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13850 N De Vries, Lodi, CA 95240 <br />08/17/2021 <br />PHOTO 5: <br />Report sinned on 02/08/2021 by owner <br />Underground S <br />UST Operator e Tank <br />Visual Inspection Report <br />5. OWNER/OPERATOR DESCRIPTION OF FOLLOyy UP ACTION <br />wi.. ,har the follow up actions to correspond to <br />from Section 3. <br />[J <br />PR0231547 <br />Program: UST <br />All answers marked "No" must be described by the designated UST oneratnr in CAr +; ,,, Q <br />-.' i IC's:=. <br />Ch <br />�z - <br />VICKY VANG-LEE, EHS Page 5 of 5 <br />f <br />.! a, <br />6. OWNER / OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br />1 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 <br />correct any compliance issues <br />Name of UST Owner / Operator (print) <br />discovered. <br />Stephen G. Wiedemann <br />UST Owner/Operator Signature Date Signed <br />P■ <br />/�Y—_ mB�Y weaMsb+en G. WieEnmrvi <br />wr. aor.oz oe 9:s.s.-neva <br />7. INSPECTION HISTORY <br />f <br />Has each follow-up action of Section 3 from the previous Designated UST <br />Operator Inspection Report been completed appropriately? <br />Yes No NA <br />Attach documentation verifying a ro mate service to this report.) <br />11( <br />8. RELEASE DETECTION ALARM HISTORY <br />Attach a copy of the alarm history report//og to this report. <br />Yes No NA <br />Is the monitoring system powered on and in proper operating mode? <br />® ❑ <br />Has each alarm since the previous inspection been responded to appropriately? <br />(Attach documentation verifying appropriate service to this report.) <br />❑ ❑ <br />Have all containment sumps, that have had an alarm since the previous <br />designated UST operator inspection report, been responded to by a qualified <br />❑ ❑ <br />service technician? <br />All answers marked "No" must be described by the designated UST oneratnr in CAr +; ,,, Q <br />-.' i IC's:=. <br />Ch <br />�z - <br />VICKY VANG-LEE, EHS Page 5 of 5 <br />