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- L) <br /> J d v51 <br /> Underground Storage Tank na <br /> to <br /> Designated UST Operator Visual Inspection Report pe519 <br /> - NSpEC 100II Cc <br /> 5. OWNER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION SVS�EM I Se�tiarj 3 ted <br /> Number the follow up actions to correspond to appropriate compliance issues from Section 3 aid in esigna ie <br /> t'��aPo0S �jee tech" d <br /> water' <br /> 0�a4aapfled e, of <br /> �o�for damag SUM <br /> free <br /> roolainment SU <br /> o.T aentsump�� R' <br /> the inspe, <br /> �aai�nsots in visually <br /> Ha! <br /> 136 �tceslopportunity? <br /> Ho !sh%011containment free o <br /> tin '�Mtstructll Is fill cap <br /> H. <br /> u. �nlamment ID <br /> `c QCT <br /> s OWNER/OPERATOR <br /> ACKNOW�EpGEME <br /> I have reviewed the results of the NT OF INSPECTION9� OCT <br /> _ designated UST <br /> description of the actions RESULTS <br /> C Name of TSU Owner/O action( <br /> I taken or to be taken to operator ins <br /> Operator(print) correct an Pec lion report and provideda SSL OCT <br /> UST Owner/Oper r Si y compliance issues discovered. <br /> ✓e <br /> gnatu <br /> 7. INSPECTIONIS�'aV <br /> HISTORY Date Signed dot ��ir�e <br /> � Has each follow- arab of <br /> Operator Ins up action of Se _ /� _2 2 ea damage <br /> Attach docurppeCtion been <br /> 3 _ <br /> Report froi� se et the earl <br /> entation verif in c0mplet d ahe previo ;• <br /> 8. RELEASED a pro riate seppt,�° elyDes�gnated UST Yes No NA <br /> ETECTION A priat <br /> Attach a copy of the BAR e to this r ort Q DSS <br /> a/ar M HISTORY e P �,2 <br /> Is the monitorinsystem ❑ D <br /> 9 m history re � <br /> Has each powered pow/og to S <br /> (Attach documentatsinlo the Previous�n and to Pro pefthis report. <br /> Have all containrne n verifying a Per <br /> be, operating ►trod Yes NO NA <br /> designated US nt sumps,thatppropriate se n respon e? ❑ ❑ pl�p <br /> service technici operator ins have ha rvice to ded to a <br /> I pection re d an alar this repo PPropriately? Q <br /> + All al pod, be na Since �� ❑ ❑ <br /> vers rnarked«No„must be en responded to by mous <br /> describedby the des qualified [] ❑ � M <br /> designated <br /> _ �1 <br /> US operator in Section 3. aRs�er deal <br /> / : 1 1 • At <br />