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UNDERGR® <br /> -��SjGNA,QED US UND ST®�, • <br /> Facili ®PERA�'®n ®N 11�Nk,c��YS TES <br /> tyNanle. Lodi Food& Liquor TjjL�INSP <br /> Facility Address: I ECTI®N <br /> Name Of 1225 Lockford Inspection D REPORT <br /> Designated UST Street ate: <br /> Operator ConductingCity: Lodi, 3 ���°� <br /> International Code Inspection: CA 95240 <br /> Council Certification No.: f1/ <br /> Signature: <br /> (oa��-arc <br /> Expiration Date: <br /> Item ( Phone: <br /> 1 Is the monitoring MONITO (916) 371-2380 ext. <br /> 2. Is the monitoring s stem RING p L/AL RM <br /> owered on and in ro er o HISTORY N/A= <br /> S stem not currentl showin eratin ► nor A ;;�;,�r� <br /> �• is the Alarm Histor ode? Yes o N/A <br /> History Report/Ogg for the pre Yes leak alarms? <br /> Designated UST Operator? month availabl ❑ ❑ <br /> `I Has each alarm for the prevrous month been res onlay t 'and has it been reviewed b ❑ ❑ <br /> I the alar",histo ! e ort/lo to this ins ection y the <br /> to ❑ ❑ <br /> r o riately? in•) <br /> : Are Tank-top cUST ontainment sumps free of waters esb EM INSPE� ` <br /> TION - v.. ❑ <br /> to/rein 6. ,�• , <br /> Sumps ultere an alarm lras occurred in the past month tints[be ins ected i a <br /> roper(roddressed,the is,and bazar ous substance? <br /> cause of dre alarm.Documentation vert in a ro ria service should be attoacl>eJd tc th c rale oro Item e lugs "Yes, ,skip <br /> f qualified service technician has not responded to, and <br /> Sump Location: �'e` No " <br /> Sump Location: ❑ ❑❑ Sum Location: Ye` No <br /> 6. <br /> Are r11 buckets containment structures)fi❑ee of water,debSu an Location: <br /> ❑ ❑ <br /> --� _ _ ( ❑ ❑ <br /> Tank i ID -37 <br /> Yes No N/A I hazardous substance? <br /> i i — ------ ❑ ❑ Tank ID- Yes No N/A <br /> 4 : 7ank ? ID-91 _-- ❑ ❑ <br /> Tank; ID-DSL '— ❑ ❑ Tank 5 ID- <br /> El--- ❑ ❑ <br /> Tank 6ID----- -- ❑ ❑ _ <br /> Are under-dispenser containment areas free of water,debris,and h zardous substance? ❑ ❑ ❑ <br /> Yes No N/A <br /> Dispenser- P2 El Dis en er-DiYes No N/A <br /> spenser-314 ❑ El El El <br /> LiDis en er- EJ 11 El <br /> 56 _- El F-1Dien er- <br /> Dispenser_78 ❑ ❑ Dispenser- ❑ El El <br /> Leak detection is Nroperly located within under-dis enser containm nt. EJ EJ ❑ <br /> __ Yes INo N/A <br /> 1 Dispenser- 1 2 ❑ ❑ DispensYes No N/A <br /> e r- El ❑ <br /> Dispenser-3 4 ❑ ❑ Dis ens r- ❑ ❑ ❑ <br /> Dispenser—5 6 ❑ ❑ Dispenser— ❑ ❑ ❑ <br /> } j Dispenser-7/8 ❑ ❑ I Dispenser- ❑ ❑ ❑ <br /> � �.• - rte, • � � .� <br /> PAPERWORK INSPECTION Yes No N/A I Date Done <br /> 9. Monitoring System Certification was completed within the past 12 n onths? 0,, ❑ ❑ 1 11-29-2011 <br /> 10. Line Leak Detectors were tested/certified within the past 12 months ❑ ❑ 1 11-29-2011 <br /> H. Spill bucket(containment structure)testing completed within the a$t 12 months? EaV ❑ ❑ 11-29-2011 <br /> 12. ! Laine tightness testing completed within the required time frame? ❑ ❑ <br /> 13. Secondary containment tests completed within the required time fra►pe? ❑ ❑ 2-11-2011 <br /> 14. Enhanced Leak Detection completed within the required time frame ❑ ❑ <br /> 15. Other required testing/maintenance was completed within required t me frame? (List testlpmaintenance items below.) <br /> Describe Test/Maintenance:Air Quality St 27&30 ❑ 12-22-2011 <br /> Describe Test/Maintenance: ❑ ❑ <br /> FACILITY EMPLOYEE TRAININ Yes No N/A <br /> 16. Have all facility employees received the required on-the-job trainin within the past year? ❑ ❑ <br /> I17. Have all facility employees hired within the past 30 da s received t e►•e uired on-the-•ob training.? ❑ ❑ <br /> 1�tnra t=v„I�in an.,"Aln" a„c\vrrc in the"'('.nmmants" seetion on the following nage.Those issues reauire corrective action from <br />