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1403 West Country Club Blvd. PR0231995 <br /> March 29, 2022 Program: UST <br /> PHOTO 3: DO report sa s that re ort was provided to owner on 11/22/2021. Re ort was signed by owner on 11/21/2021. <br /> FND <br /> ALARM HISTORY REPORT <br /> __SENSOR ALARM <br /> L 7: aEN'ORS � <br /> OTHER <br /> Undergnounc <br /> Designated UST Operator �rt <br /> `,,5. OWNER/OPERATOR DESCRIPTION OF FO °THFR -en3oR6 <br /> 'Number the follow up actions to correspond to ar <br /> nom Section 3. <br /> Ylvy <br /> . "...END x x x x. <br /> 6. OWNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> I 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 correct any compliance issues discovered. <br /> Name of UST Owner/Operator(pent) i-'60, C�✓ <br /> USTOwner/Operator Signature � Date Signed <br /> v11 <br /> -a(•zl <br /> 7. INSPECTION HISTORY <br /> 1 <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> Operator Inspection Report been completed appropriately? ❑ <br /> Attach documentation verifying appropriate service to this report.) <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history report/log to this report. Yes No NA <br /> Is the monitoring system powered on and in proper operating mode? ❑ <br /> Has each alarm since the previous inspection been responded to appropriately? ❑ ❑ �/ <br /> (Attach documentation verifying appropriate service to this report) <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 /> service technician? <br /> All answers marked'No"must be described by the designated USToperator in Section 3. <br /> Page 2 of 4 <br /> t' <br /> Lydia Baker, SR. REHS Page 3 of 3 <br />