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Underground St01rege Tank ction Rep ott <br /> Designated UST operator VISUal In5Papate last <br /> _-- Yes No NA performed <br /> 10. TESTING AND MAINTENANCE ❑ 9i/30/2021 <br /> Has monitoring system certification been completed <br /> -within the pest [✓� _ <br /> 12 months? ❑ 9/30/2021 <br /> Hass Pill container testing been completed within the past ❑ <br /> 12 months? 15/4/2021 <br /> Has overfill prevention equipment inspection been Comuluh;d williiri ❑the past 36 months? _ _ El <br /> EW18/2021 <br /> Has secondary containment testing been completed within the Pest ❑✓ CJ ' <br /> 36 months? ❑ ❑ <br /> Has tank tightness testing been completed within required �] <br /> timeframes?' _ <br /> Has line tightness testing been completed within tho required 0 ❑✓ <br /> timeframes? El ❑ ❑ <br /> Other Test 1 Maintenance: <br /> Other Test/ Maintenance: _ — ❑ ❑ ❑ <br /> Other Test/ Maintenance: El El 21 <br /> 11. FACILITY EMPLOYEE TRAINING Yes No <br /> Have all individuals performing facility employee duties received the required facility ❑ <br /> employee training within the past 12 months? <br /> 13. COMMENTS <br /> This section may be used to record comments or observations that are not current compliance <br /> deficiencies. <br /> L� <br /> All answers marked"No"must described by the designated UST <br /> oper,�tor in Section 3. <br /> �I <br />:. Page 4 of 4 <br /> I — <br />