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C <br />Designated Underground Storage Tank (UST) Operator <br />Monthly Visual Inspection Checklist <br />Facility Name: ConocoPhilli s Site #2705447 <br />Date: 9/28//06 <br />Facility Address: 1469 E. Hammer Ln. <br />I <br />City: Stockton <br />Zip Code: 95210 <br />Designated UST Operator Conducting the Inspection: Julie Lee <br />x <br />International Code Council Certification #: 5248777 -UC <br />Expiration Date: 12/14/2006 <br />Signature: -," <br />Phone: (510) 245-5218 <br />Y = Yes, N = No, NA = Not Applicable <br />Item <br />MONITORING PANEL / ALARM HISTORY <br />Y N NA <br />I <br />Monitoring system is powered on and in proper operating mode. x <br />2 <br />Monitoring system is not currently showing any alarms or warnings. <br />x <br />3 <br />Alarm history report/log for the previous month is available, and has been reviewed by the <br />Designated UST Operator. Attach a copy of the alarm history report/logreporillog to thisform if available. <br />x <br />4 <br />Each alarm for the previous month has been responded to appropriately. <br />x <br />5 <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />x <br />5a <br />- List all tank -top sumps where alarms occurred in the past month: <br />N/A <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified service technician responded to, and <br />properly addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. <br />Ifsump inspection is re uired, record results in item 6, below. <br />���n {���t�ii�"�i. . .,iS ( @ ,Vni";M ai.H�NI) i �1 ..� �P .Y:u <br />UST SYSTEM INSPECTION <br />6 <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection o sum s is only required in sumps where an alarm has occurred in the Last month for which there is no service record. <br />Y N <br />Sump Location: <br />Sump Location: <br />Sump Location: <br />������ji'xi�l„� <br />�R <br />�; i i; <br />Sump Location: <br />Sump Location: <br />Sump Location: <br />Y N <br />�> <br />7 <br />Spill containment structures are free of water, debris, and hazardous substance. <br />Y N NA <br />Y N NA <br />Tank 1 — Contents: 91 x Tank 3 — Contents: 87 <br />x <br />Tank 2 — Contents: 89 x Tank 4 — Contents: Diesel <br />x <br />8 <br />Under -dispenser containment areas are free of water, debris, and hazardous substance. Sensors are located properly. <br />Y N NA <br />Y I N INA <br />Dispenser 1 / 2 x Dispenser 9 / 10 <br />x <br />Dispenser 3 / 4 x Dispenser 11 / 12 <br />Dispenser 5 / 6 x Dispenser 13 / 14 <br />Dispenser 7 / 8 x Dis enser 15116 <br />. rwun'as. .�.., i. .,;!,'I'III its,,,:,a.,u,Ut ?•ii.f,l,,.a•' MHs <br />PAPERWORK INSPECTION Y N NA <br />DATE DONE <br />9 <br />Monito ing system certification has been completed within past 12 months. x <br />10 <br />Secondary containment tests have been completed within the required timeframe. x <br />11 <br />Spill containment structure bucket testing was completed within the past year. x <br />12 <br />Tank tightness testing was completed within required timeframe. x <br />13 <br />Line ti htness testing was completed within required timeframe. x <br />14 <br />Other required testing/maintenance was completed within required timeframe. List test/maintenance items below. <br />Test/Maintenance: <br />Test/Maintenance: <br />Test/Maintenance: <br />FACILITY EMPLOYEE TRAINING <br />Y N NA <br />15 <br />All facility employees have received the required on-the-job training within the past year. <br />x <br />16 <br />All facility employees hired within the past 30 da s have received the required on -the job trainin <br />x <br />Note: Any answer of "N” should be explained in the comment section on the following page, and will require <br />follow-up action. <br />Page 1 of 2 <br />