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Chevron Station #1731, 3355 E. Hammer Ln, Stockton, CA <br />Designated Underground Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />i ,,. ility N ,.le : CSI 208118/[+9t -CHV Date :03/07/2014 <br />r y <br />I 's. ," Adi_. ;. 3355 E HAMMER IN <br />0t, . SIOCKTON Zip Code : 95212-2817 <br />OCu10r tad UST Operator Conducting the Inspection : Edward Dahlgren <br />`< fl,ternanonal Code Council Certification : 8164364 'Expiration Date: 06/2812014 <br />r <br />7 <br />'nature. ! <br />+,./`' / Phone ! (209) 601-8163 <br />Y= Yes, N= No, NA= Nat Applicable. <br />-N <br />,; MONITORING PANEL ALARM HISTORY Y NA <br />tutoring system is powered on and in proper operating mode X <br />• <br />omtonng system is not currently showing any alarms or warnings. x <br />.Alarm history report/log for the previous month is available, and has been reviewed by the 'X <br />a Designated UST operator, (Attach a copy of the alarm history report/log to this form if available). <br />Each alarm for the previous month has been responded to appropriately. x <br />Sensors located in tank -top containment sumps have not alarmed in the Past month. x <br />List all tank -top sumps where alarms occurred in the past month: <br />Note: Sumps where an alarm has occurred in the past month must be Inspected unless a qualified service technician responded to, <br />and property addressed, the Cause of the alarm. Attach documentation verifying appropriate service to this report: If sump inspection i5 <br />required.record results in item 6,below. <br />- UST SYSTEM INSPECTION ., <br />6. lark top containment sumps are free of water, debris, and hazardous substance.Sensors ate located property, <br />Nots: Visual Inspects"', of sumps a only required n sumps where an alarm has occurred in the past month for which there is no <br />sere m record. <br />..: .. Y ,N jNA .` <br />Sump Location: Supreme STP only x 'A J�Wjjawlia <br />Sump Location. Regular STP only x <br />' Sump Location:. _ - .. .... t ,.... <br />� Sump Location: <br />Sump Location: <br />' SumA Location: ..... <br />_ 'SUR)P Location: Sump. Location' <br />i <br />r 7. Spill containment strUClures„are free pR [Yater, deb[Is'_aod`hazardous l "rii6il l <br />substan42, <br />-�! °I '""'` - <br />#' Contents <br />�! Tank 1 C'-1!X---j--� <br />F , supreme ,look 6 •`CoRtbrl4,5 -- j <br />s <br />°Tank Z • Contents :regular ix v; . <br />STank 3 Contents <br />March 2014 D.O report <br />Page 1 of 4 Photo taken on February 13, 2015 <br />