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�1'1t1t1; 1 16-31 <br /> Designated Underground Storage Tank (UST) Operator— <br /> Monthly <br /> +erator l onthly Visual Inspection Checklist <br /> S ility Marne®MNTCCAXGIt Manteca CO Dates "19/17 <br /> Pecili i! t�sc 43 .Center Street <br /> iManteca 2i e, 6 <br /> Desiggatcd LIST 9perator Conducting the inspection: David Smith <br /> International Code Council Certification## 9260473 Expiration Date:61711 8 -7-7,w, w <br /> Signature: SmIth Phone:t888)58"737 <br /> o.PYA Not cable <br /> –ft—em MONITORI[NG PANEL 1 ALARM RLSTORV Y I N NA <br /> IMonitoring system isa �ercd onand in r o stating mode. e/ <br /> 2Monitoring s stent is not currently showing alarms or warnings. td' <br /> 3 Alarm historyreport/log for the previous can is vatilab! .and has been review a , <br /> DesignatedUST Operator.(Attach u copy( Rthe alp h,slaty r� r�llrr tra#leis a 1 llcrble l <br /> 4 Each alarmoor a previous month has been responded to appropriately. <br /> 5 ge—n9orslocated in tank±op containment s have not alarmed in the past month. sC <br /> ® List crll tcrnketop sumps where alanns occurred in lite past month: <br /> wJ :Sumps wknre an alarm has ocrimnW iar thepwx month tersest he rtt re e d urines as qualodserviry terhWeian la,and <br /> F"Werly addressm the sasses of'the alarm.Anaath d$otwmmenraatia tj ver*Iag qj4mqjAatr senIce to this repart <br /> Pfau Insrtt d�tc it8 rt I ttrlrs In ikar�►#i trs eaaa. <br /> UST SYSTEM1l�+iSP I 1 <br /> 6 Tank-top c I o I mainment sumps are tkee of ter,debris, d ° . crus substance.sensors t edy. <br /> 'Voll,t Wal.feartxr it i of-wm drr t"r rrt d rye"amp""*err east"tat oerwynd in the pmt momehfew evhkh Mwrr ra no senitv , <br /> V N _ Y N <br /> Sstitf Let snit .Sump Location. <br /> Sttrrrp Location SU Locafiot 1 <br /> Strrtt cardiraatt,4 Sump Location: <br /> 7 S ill containment structures free of water,debri&and hazardous substance. <br /> NA I V N NA <br /> Tank t-Contents: dieul Tank 3- omentc> <br /> Ta—2-Contents Tank 4 e Contents: <br /> Under-dispenser coniaiment areas free of water,debris,and hazardous substance.Sensors am located so rl <br /> V N NA V Ica NA <br /> is rtsr t/2 Dispenser 9/10 <br /> Ls p enser 3/4 ispetiser 11 J 12 <br /> Dispenser S/6 lis riser 13114 <br /> DiISP enser 7/S Di s s 13 116 <br /> PAPERWORKINSPECTION V Y NA DATE DONE <br /> Monitoring system certification has been completed within past 12 months. V 01IM3116 <br /> to econda containment tests have completed within thetai timet—7C. W 0111=14 <br /> 11 Spill containment s bucket testing was completed wi the V O 16 <br /> 12 T ti true tesqm was completed within required timeframe. oe <br /> 13 Line tightness testing wag ccs plet within it timcframe. <br /> 14 Other qMired testinWmaintenance was completedwithin sired timeframe.fL/st test maintenance items below.) <br /> restlMaintenance. 4 <br /> ?"est Uaimenance. <br /> Test/. aittte nce® <br /> FACILITY P YEE TRAINING V N NA <br /> 15 Allf slit to vereceived the!Squired on- tiob n, ., in within the pLm oe <br /> 16 All acilit loyees hind withirs e t 3(7 dais hs � civ�1� ui nb-tits-!d stirotc y ons r o 'a ' shoo a eX l ecu t o n n age,ao are <br /> follow up action. <br /> APPROVED <br /> 411 912 17113;43 <br /> Page l off November 2004 <br /> REV,5.0 <br />