /> 3 r* O <br /> (D o Cr N <br /> N � l-D (n <br /> = _n N = <br /> fD <br /> N <br /> _ UST.OPERATOR MONTHLY INSPECTION f 0) <br /> V) o n <br /> T <br /> � paciUt <br /> _ Y ame:FtenukC�.arno'Caxdlock ... fD <br /> to Fxatity Arldres5:10g42 S.fiarWt Rd "" 73 <br /> (D CnYlltiyefelTrp:prench Camp ZT <br /> CL Designated UST Phonc:916 371.2.§70 () <br /> Operator:Slem richardmn W <br /> rD ICC Ce[tif:8218GOd Cxpirativn Dau:g-.24-§S <br /> 0 Sigmture: Date: 1 -a <br /> n <br /> Q D <br /> Item :MONTTURSNG PANEUAtAR.tt HMORY Y N �. <br /> D <br /> ( 1 Monitoring system is powered on and in proper operating mode. - <br /> � 2 Monitoring system is not currently shawiugarsy alarms or warnings. <br /> fy 3. Abum history rupoMog for the previous mouth is available,and bas been reviewed by the Designated UST Cf[rera;oL <br /> C 4 Foch a1a[m for the previous month bas been r�iponded ro appropriately. <br /> 5 Serials 1.md in tank4op cotluinment sumps have ant aarmdumh <br /> N <br /> N­ <br /> lfmavarn.. recadrkwasmiam a.Debar. i' <br /> N UST SYSTEM INSPECTION <br /> O 6 Tankaop containment sumps are frr of water,debris,and hvardous substamz.Sensors arelocated properly. <br /> I-� <br /> N—,vit n1' ioa a—,m ,ts rs�mJ in w wtcrc ac aYm M.s occurcsd in�h mnaa ax wata CGz is as xrvtre nxom. <br /> Y N NIA e - Y' 'N N/A <br /> Sump location: l Sump l.otatiom <br /> Sump location: ---��] Sump non:-T -m <br /> Sump tuckdm -� Sump lorahou1 01 010 <br /> Sump l..oca&W 10 Sump Location:-- 4 <br /> 7 Spr71 comainmentstrecturet arc ice n[water,debris,and hazsrdous substance. <br /> Y N NIA F ( S NIA <br /> Teak1-Contents.DkY' Tank 6-Contents: <br /> Tack 2-Contents: ---.-____ Tank 7-Contents: f <br /> Txnk3-+Cautenb: Tank S-Contents: -- 3 <br /> 7ank4-Contents: Tank 9-Contents: 1 01 01 0 <br /> ;«qd Tank 5-Convents: Tank 10-Contents: <br /> 8 Under-dispenser contamrn m.teas are frac of water,debris.and hazardous substance.Sensors are located properly. <br /> Y N NIA Y N I NIA <br /> WD <br /> #-hl3 i+f f Dispenser# <br /> at - ., t Dispenser# <br /> # .Dispenser# �-- - 'v ! O <br /> -- <br /> Dispenser# Dispenser rLrl <br /> ## Uispepcer# Ln# _ ' Dtspeurfl <br /> flz <br /> } <br /> $OX 401 W SAC. ttRN[ 1 {S00)<71-77.66 <br /> -P <br />