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Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> g1r, <br /> TESTING AND MAINTENANCE pate last <br /> Yes No NA perfe rued <br /> onitoring system certification been completed within the past <br /> nths? © © 6/16/22 <br /> pill container testing been completed within the past <br /> nths? 6/16i22 <br /> erfill prevention equipment inspection been completed withint 36 months? 7n/2� <br /> condary containment testing been completed within the pastths? t❑ 0VPH <br /> k tightness testing been completed within required <br /> es? © © 0 <br /> Has line tightness testing been completed within the required <br /> timeframes? <br /> Other Test/ Maintenance: <br /> Other Test/ Maintenance: El <br /> © ®Other Test/ Maintenance: 0® El11. FACILITY EMPLOYEE TRAINING <br /> Have all individuals performing facility employee duties received the required facility Yes No <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 /> liance <br /> p <br /> Tank and line tightness test is not required on double wall tanks and lines <br /> ill answers marked "No"must be described by the designated UST <br /> operator In Section 3. <br /> Page 4 of 4 <br />