COMPLIANCE INFO_2024 - Laserfiche WebLink

Home Browse Search

UNDERGROUND STORAGE TANK DESIGNATED UNDERGROUND STORAGE TANK OPERATOR VISUAL INSPECTION REPORT(Page2of2) I VII. INSPECTION HISTORY Y I N- - each follow-up action of section III from the previous inspection been completed appropriately? -- "` Yach documentation verifying appropriate service to this report) I C� ❑ ViIi. ALARM HISTORY Attach a copy of the alarm history reportllog to this report. YI N INAI Is the monitoring system powered on and in proper operating mode? ® ❑ ❑ Has each leak detection alarm since the previous inspection been responded to appropriately? (Attach documentation verifying appropriate service to this report) d ❑ ❑ Have all containment sumps,that have had a leak detection alarm since the previous inspection,been responded to by a qualified UST service technician? ❑ I ❑' List below in section IX,at/containment sumps that have had a leak detection alarm since the previous inspection and have not been responded to by a qualified UST service technician. Containment sumps listed below require a visual inspection for damage,wafer,debris, hazardous substance,and proper sensor location. The results of the visual inspection must be recorded in section X. �_ IX. UNDERGROUND STORAGE TANK SYSTEM INSPECTION Is the containment sump free of damage,water,debris,and hazardous substance? Containment Sump ID _ JE3, N Containment Sump ID Y N TA0252102-ARROW- UNLEADED-WEST ❑ — ❑ ❑ TA0252101 -ARROW- DSL- EAST ❑ ❑ ❑Are all sensors in containment sumps inspected located to detect a leak at the❑earliest opportunity? ❑ ❑ Is the spill container free of damage,water,debris,and hazardous substance? ❑ TANK ID TA0252102-ARROW-UNLEADED-10K ❑ ❑ TA 2252101 -ARROW- DSL- 10K ❑ ❑ ❑ Is the fill pipe free of obstructions? TANK ID TA0252102-ARROW-UNLEADED-1 OK ❑ ❑ ❑ TA0252101 -ARROW- DSL- 1 OK ❑ ❑ ❑ the fill cap securely on the fill pipe? TANK ID TA0252102-ARROW-UNLEADED710K El ❑ ❑ TA0252101 -ARROW-DSL- 1 OK I.Pj ❑ ❑ Is the under-dispenser containment free of damage,water,debris,and hazardous substance? Under-dispenser Containment ID Y N Under-dispenser Containment ID Y N INA East Dispenser Hose#1 -Diesel 91 ❑ ❑ El ❑ ❑ East Dispenser Hose#2-Unleaded 19 ❑ ❑ ❑ ❑ ElWest Dispenser Hose#3 - Diesel ff ❑ ❑ ❑ ❑ ElWest Dispenser Hose#4- Unleaded ❑ ❑ El ❑ ❑ ❑ ❑ El 11 El ❑ ❑ ❑ ❑ ❑ ❑ Are all sensors in under-dispenser containment located to detect a leak at the earliest opportunity? ❑ ❑ X. TESTING AND MAINTENANCE Y NNA PERFORMED DATE LAST Has the monitoring system certification been completed within the past 12 months? 01 11 01/24/20 Has the spill container testing been completed within the past 12 months? NJ ❑ 01124/20 Has the overfill prevention equipment inspection been completed within the past 36 monis? ® ❑ ❑ 10/12/18 Has the secondary containment testing been completed within the past 36 months? ® ❑ 11 12/14/17 Has the tank tightness testing been completed within required timeframes? El ElHas the line tightness testing been completed within the required timeframes? ❑ ❑ l 9 Other required testing/maintenance was completed within required timeframe. (List test/maintenance items below. Test/Maintenance:Annual Leak Detector Test ® ❑ 01/24/20 Test/Maintenance:SB989 Secondary Containment Testing Due 12/14/2020 ® ❑ 12/14/17 Test/Maintenance:Overfill Prevention Inspection Due 10/12/21 ® ❑ 10/12/18 Test/Maintenance: ❑ ❑ Test/Maintenance: ❑ Test/Maintenance: ❑ ❑ XI. FACILITY EMPLOYEE TRAINING :::=N Have all individuals performing facility employee duties received the required facility employee training within the past 12 months? ® ❑ If the facility has more components than this form accommodates,additional copies of this page may be attached. I Y=Yes,N=No,NA=Not Applicable,ID=Identification