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UNDERGROUND STORAGE TANK SYSTEM DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT Facility Name: City of Lodi Inspection Date: June 20, 2008 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: �a Phone: (209) 333-6800 ext_2690 N/A=Not Appikable Item I 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? 3. Is the Alarm History Report/log for the previous month available,and has it been reviewed by the ® ❑ Designated UST Operator? (Attach a copy of the alarm history re ort/log to this inspection form.) 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:Ifihe answer io Item 4 was "Yes,-skip to Item 6. Stoups where un alarm has occrrr-red nr the past mc>,tth mus!he m.cpected it a gtahlied service teclnrrcran has not responded to, and properly addressed,the cause of the alarm.Documentation veri ung a ro rule service should be attached to this report- Yes e rtYes No I I No Sump Location: S/W Fuel Island ❑ Sump Location: N/E Fuel Island M I ❑ Sump Location: N/W Fuel Island ® El I Sump 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 ® ❑ ❑ Tank 4 ID—Waste Oil ❑ ❑ Tank 2 ID— 2,000 Unleaded ® I ❑ I El Tank 5 ID— Tank 3 ID— 5,000 Diesel 01 ❑ Tank 6 ID— ❑ ❑ ❑ I4 7. Are under-dispenser containment areas free of water,debris,and hazardous substance? Yes No N/A Yes No N/A Dispenser— 1/2 Multi-product Dispenser— ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ 0 Dispenser— ❑ El 0 Dispenser— ❑ Dispenser— Li L1 1 ❑ 8. Leak detection is properly located within under-dispenser containment. iI Yes No N/A Yes No N/A Dispenser— 1/2 Multi-product E ❑ ❑ Dispenser— ❑ ❑ Dispenser— ❑ ❑ Dispenser— 1:1 El ElDispenser— El ❑ Dispenser— El El Dispenser— Dispenser— ❑ ❑ ❑ PAPERWORK INSPECTION Yes No 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? Ej 1 ❑ 9/27/2007 11. Spill bucket(containment structure)testing completed within the past 12 months? ® ❑ 1 ❑ 9/27/2007 12_ Line tightness testing completed within the required time frame? ® ❑ I ❑ 2/13/2007 13. Secondary containment tests completed within the required time frame? E I El I El 10/5/2007 z i est 14. Enhanced Leak Detection completed within the required time frame? ❑ I El I ® I t $ o i 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? ® ❑ ❑ 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.unidoes.org 9/26/05