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UNDERGROUND STORAGE TANK SYSTEM DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT Facility Name: City of Lodi Inspection Date: April 22, 2008 a, Facility Address: 1331 S. Ham Lane City: Lodi Name of Designated UST Operator Conducting Inspection: Dennis Callahan International Code Council Certification No.: 1004653-UC Expiration Date: 12/20/2008 Signature: Phone: (209) 333-6800 ext.2690 N/A=Not A Dficable F11 em MONITORING PANEL/ALARM HISTORY Yes No N/A 1. Is the monitoring system powered on and in proper operating mode? ® ❑ ❑ 2. Is the monitoring system not currently showing any leak alarms? 0 El El 3. Is the Alarm History Report/log for the previous month available,and has it been reviewed by the ® ❑ El Designated UST Operator? (Attach a copy of the alarm history report log to this inspectionform.) 4. Has each alarm for the previous month been responded to appropriately? ❑ ❑ UST SYSTEM INSPECTION 5. Are tank-top containment sumps free of water,debris,and hazardous substance? Note:If the answer to Item d was "Yes,"skip to Item 6. Gimps where an alarm has rXrnr-red rn the past morph must he inspected a a qualified service technrcuar has not respnnW to, and properly addressed,the cause of the alarm.Documentation veri rin g a r riole service should be attached to this report Yesl No I I Yes No Sun1p Location: S/W Fuel Island Z I ❑ Sump Location: N/E Fuel Island Sump Location: N/W Fuel Island M= F—Sunip Location: S/E Shop 6. Are spill buckets(containment structures) free of water,debris,and hazardous substance? Yes No N/A Yes No N/A Tank I ID— 10,000 Unleaded ® I ❑ I ❑ Tank 4 ID—Waste Oil IT ❑ Tank 2 ID— 2,000 Unleaded ❑ Tank 5 ID— ❑ ❑ ❑ Tank 3 ID— 5,000 Diesel ❑ Tank 6 ID— 7. Are under-dispenser containment areas free of water,debris,and hazardous substance? Yes No N/A Yes No NIA A Dispenser— 1/2 Multi-product Dispense — ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ == Dispenser— ❑ ❑ ❑ Dispenser— ❑ 1 ❑ 1 Lj Dispenser El El El — 8. Leak detection is properly located within under-dispenser containment. Yes No N/A Yes No N/A Dispenser— 1/2 Multi-product ® ❑ ❑ Dispenser— = ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— Li I ❑ I ❑ I Dispenser— ED= ❑ PAPERWORK INSPECTION Yes No I N/A Date Done 9. Monitoring System Certification was completed within the past 12 months? ® ❑ ❑ 9/27/2007 10. Line Leak Detectors were tested/certified within the past 12 months? ® ❑ I ❑ 9/27/2007 11. Spill bucket(containment structure)testing completed within the past 12 months? ® ❑ ❑ 9/27/2007 12. Line tightness testing completed within the required time frame? ® ❑ ❑ 2/13/2007 13. Secondary containment tests completed within the required time frame? ❑ ❑ 10/512007: ;eyeA 14. Enhanced Leak Detection completed within the required time frame? ' 15. Other required testing/maintenance was completed within required time frame? (List test/maintenance items below Describe Test/Maintenance: Drop Tube Integrity Test-every 3 yrs ® ❑ ❑ 10/31/2005 Describe Test/Maintenance: Static Torque&Rotation Test-every 3 yrs ® ❑ ❑ 10/31/2005 FACILITY EMPLOYEE TRAINING Yes No N/A 16. Have all facility employees received the required on-the-job training within the past year? MIE11 ❑ 17. Have all facility employees hired within the past 30 days received the required on-the-job training.? Note: Explain any"No" answers in the"Comments" section on the following page. Those issues require corrective action from the UST owner/operator. UN-057-1/2 www.unidocs.org 9/26/05