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4950 Buckley Cove Way PR0231028 <br /> January 13, 2022 Program: UST <br /> PHOTO 4: Incorrect test date for secondary containment testin . <br /> Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> Date last <br /> J.TESTING AND MAINTENANCE Yes No NA performed <br /> e <br /> ias monitoring system certification been completed within the past ❑ 11 1/22/21 <br /> 12 months? <br /> Has spill container testing been completed within the past 1/22/21 <br /> 12 months? ❑ ❑ <br /> Has overfill prevention equipment inspection been completed within 7/16/21 <br /> the past 36 months? ❑ ❑ 2/5/21 <br /> Has secondary containment testing been completed within the past <br /> 36 months? <br /> Has tank tightness testing been completed within required ❑ EJ ✓ <br /> timeframes? Z ❑ ❑ 1/22/21 <br /> Has line tightness testing been completed within the required <br /> timeframes? ❑ ❑ _ <br /> Other Test I Maintenance: ❑ ✓ <br /> Other Test I Maintenance: ✓ Yes No _ <br /> Other Test 1 Maintenance: ❑ <br /> 11.FACILITY EMPLOYEE TRAINING io ee duties received the required facility <br /> Have all individuals performing facility emp Y <br /> emPioyee training within the past 12 months? compliance <br /> 13•COMMENTS <br /> This section may be used to record comments or observations that are not currentcom <br /> deficiencies, <br /> Aq answers marked"No"must be described by the designated <br /> ST' <br /> eratet' <br /> Lydia Baker, SR. REHS Page 4 of 5 <br />