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UNDERGROUND STORAGE TANK SYSTEM DESIGNATED UST OPERATOR MONTHLY INSPECTION REPORT Facility Name: City of Lodi Inspection Date: February 22, 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 N/A=Not Applicable Item MONITORING PANEL/ALARM HISTORY Yes No N/A L Is the monitoring system powered on and in proper operating mode? ® ❑ El 2 Is the monitoring system not currently showing any leak alarms? 1:13. Is the Alarm History Reportllog for the previous month available,and has it been reviewed by the Designated UST Operator? (Attach a co o the alarm history re ortllog to this inspection form.) 4. Has each alarm for the previous month been responded to appropriately? r1p LAizjkA 5 1 ❑ ❑ UST SYSTEM INSPECTION j 5. Are tank-top containment sumps free of water,debris,and hazardous substance? Note:Ifthe answer to Item d was "Yes,"skip to Itron /. Sumps ullcre an alarm has occurred in the Past month most he inspected it a gnalijied service techmcum has uor respnmk•d to, and property addressed,the cause o the alarm.Documentation vert)�in a riaie service should be attached io this re ! Yes No I I Yes I No 1 Sump Location: S/W Fuel Island Sump Location: N/E Fuel Island 1010 Sump Location: N/W Fuel Island 0 El I I Sump Location: S/E Shop I ® I ❑ 6. Are spill buckets(containment structures)free of water,debris,and hazardous substance? Yes No N/A Yes No N/A u Tank I ID— 10,000 Unleaded ® ❑ ❑ Tank 4 ID—Waste Oil ❑ ❑ Tank 2 ID— 2,000 Unleaded ® 1 ❑ I ❑ Tank 5 ID— ❑ ❑ ❑ Tank 3 ID— 5,000 Diesel NJEJ1 0 Tank 6 ID— ❑ ❑ ❑ 7. Are under-dispenser containment areas free of water,debris,and hazardous substance? Yes No N/A Yes No N/A I� Dispenser— 1/2 Multi-product ® ❑ ❑ Dispenser— Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ Dispenser— ❑ 8. Leak detection is properly located within under-dispenser containment. Yes No N/A Yes No N!A 4i Dispenser— 1/2 Multi-product El Dispenser— ❑ ❑ I ❑ Dispenser— ❑ ❑ ❑ Dispenser— ❑ ❑ ❑ I Dispenser— ❑ 1 ❑ 1 ❑ Dispenser— ❑ ❑ ❑ 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? ❑ 9/27/2007 I L 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? ❑ 10/5/2007= iese( 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 I ® I ❑ 1 01 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-lob 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