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nK <br /> r round Storage spection Repo <br /> d QST <br /> Underground <br /> VISU <br /> Designate UP ACTT es from Section 3. <br /> OVV� ON <br /> OR DESCRIPTION OFo PPr p ate compliance issu <br /> NER/OPERAT correspond <br /> ,umber the follow up <br /> actions to <br /> I <br /> 6. OWNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTIOeCRon�re Tort and provided a <br /> s p <br /> UST <br /> operator in p <br /> of the designated <br /> I have reviewed the results g <br /> description of the action(s)taken or to be taken to correct any compliance issues discovered <br /> Name of UST Owner/Operator(print) <br /> UST ner/Operator Sign ure Date Signed <br /> t <br /> 7. INSPECTION HISTO <br /> =each -up action of Section 3 from the previous Designated UST Yes No NA <br /> tion Report been completed appropriately?antation verifying appropriate service to this report.) <br /> h 8. RELEAS�DETE�CTION�ALARM HISTORY <br /> pE Attach a copy of the alarm history report/log to this report. <br /> Is the monitoring system powered on and in proper operating mode? Yes No NA <br /> S, Has each alarm since the previous inspection been responded to a © ❑ <br /> ppropriatel <br /> tiler (Attach documentation verifying appropriate service to this report.) Y <br /> Stor Have all containment sumps, that have had an alarm since the ❑ ❑ <br /> designated UST operator inspection report, been responded to previous qualified p p p <br /> service technician? p Y a qualified <br /> All answers marked"No"must be described by the designated <br /> UST operator in <br /> Section 3. <br /> page 2 of 4 <br />