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900 S Cherokee Ln, Lodi, CA 95240 PR0231841 <br /> 10/27/2021 Program: UST <br /> PHOTO 3: <br /> The owner/o erator failed to rovide date of signature (page 1 of 2) <br /> R;stgrtated UST erground Storage Tank <br /> Aerator Usual Inspe�on Report <br /> Umber <br /> obwNERt olp w�u Tp <br /> R DESCRIPTION <br /> P actions to comes OF FOLLOW UP ACTION <br /> pond to appropriate compliance issues from Section 3. <br /> OR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> I have reviewed the results of the designated UST operator inspection report and provided a <br /> description of the action(s)taken or to be taken to correct any compliance issues discovered. <br /> Name of UST Owner/Operator(pri <br /> UST Owner/0 r i�nat_r. Date Signed <br /> � II <br /> 7. INSPECTION <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> Operator Inspection Report been completed appropriately? ❑ ❑ ] <br /> Attach documentation verifying appropriate service to this re ort. <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history report/log to this report. Yes No NA <br /> Is the monitoring system powered on and in proper operating mode? 5� ❑ <br /> Has each alarm since the previous inspection been responded to appropriately? ❑ ❑ <br /> (Attach documentation verifying appropriate service to this report.) <br /> Have all containment sumps,that have had an alarm since the previous <br /> T o erator inspection report,been responded to by a qualified ❑ ❑ <br /> All answers marked"No"must be described by the designated UST operator in Section 3. <br /> Page 2 of 4 <br /> VICKY VANG-LEE, EHS Page 3 of 4 <br />