Laserfiche WebLink
Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 5. OWNERIOPERATOR DESCRIPTION OF FOLLOW- UP ACTION <br /> Number the follow up actions to correspond to appropriate compliance issues from Section 3 . <br /> 6. OWNER / OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> have reviewed the results of the designated UST operator inspection report and provided a <br /> description of the action (s) taken or to be taken to correct any compliance issues discovered . <br /> Name of UST Owner 1 Operator ( print) <br /> UST Owner/Operator Signature Date Signed <br /> 7 . INSPECTION HISTORY <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> Operator Inspection Report been completed appropriately? ❑ ❑ <br /> Attach documentation ve "9 appropriate service to this report. <br /> 8 . RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history report/log to this report. Yes No NA <br /> Is the monitoring system powered on and in proper operating mode ? © ❑ <br /> Has each alarm since the previous inspection been responded to appropriately? © ❑ ❑ <br /> (Attach documentation verifying appropriate service to this report.) <br /> Have all containment sumps , that have had an alarm since the previous <br /> designated UST operator inspection report, been responded to by a qualified ❑ ❑ (� <br /> service technician ? <br /> All answers marked "No " must be described by the designated UST operator in Section 3. <br /> Page 2 of 4 <br />