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a L L -0 Lri L UNDERGROUND STORAGE TANK SY E (U o DESIGNATED UST OPERATOR MONTHLY INSPEC 0- aj v — +� FacilityName: City of Lodi lnspeetion Date: N o r o October 30, a o Facility Address: 1331 S.Ham Lane City: Lodi N Name of Designated UST Operator Conducting Inspection: Rand Lane o Y o 5317552 Expiration Date: N U N International Cod Council Cenzation No.: 6/Z712015 0 m c Q Signature: Phone: (209)333-68M ea.2684 Q o U wA.� co U MONITORING PANEL I ALARM HISTORY YesNo NIA U a 1 73. 1s `-- rn a "� he ntonitorin system powered on and in ro er o eratit mode? L U L L Q he monitorin system not currently show7n an leak alarms? to 3 J he Alarm History Report/log for the previous month available,and has it been reviewed by the si aced UST operator? (Attach a co }ofdte ttlarnr history re ortllo to this in ection or n o a 3 _ sz 4. Has each alarm for the revious month been responded to appropriately? U o aj aD -a +1 J UST SYSTEM INSPECTION p -0 L 5, Are tank-top containment sumps Gee of mater,debris,and hazardous substance? .Vote:!f rhe answer to Item 4 was"Yes,"sup a � - to hem 6.Sumps where an alarm h(a occunrd in die pact mondt must he inspected if a yuali(ed senice technician has not responded to,and U tiA (� properly addressed.the cause o!the alarm.Docunrrn(ation Teri cin,q n ro nate sen�ice should be attached to this s re rt. � Yes No Yes No t - Sum Location:N'E Fuel Island }' a� 0 Sum Location:SSV Fuel island _®_ ❑ ro n Sum Location:N/W Fuel Island ® ❑ Sum Location: U P 6. Ares ill buckets(containment structures)free f_owater.debris,and hazardous substance'? a L Yes No N/A i o Yes_No N'/:1 L o ro M CL L Tank—IID-10,000 Unleaded !❑ ❑T❑ Tank 4 ID- 4-- cual -- -- v, L Q Tank 2 ID- 2,000 Unleaiied ❑_ Tank 5 lD- aj p Tank 3 ID- 5.000 Diesel f aok n l l)- o -0 S` 7. Are under-dispenser coi;n r -" n ta:ardour substance•? U + nal! "- Yes No N/A n + c __ -- 1 ,) •on Dispenser-U2 Multi-pru; .-- nxr 4- F— U n •— Q) Dispenser- ,t_.er v -0 U Dispenser- -- ) mer— --- ElO Dispenser- _ D:spc,iser- 00 0 't 8. Leak detection is properly located within under-di,peu r:mtainment. t U YcsI No N/A j Yes No NIA v o 0 •� lit Multi-product ® ❑ ❑❑j Dispenser- p 4- Dispenser- a� L Dispenser- ❑ ❑ ❑ Dispenser- v Dispenser- ❑ ❑ ❑ Dispenser- 0 0 0 0 N Dispenser- ❑ ❑ ❑ Dispenser- Y N _ al •� PAPERWORK INSPECTIONYes No N/A Date Done. @ + 9. Monitoring System Certification was completed within the past 12 months? ® U U 9/2512014 10. Line Leak Detectors were tested/certified within the past 12 months? 9/25/2014 0 ' CU� 11. Spill bucket(containment structure)testing completed within the past 12 months? 9/25/2014 -o -0 c Q) Ln •— 12. Line tightness testing completed within the required time frame? U '- o 13. Secondary containment testi completed within the required time frame'.' 10/1W2011 O 0 14. Enhanced Leak Detection completed within the required time frame? 0 a L 15. Other required testis maintenance was completed within required time frame? (List tesilmaintenance itau below L ro Describe TestfMaintenance:Drop Tube Integrity Test-every 3 yrs o- v c Describe Test/Maintenance:Static Torque&Rotation Test-eve 3 4I2 o n o N to vvi FACILITY EMPLOYEE TRAINING 16. Have all facilityemployees received the required on-the-job trainingwithin the past ear? a x t c t = N 17. I Have all facility employees hired within the past 30 days received the required on-the-job tin +� `1 o Qj � o al o N www.ucldamorQ kiw-_ ;, H 4� a ro a