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K <br /> Inspection R.Port <br /> - �tora9e Tan <br /> ;rator ISual pate last <br /> Yes No NA performed <br /> leted within the past <br /> f{cation been comp � <br /> -ysterr+ cert A--14-20224, <br /> feted within the past <br /> ' been comp <br /> - , - <br /> pill container testing <br /> 12 months? t inspection been completed within ® 7_7_2020 _ <br /> Has overfill prevention equipment <br /> the past 36 months? ® <br /> (� _ <br /> Has secondary containment testing been completed within the past `�'' - <br /> 36 months? :)d(Has tank tightness testing been completed within required ® — <br /> timeframes? <br /> Has line tightness testing been completed within the required <br /> timeframes? <br /> Other Test / Maintenance: <br /> Other Test / Maintenance. <br /> Other Test / Maintenance: Yes No <br /> 11. FACILITY EMPLOYEE TRAINING <br /> Have all individuals performing facility employee duties received the required facility <br /> employee training within the past 12 months? <br /> 13. COMMENTS <br /> cord comments or observations that are not current compliance <br /> This section maybe used to re <br /> deficiencies. <br /> IIS <br /> i <br /> All answers marked "No"must be described by the designated UST operator in Section 3. <br /> Page 4of4 <br /> .,�It, U5T = Iv <br /> Underground <br />