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n <br />■irr <br />f f • r, I sMPM <br />faailit� }erne: Lodi Food & liquor- <br />inspection Dote: - <br />kFacilit�, Address: 1225 Lockford str;et <br />-- <br />Ciry, Lodi, CA <br />Surae O"Designated UST Operator Conducting <br />-95240 -� <br />Inspection; <br />,t�,. `_.�Y <br />=InTeymad�on.%O Code Ccunc�il Certification Ala: <br />}M rmt10n [?ate: <br />y Sig:{aturePhone; <br />�t44rnt �71_7?itan mvr t. <br />•+j raav rvf f Nf 67 �YVn Watt ilNS � <br />3. is tlyn Aituar, H;staay 12epflrJlaA far she previous mond a �ailabie, and has i; been reviewrd by the. I ;, <br />Posignated UST O o r? attach a copy o/ ibe alarn, histor jreyorr/la to this inslve:tfoPj forme ' <br />Pias "6 alarm for the revioas wonth been res onded to A ro rWely? <br />J .. .. .. �. UST SYSTEM INSPECTION' <br />y S. Aro :snJ--tc+p Coni meat aurrips f;ee of writer, debris, and hanrdous substance? .Vara .(/'rye arurvor ro /evf>t d �®va Yes. " rx.� <br />1 e. Same', whs.,#v or alprm ho; t scumd lr: rhm pprd manth must be lmsftvted if arc1 jfj ri ;rsrllero llAl lot mWonued to, aid <br />�rfl adetwrrseri ch Cavic Cf 1hc> aill �<�cttole+ dptldtY tdrl. in re rrara �oPvt h010tl bt cueahsct to rhta r7 drr. <br />Bra L ocatlon: �,, ` Stan Lawton <br />Stu Lpca:iori; � <br />Sure Location , ,,' .. <br />h <br />-ACC will b (cortrairu nt struc6 tree free Of water, clebraf: atld hacstdau$ sutrstar►ce' <br />_ <br />Y•ra No N/A <br />' Tarilc 1 ; fl - $'7 "batik 4 ID - <br />-� y� <br />I Yes <br />,W* I'D -91 Tank S ID -• a <br />i(—r Ea* 3 D - DSL Teak G A <br />_ <br />?. ATe urEr et -disperser c0� witai>agilm, mrow NO of Water debris and hAzarcjoms sub3.en*0 <br />Vest ilio /A _ " -°— <br />Dispenser- I/�- Dis enser- <br />Dispenser _- 3/4 Dis enser - <br />�. <br />`Kers lea NSA <br />—Dim—Pur -• 5/6 ^ <br />1�Is erser- <br />Dlspenser-7/8 - Dispenser- <br />_Tx <br />8, Leak detection is Zo rly located within under -dig owwr wntalnriierit. <br />Fr Yes No N/A -- <br />Yes Nv AilA <br />' <br />2F rtszr- l/� <br />tls��enser— 3f4 <br />e^ser - 5(6 <br />Dis engor <br />Dis end_ <br />- <br />Dispenser 7/8 Dis eiaaer- <br />i <br />?AP �R'iWORK INSPECTION ices , Na ltii/A <br />r;•y. '..Rlri <br />Date Dane <br />Monitoring S stern Certification was tsorrt�►'eted witltln the past 12 months? <br />i'-23-2010 <br />10. Linc loak_Deteemrs ware tcstedicenified wltt:ug th� a prst 12 months? <br />9 �*23-2t3 i0 <br />11, S- ! 31 bucket NomaLmant smruct u'0} 14St'in&complamd within the past 12 months? <br />I � -23 2010 <br />12, bine ti .rtrress Wging CQmptewl Wi6in tl:e reo4ir0d time forme? <br />` 13. Smo:c.dsry Cou3i21rriOnt wsts.completed within the regruired dme fi-mrie. <br />1.115-2006 <br />11, T Enhanocd Leak Vmction opuipleted within the required timc t oris? <br />15, 41yr req�tlred tes4ma/maintenanee was coylotad within required time Brame? (List tgLttn rfntenance <br />liam below.} <br />I}escrU Tut/Malmenance:: Air ual;* St 27 & 30 — - <br />- <br />11-23-2010 <br />Describe Test/Maintenance: OA <br />_ PA60Lfit"i' P.M]PLOYKE TRATNJNG <br />16. ve all fullity wnployces received the required on-thm.iob nining within the est Genr'iUZ <br />Yee No NIA <br />17, Hem all filciliainin ,7 <br />51 J <br />Nota: t;xl;iuir: an', 'gNo" aaslvers in the "Cowrivnty" soctlon an the following page. Those :ssuna require corrective action from <br />the Lr.' STT owner, aperator, <br />UN -0.47, In w%**V,v1Ak1we.Or9 910LG . <br />