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6638 Pacific Avenue PR0231784 <br /> January 20, 2022 Program: UST <br /> PHOTO 2: 12/20/21 DO report not si ned by owner/operator. <br /> �ata 11 <br /> r... <br /> -Pa 44{,, Ave Chevron arrrNM-CG M <br /> r a mn� <br /> y <br /> f �" <br /> 4 �Y19'S <br /> rrc <br /> DeSt9nated USTderg ound Storage TankUnderground Storage Tank <br /> r <br /> PT Operator Visual Inspection <br /> Number Report "*^r Visual Inspe <br /> O�th�Ot RATOR DESCRt <br /> w uP aeons to rprresPond t F PP PriatepcomTlON <br /> ips that have h <br /> ,y�flU$(Q�r phance issues fro sPaction Repoi <br /> m Section 3, nt sumps lister <br /> s substance,ai <br /> - acoa°'J '06s,end hazb <br /> nor����-� Containment <br /> amP-located <br /> Ins,end hazar <br /> Pe? <br /> ^'��pps+ SPIII <br /> - S- OWNER/OpERA70R ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> t have reviewed the results of the designated UST o <br /> -- description of the erator inspection re actions P <br /> Name of UST ()taken or to be taken to correct any compliant: sues Sand erovltled a ardor <br /> Owner/Operator s subs) <br /> crc� (print) discovered. Vo U <br /> UST Owner/Operator Signature UDC ID <br /> Date Signed <br /> - 7. INSPECTION HISTORY j <br /> Has each follow up action of Section 3 from the premouD <br /> Is esignated UST <br /> Mach Operator Inspection Report been completed appropriately? Yes No NA <br /> Adocumentation vent ing a ro riate service to this reort 0 <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history report/log to this report. <br /> s Is the monitoring system powered on and in proper operating mode? Ye No NA <br /> Fn <br /> Has each alarm sincecumthe previous inspection been responded to appropriately? _ <br /> -� (Attach documentation verifying appropriate service to this report) Ll U <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 ❑ design <br /> service technician? <br /> ' Alf answers marked"No"must be described by the designated UST Operator in Section 3. <br /> Page 2 of 4 <br /> Lydia Baker, SR. REHS Page 2 of 2 <br />