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MEMMMMM <br /> Vtr1t1i1t 1 267 <br /> Designated Underground Storage T Operator - � � - �w <br /> { Jil <br /> Monthly inial Inspection Checklist y <br /> Facility Name:MNTCCAXGI/ ante ate; a 17 � R <br /> Facility Ad . 43 center t_ _ <br /> Ci MantecaTH <br /> Pg:teatcd UST"9perator Conductig the cction: Davl4d Smith 4 ,, !� <br /> International Coda Council Certification 9260473 i Date,°6/7/18rc <br /> Si t :David Sin` ori f 1 737 <br /> V Yes,N No.NA of Applicable <br /> Item MONITORING PANEL I ALARM HISTORY Y NA <br /> lonitori, system i ed on and in raa r r 'r7g ys <br /> 2 Monitoring system is t#at currently showin any alanns or warnings, <br /> Alarm history report/log report/logfor the previous on is available and has been reviewede � <br /> Designated UST Operator.(Att h a c •(if tlae alami hisloty repotillog to thisform if available.) <br /> ppraprtaey4 alarm or a previous months n to <br /> ­§c-nsors located in tank6to containment ve not alamcd in east mon <br /> Sa Gist llian ®topsumps where almms otrurred In the post month: <br /> Nwe.,Su#Ws where an ala nn Naas oemyred try the past nton th mun be ler_s�ee m lessea quallfkd ser vine,technlc°{aar respwded to aml <br /> Ptwpaet°}►°er es"s t een aat'mh�atlrar°ralN#ttatadathae�rre teatt p��rdrd�tJp eat 'adabte r�te�*trrihlt r°d. <br /> If: irt, -111-11 Is e r tarty t,rt-&wd wAultv ter Errant 6, <br /> UST SYSTEM INSPECTION <br /> 6 T - c taifintem smfips aixi fr of watet;debris,and vus substance.Sensors are located <br /> rya_ <br /> i rsrrvt invivrtho4v of wrn &a"1s° uira°tt rra,srtrtrpt a where aata Ito%oa° : sd in O o sartth or°afr6kh ra tx no sen4t r <br /> Y PV _ _ N <br /> tarar Lapt tscrn <br /> Sump L aati ra <br /> 5arrrrlr Lcr tion i �tanap Location: <br /> rra tgation. Sump&! <br /> S ill containment structures are free of water.debris.and <br /> hazardous substance.' <br /> Tank I -Contents: i V Tat m Contents: <br /> Tank 2- ontents® Tank 4-Contents: <br /> Vocler-dispenser containment area are free of water.debris,and hazardous substance.Sensors are located properly. <br /> V N PIA IV N NA <br /> Pis nser°1/2 9/10 <br /> _PIvpenser314 speiser 1 /12 <br /> D s tenser J 16 L>is_ riser 13114 <br /> f riser <br /> 718 dais .nser 13116 <br /> WIN MONO== <br /> PAPERWORKINSPEC11ON Y N NA DATE <br /> Monitoring system certification s been completed withint 12 months. OBAW16 <br /> to Secondary containment tests have n completed willtiit e2—JE11 timefraine, W QWW14 <br /> I I S iiI eontainment s bucket testing completed within the ✓ O 16 <br /> 12 Tank tightness tesft was,coTpleted within requiredtimeframe. <br /> 13 Un-—fightness testing was completed within required firme—frame. <br /> 14 Other Muired lestinWmaintenancewas completedwithin requiredtimeframe.(List testi raalnten ance items below.) <br /> TeOlUalatenance. Cathodic roteetion 0W=14 <br /> 7estl iaintenancez <br /> 7est/Maintenance. <br /> MOM W <br /> FAC' I EMPLOYEE TRAINING <br /> 0 All facHity employeesivied theHired on-thsjob trainin within the t year. y" <br /> lb All facility loges hire�beex t e t 30,days have receivedt 'red the-Job ` ink tI" <br /> otd: llayP an era " " a oar d a eon ton ori t o 0 0 ahs dl i re <br /> olio « p action. <br /> APPROVED <br /> 519120173:18 PMBrandono <br /> Pap I of 2 November 2004 <br /> REV;5.0 <br />