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Tait Environmental Services <br />UST Construction • Design • Maintenance • Compliance <br />Designated Operator Monthly Inspection <br />Checklist <br />Facility Name: AT&T Corporation Lodi: LODICA02 CAK482 <br />Date: 06/29/2007 <br />Facility Address: J110 W. Turner Rd. <br />1 <br />City: Lodi <br />Zi Code: 95242 <br />Designated UST Operator Conducting the Inspection: Koffel Georc e <br />International Code Council Certification #: 5247982 -UC <br />Expiration Date: 12/19/2008 <br />Si nature <br />Phone: 714-920-5387 <br />Item <br />MONITORING PANEL. / ALARM HISTORY <br />1 <br />Monitoring system is powered on and in operating mode <br />Yes <br />2 <br />Monitoring system is not currently showing any alarms or warnings <br />Yes <br />3 <br />Alarm history report/log for the previous month is available, and has been reviewed by the <br />Desi nated UST Operator Attach a copy of the alarm histo rep2rtliog to this form if available <br />Yes <br />4 <br />Each alarm for the previous month has been responded to appropriately. <br />N/A <br />5 <br />Sensors located in tank -top containment sumps have not alarmed in the past month. <br />JYes <br />5a <br />List all tank -top sumps where alarms occurred in the past month: <br />Note: Sumps where an alarm has occurred in the past month must be inspected unless a qualified technician responded to, and properly <br />addressed, the cause of the alarm. Attach documentation verifying appropriate service to this report. if sump inspection is required, record <br />results in item 6 below. <br />UST SYSTEM INSPECTION <br />6 <br />Tank -top containment sumps are free of water, debris, and hazardous substance. Sensors are located properly. <br />Note: Visual inspection of sumps is only required in sums where an alarm has occurred in the past month for which there is no service record <br />YIN I Deb I Uq I <br />YIN I Deb Liq <br />Sump Location: Sump Location: <br />Sump Location: Sump Location: <br />Sump Location: Sump Location: <br />7 <br />Spill containment structures are free of water, debris and hazardous substance. <br />Tank 1 - Contents: Diesel <br />Yes <br />Tank 3 - Contents: <br />N/A <br />Tank 2 - Contents: <br />N/A <br />Tank 4 - Contents: <br />N/A <br />8 <br />Under -dispenser containment areas are free of water, debris, and hazardous substance. Sensors are located <br />properly. <br />Dispenser 1/2 <br />N/A <br />Dispenser 9/10 <br />N/A <br />Dispenser 3/4 <br />N/A <br />Dispenser 11/12 <br />N/A <br />Dispenser 5/6 <br />N/A <br />Dispenser 13/14 <br />N/A <br />Dispenser 7/8 <br />N/A <br />Dispenser 15/16 <br />N/A <br />PAPERWORK INSPECTION <br />DATE DONE <br />9 <br />Monitoring system certification has been completed within past 12 months. Yes <br />07/28/2006 <br />10 <br />Secondary containment tests have been completed within the required timeframe. No <br />09/09/9999 <br />11 <br />Spill containment structure bucket testing was completed within the past year. Yes <br />07/14/2006 <br />12 <br />Tank tightness testing was completed within re uired timeframe. N/A <br />13 <br />Line ti htness testing was completed within required timeframe. N/A <br />14 <br />Other re uired testing/maintenance was completed within required timeframe. List test/maintenance items below. <br />Test/Maintenance: N/A <br />Test/Maintenance: N/A <br />Test/Maintenance: N/A <br />