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Underground round Storage Tank <br /> DesignatEd UST Operator Visual Inspection Report <br /> 1 Date last <br /> F� <br /> 16. <br /> 'TE TING AND.MAINT �INcPYes No N performed <br /> Has nititoring system certfl i Seton been completed within the past <br /> 12 m n hs? <br /> ❑ 01/012/2020 <br /> Has slpi I container testing Ibcompleted within the past <br /> 12 m Q n hs? 0 ❑ 01/0212020 <br /> Hasvrfil[ prevention equi i Brit inspection been completed within <br /> 0 El05/0;2/2019 <br /> the 4s�36 months? <br /> Has se ondary containment t ting been ' ampleted within the past <br /> 36 mcn hs? 0 ❑ Ell 04/02/2019 <br /> Has t k tightness testing b omplete. within required El Eltimefr � es? <br /> j <br /> Has lin tightness testing bee completed',Nithin the required <br /> El Eltimefr' es? <br /> Other T st/ Maintenance: ❑ ❑ <br /> I <br /> Other T st 1 Maintenance: El 13 <br /> OtherT st ! Maintenance: El ❑ <br /> 11. F�A,l.-*ILITY EMPLOYEE INING Yes No <br /> Have al individuals perFormi i facility employee duties received the required facility ❑ ❑ <br /> empldyEpe training within the s 12 mant s? <br /> 4 <br /> This se tion may be used to rd comm hts or observations that are not current compliance <br /> deficien ies. 1 <br /> i <br /> All answers marked "No"mu describe by the designated UST operator in Section <br /> Page 4 of 4 <br />