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T D <br />QJ , <br />cQ (D <br />m rn <br />00 0 <br />O :3 <br />to <br />00 m <br />O <br />CJ <br />O <br />W <br />r <br />O <br />(D <br />C-) <br />O <br />D <br />Q <br />Sv <br />Sv <br />O <br />r -f <br />U) <br />r- <br />QJ <br />3 <br />U) <br />D <br />O <br />r -r <br />Q <br />O <br />n <br />r_ <br />(D <br />O <br />Q <br />O <br />(D <br />1)7O <br />O <br />r-. O <br />v � <br />T W <br />o <br />O <br />N � <br />O <br />-P <br />UNDERGROUND STORAGE TANK SYSTEN1 <br />DESIGNATED UST OPERATOR MON'T'HLY INSPECTION RETORT <br />Facility Narnc; Flag City Chevron Inspection Date: October 3, 2013 <br />Facility Address: 6421 Capital Ave l rt` Lodi - <br />Namc oflhsignaled tJS I' Oparniti)r Conducting Inspection. Alex Jabbari - <br />Internntional Code Council Ccrtifiication No 5243897 -UC lixpiralirn, pate_ 10!6/2014 <br />Signature Q , Phone. (925) 389-1262 <br />Item <br />MONITORING PANEL I ALARM HISTORY <br />Yep No NIA <br />- <br />1. <br />_ -- <br />Is the monitoring—roper%V,;tLm powered on and in tip ratingernudc? <br />2. <br />_ <br />Is the monitoringsystLm not currently shoiwin anv leak alarms? - — <br />Is the Alarm History' Report/log fir the previous month available, and has it been reviewed by the <br />Designated I IST Operator? (Attach a copy o the alarnt history reporyrlog to ibis lits ectrn rrru j <br />a <br />Has each alarm for the previous month been r!slNnded Co appruprialelv'' <br />UST SYSTEM INSPECTION <br />J <br />Are lank -top contamnrent swops free! of %voter, debris, and hazardous substance'' Nate: If the answer to Item a was "Yes, "or <br />-NA" skip to Item h Sumps where an alarm lots occurred to the post month roust he Inspected # a quahfred service technician has not responded <br />to and rorlv addrrrsed. the cause orthe alarm. Ikxumentatlon\err i approprtare service sNrruld be attachrd to This re rt. <br />_ <br />L19: seconde vapor alarm <br />Yc9 <br />No <br />No Sum alarms <br />Yep <br />Sum Location: 91 Fill sump[� <br />Sum Location <br />gNo <br />Sum Location: I.11: 87 Sla�� <br />Sump Localism. <br />.e <br />A — ....:tl 1..—U..e.. /,..... <br />A... AA'" <br />- ....,1 ti ---- I -.....-..1....____n <br />a <br />/'1 <br />V ' <br />N <br />N <br />