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UNDERGROUND STORAGE TANK SYSTEM DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT Facility Name: City of Lodi Inspection Date: May 23, 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: Phone: (209) 333-6800 ext.2690 IJ N/A=NotApplicabi Item MONITORING PANEL/ALARM HISTORY Yes No 1 N/A 1. Is the monitoring system powered on and in proper operating mode? 9-a El- 2. Is the monitoring system not currently showing any leak alarms? 0 ❑ El 3. Is the Alarm History Report/log for the previous month available,and has it been reviewed by the ff ❑ E Designated UST Operator? (Attach a copy of the alarm history report/log to this inspection form.) 4. Has each alarm for the previous month been responded to appropriately? 10 0❑ 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 h. Amps inhere cm Worm hus occurred nr the past month must he inspected q a qualified serrice technician has nor responded to, and properly addressed,the cause o the alarm_Documenlation veri-ying appropriale service should be anached io this report- Yes e rtYes No Yes No Sump Location: S/W Fuel Island ® ❑ Sump Location:N/E Fuel Island Sump Location: N/W Fuel Island ® Sump Location: SIE 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 41D-Waste Oil ❑ ❑ - Tank 2 ID- 2,000 Unleaded ® I ❑ I ❑ Tank 5 ID- ❑ Tank 3 ID- 5,000 Diesel ® I Lj I L1 Tank 6 ID- ❑ ❑ 7. Are under-dispenser containment areas free of water,debris,and hazardous substance? Yes No N/A Yes No NIA Dispenser- 1/2 Multi-product ❑ Dispenser- ❑ ❑ ❑ Dispenser- ❑ ❑ Dispenser- ❑ ❑ ❑ Dispenser- ❑ ❑ I ❑ Dispenser- ❑ ❑ ❑ G Dispenser- ❑ I ❑ I ❑ Dispenser- ❑ Q E 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- ❑ ❑ I ❑ Dispenser- ❑ 1 ❑ ❑ 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? IT TT 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 fi-ame? ® ❑ 2/13/2007 13. Secondary containment tests completed within the required time frame? ® ❑ ❑ /0 10/5/2007= Ai6 14. Enhanced Leak Detection completed within the required time frame? ❑ ❑ 1118 p S- 15. Other required testing/maintenance was completed within required time frame? (List lest/maintenance items below.) Describe TestlMaintenance:Drop Tube Integrity Test-every 3 yrs ® 10 1 ❑ 1 10/31/2005 Describe Test/Maintenance: Static Torque& Rotation Test-every 3 vrs ® I ❑ I ❑ 1 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? ® ❑ 11 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-057-112 www.unidocs.org 9/26/05