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Underground Storage Tank <br /> Inspection Re>P°� <br /> Designated UST Operator Visualpate last <br /> Yes No NA performed <br /> 1 �monitodlng <br /> G AND MAINTENANCE ❑ 9/30/2021 <br /> s stem certification been completed within the past 0Has y ❑ 9/30/2021 <br /> 12 months? ✓ <br /> Has spill container testing been completed within the past <br /> 12 months? ❑ ❑ 5/4/2021 <br /> Has overfill prevention equipment insp <br /> ection been completed within 0 <br /> the past 36 months? 8/18/2021 <br /> Has seconds containment testing been completed within the past � ❑ ❑ <br /> Ha rY <br /> 36 months? ✓❑ <br /> Has tank tightness testing been completed within required [] ❑ <br /> timeframes? <br /> ❑ ✓ <br /> Has line tightness testing been completed within the required El <br /> timeframes? ❑ ❑ ❑✓ <br /> Other Test/ Maintenance: ❑ ❑ <br /> Other Test/ Maintenance: El ❑ ❑ <br /> Other Test/ Maintenance: <br /> Yes No <br /> 11. FACILITY EMPLOYEE TRAINING <br /> ❑ ❑ <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 /> g <br /> All answers,marked"No"must be described by the designated UST <br /> Operator in Section 3 <br /> page 4 of 4 <br />