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Desigtl<eted':Unde untf torgge Tank(UST)Operator <br /> Ro YisuW* ection Checkli <br /> Fill rla:nm• biii- <br /> Ily Addreat• <br /> Ci m zip Cdft: 0 <br /> rh3f8MLW U , oA: - <br /> Sf <br /> Intonational Eouncil #i -Y'- .'v Ex iretion bate: 'e...i <br /> Phone: "7 <br /> Y` N_ o NA.NotA Iker <br /> Item 1VIt3 hN6 F / HISTORY. Y ' N NA <br /> l IMoui �S op a0d' mode. 141 low <br /> 2 1Vlanita ' " lean is dot .sh al s or W=ing. <br /> 3 Alarm histpry report/log forthe pa'eulrous•mbnth is available,and has been roylowed by the <br /> fbmsl IJP' r. .tttaA a co o the a1 ARM rt/10 to this rm`i ravailuble. <br /> 5a5 Bachalign fog•the revious-m Imnded to rtrWe .eSensors1 in,tank-to mpt htivo:notal .iiitha 4stmonth, <br /> . List all twL+4 p where Jn the past Manth; <br /> Nola:. trlrane an,alatgt har fere 11�4i Dual asoirth e3a d wrl®as a gttal(lletd adrvloe ldChePtclan responded l0,did <br /> prOP60 00flea gjtht ' Xtt JF pint wr�j+/evg afro •luta nel vtcr.to tl r rtpor� <br /> is tam 6 kkw. <br /> YMM E <br /> • IN CCION - <br /> 6• Tank- , , ',top •sdiiips def' ' ,debAk and hazardous substanm:Sensors are Located properly. <br /> oar�M�u�ratrJ txlaa /,t, rd wleera an atprtg!etas d pr!h8 t nroxtb or wglch!hens it no aarVloe ra ' <br /> IR/GQiipts: LgaWlon <br /> • Locatiortr <br /> Sunt '• :. .. <br /> ,Goocuton: . <br /> �-7' <br /> Tanis 1-t aateYnts; N NA Y. N NA' <br /> 2-C I' Tank 3-'Cantertts• <br /> t Tanis 4 <br /> 8 U of ' r1s and h' us substance. Sensors are located erl <br /> Y . N ,` 'N NA <br /> NA Y <br /> Is ar112 b er 9/10 <br /> DPs �•3/ <br /> 41 1a 11/laDema3/6r . <br /> attser M/14 <br /> .Dtf a 77/8 <br /> PAP YORK INi3F1�C"t'It3N Y ' lY NA UATI C DONE <br /> MEN <br /> 9 lVloni certa " loted�vlthin ast.l2`nioniiis. -1 . y <br /> 10 Sabn containaaem foals iti the ad ehal» . t J y" •�Y . :. <br /> t 1 3 lll.co :yy40roPloted w(d the <br /> l2 'Teak tl �� fs..�•' �. <br /> Cesstlta wall' i •tan m. <br /> 13 1:, a mess�stin way letad wlrtt� a o. � . <br /> L14 Hin0rTvVBs n re timeftama. tot testlmaintenanaes!teats.batexw. . <br /> esdMattrtenartao; <br /> Te�sdMalrttsnancs:; . <br /> re�dnt • <br /> IS 1 i9aciEi �, <br /> PACILnT SPOLD 'TRAINYIVG <br /> reMved faired or�tha-ob trahiin the tear, t <br /> 16• A11 the nLimhirsed within the 30 have npraoie+ed the'. aired on�tty ob era�in . . <br /> Nota: And answer ac of�1V"ahonkt be oScphii�a4 in the Comm,cut seat* on the Poll 1W z Dago,and will reauhv <br /> tolltt~v-up action. . ' . .. - <br /> : . . olof2 <br /> i ;F NoveM6r.2004 <br /> Zd WdST:20 SOW ZO 'C)a(I ObSE TLE 9Z6: 'ON Xtid 90NUN31NIbW NOI1d1SS0I0N3S'Z'9: WONA <br />