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OCT-27-2008 131:23 CIT`' OF LODI 2609 333 5710 P. 12 <br /> UNDERGROUND STORAGE TANK SYSTEM <br /> DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT <br /> Facility Name: City of Lodi Inspection Date: January 25, 2008 <br /> Facility Address: 1,331 S. Han Lane City. Lodi <br /> Name of Designated UST Operator Conducting Inspection: De nniS Callahan <br /> International Code Council Certification No.: 1001653--UC Expiration Date: 12/20/2008 <br /> Signature: Phone: (209) 333-6800 ext.2690 <br /> N/A=Not A abk <br /> Item MONITORING PANEL/ALARM HISTORY Yes No NIA <br /> I- is the monitoring system powered on and is prop5r opemin mode? <br /> 2. Is the monitoring tem not current!y showing any leak alarms? <br /> 3. is the Alarm History RepoWlog for the previous month available,and has it been reviewed by the <br /> Desi sated UST Operator? Attach a copy of the alarm history report/l to this inspection orm. <br /> 4. Has each alarm for the previous month been responded to a ro riatel ? <br /> UST SYSTEM INSPECTION <br /> 5. Are tank-top containment sumps free of water, debris,and hazardous substance? Note.fjus-answer 10 hem 4 was"Yes,"shiP <br /> fo Rcm 6. Sumps lrlrere all alarm 1104 OCCHrred rn rlw parr monllr mnsr be,nspeered if'a qualryir>d semce rechrllcfan hos nor responded to, and <br /> properly addreur4 the cause o lbt akv7m Docwaagatlo+r , a ryp2qt srfvwg sho+ld be attw#wd to this <br /> Yes No Yes No <br /> Suns Location: S/W Fuel Island Location:WE Fuel Island <br /> hop <br /> S Location_N!W Furl Island Svtn Location: SIE 5 <br /> 6_ Ares ill buckets(containment structures)free of water,debris,and hazardous substance? <br /> Yes No N/A Yes No N/A <br /> Tank I ID-- 10,000 Unleaded Tank 4 ID—Waste Oil <br /> Tank 2 ID— 2,000 Unleaded N I Li I U I Tank 5 ID El U <br /> - <br /> Tank 3 m— 5,000 Diesel Tank 6 ID TT q <br /> — <br /> 7. Are under—dispenser can181nment areas free of water,debris,and hazardous substance? <br /> Yes No N/A Yes No N/A <br /> Dispenser— 12 Multi-ppquct Dispenser— <br /> Dispenser I U I D Dispenser El <br /> - <br /> Dispenser 1 0 1 Lj Dispenser- <br /> Dispenser- Dis nser- <br /> S. Leak detection is property located within und 'spenser contamment. <br /> Yrs I No N/A Yes No N/A <br /> Dispenser— 12 Multi-product Di ser— <br /> Dis ser— Di ser— <br /> Dispenser 0 Mspenser— <br /> Dispenser Dis user— <br /> -- <br /> .. ,.., <br /> PAPERWORK INSPECTION Yd I No INIA Date Done <br /> 9. 1 monitorin&System Certification was completed within the post 12 months. 27/2007 <br /> 10. Line Leak Detectors were tested/certified within the 12 months? 9/272 � <br /> 11- Spill bucket containment structure testin completed within the t 12 months? 9/13/2007 <br /> 12. Line tightness testis com feted within the required time frame? <br /> 13. Secondary containment tests completed within the Tquired time frame? tag 007_ ' <br /> 14_ Enhanced Leak Detection completed within the required time flame? <br /> 15. Other r uired testis maintenance was completed within required time frame? lest/mmntenance items below. <br /> Describe Test/Maintenance: Dr Tube[rat Test-ev 3 10/31/2005 <br /> Describe Test/Maintenance: Static Torque 8t Rotation Test-every3yrs I Lj I Lj 1 10/312005 <br /> FACILITY EMPLOYEE TRAINING Yes No NIA <br /> ED El I Li <br /> 16. Have all facility employees received the required on-the= b uAining within the post ycaO <br /> 17. Have all facility employees hired within the past 30 days received the required on-the=ob trainin ? <br /> Note: Explain any"No" answers in the"Comments"section on the following page. Those issues require corrective action from <br /> the UST owner/operator. <br /> UN-057-1/2 wwwualdocsort 9/26105 <br />