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Lodi Food & Liquor 1225 W. Lockeford St. Lodi , CA 95240 <br /> B.Z.Service Station Msinten _ UNDE[ZGROUND STORAGE TANK SYSTEM <br /> .r , ,h<�, <br /> �> U OPERATOR MONTHLY INSPECTIONREPORT, <br /> 1(141'[riangle_Court 1 P.O.Box 933( `" e i. <br /> West Sacramento,California. :Is msec on Date. <br /> Phcne(916)371-33 ;x y <br /> •— Fax(916)371-2541... - t,4 .,' Lodi,CA 95240 <br /> laic.9433159IA i' a <br /> ,tG,. Expiration Date: tf s <br /> r.. <br /> Phone:-(916)371-2380 ext. <br /> Monthly Desi¢nated 0 2erator Che' ., .,.,. , -Mui. NrA-notA leabte <br /> Name /' ' '" to _ MO NC YANELIALARMH RY Ya No NtA. <br /> .: -rte-j o- e. -' r c.�c I Is the onnonnu.aystam r o—red and_irtp <br /> 2 IS ttlC Mo I ring system nut curre tly h 1 ek 18 ns? <. =� -" ' <br /> s^J 7s tl,c Alarm}iigtary Rep Nlog f i}i p o th d bl,and has 4t trean r4vigWed by— ' <br /> Confirm Correct Compliance T'estmg £ Dc, ni�riatad CJST Oncrntar�.lrr h ni 1 rl f h u orr!/ to chis ins action or <br /> 9!' SB989 a ttas rock alrrnn far d'r ious m br<n_n .,.d_d t u tiaml <br /> p Monttorinl,Cert "? _ US'T SYSTEM 7NbPEC1'ION' <br /> 4 Vapor Recovery I S A tank-top*.[moment sumps free of water,d ris,soil hazardous substance? :Ifo. r/a "Yes•">;'i+v <br /> p Employee Training ro Lem 6 Sumprwhere farm haarcensred/n rhe.yasr o rrh m sr be nape ted ja q Jtl+ 'a ch >�n�'°p°1dedio,sed <br /> - a�.fradme.,ed rhe o rha tilamr.lMeum¢r r r re nrvha xhoatdLe ralud rh rreior+ <br /> Monitoring Log: - —vwr No '•a r Ye! No <br /> 7 All 2tatms aze recorded Sum Location: Sum I:bCatiOn. <br /> Date,Alarm.Employee,So' Sump t.oeation: __ sum I,ucafion <br /> All Alarms Pastor Present 6, Are ill huckets(commnmem structures)fr-of water debris,and hazardous substance? <br /> i <br /> __ Yes No N/.. <br /> . .. I ' No N/A <br /> `,'' � Yea <br /> ,° ) tank I ID-87 Tank 4 iD__ _ <br /> r•'Rep4 -* `t '(unk21D 91 'fankSlD- <br /> Pull two reports ��., r t�i. Tank 6 71 <br /> - <br /> - In I dr gISD 7 C tka lit USI. _ <br /> s 7 Art, d r-d nser comarmment areas free ofwale,debris,and hazardous substance? _ _ <br /> Tdlatch to M t.rung Log : s tP. ' "t Y No N/A Yn No N! <br /> rz/ Note arty-.alaoxts an DO unpe..t on t a1 Dlcw. IRS DI, —r- <br /> Lu <br /> ser _ <br /> wx <br /> _ <br /> Di:Lr 314. ', _ D ser- <br /> tandCompl t lapanvotk onsite -tji 516. D' er- <br /> _if any not onsite �� _�_Ir 71e� D P r <br /> Yearly Lmptoy T mng �} % I<>k wt coon is txoparly]-at tahio and d scrco to t <br /> Cument year ofPX)mspecti ns aX(q" _ Y x No N/A _ Yes Nn N/ <br /> 2years of Cnmplia t sung 'a' +— _ D ser -31til UK <br /> - <br /> Repair&Maintenance IDiser' <br /> Disnser- <br /> es '= <br /> n Sita Equipment: Densor _ _-- <br /> RwORK INSPECTION r`' �Y No N/A `Date'Doae''.. <br /> ralwr Buckets ) yyff 41t rirrrm 8 stem Certification was coin lewd within the an 1 e: `11-20-2013 <br /> a„rtPtunp out any water /f) !t,-1 a rak t)aracaors wire test<Nunified within the ast t2 montiu--_,. R 11-20-2013 <br /> .Clean out debris i f S ill bu<keµ4 cnit4thtment atrucmr testin c m feted wi[hm the ast 12: I 11-20-2013 q <br /> 2 handled I1 Lina t t teMrrt cam feted within rhe r *ed tsme£cameo } <br /> 13 Six tit. crinis mneut tests crxnplim d*vino th q aired t e forme? 2-5 2014 }91 <br /> "cob webs ” coMD1 d within the taqu red time framc7 <br /> 14 Fnhancad Leak Detection arnn <br /> debris'. 4 I S r){her requirad.testinp/mumlerimice was cnmpAoted wwiin,regmred time frame'(Lisa resUmainrenun�a i[ems 6c(on.) <br /> CrBZ handled €a _�._Uoscribe TcsVMaumm:ttce:Air Quality IM 7&30 ._�`y 12-d 2013 <br /> Y�escrih<Test/Mainumaoce: 1 <br /> FACILITY EMPLOYEE TRAINING 7 Yes No' N/A <br /> itity employees mceived the required on-the-job training within the pastye <br /> Customer Signatureifiry employces Aired within the past 30 days reccrved there aired on-tha-oh uamme� <br /> "No"answers in the"Cammems"section on the following page.rht iss,c s mgwre corctcnve action fmm. <br /> -rlajlerdtOf. <br /> .aolJaeuir4 +?Rbm-s. <br /> Sp <br /> The designated operator failed to document all the alarms form the attached alarm history on the 6-4-14 designated <br /> operator monthly inspection report and failed to check that they were responded to appropriately. The missing alarms <br /> include: 5-25-14 diesel sump alarm. <br /> Page 1 of 3 Photo taken on 11-19-14 <br />