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Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 9., UST SYSTEM INSPECTION <br /> List below and in Section 3 all containment sumps that have had a release detection alarm <br /> since the previous Designated UST Operator Inspection Report and have not been responded <br /> to by a qualified service technician. Containment sumps listed below require a visual <br /> inspection for damage, water, debris, hazardous substance, and proper sensor location. <br /> Is the containment sump free of damage, water, debris, and hazardous substances? <br /> Containment Sump 1D Yes No Containment Sump ID Yes No <br /> ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ <br /> Are all sensors in visually inspected containment sumps located to detect a release at ❑ ❑ <br /> the earliest opportunity? <br /> Is the spill containment free of damage, water, debris, and hazardous substances? Is the fill pipe <br /> free of obstructions? Is fill cap securely on the fill pipe? <br /> Spill Containment ID Yes I No Spill Containment ID Yes No <br /> T1 :Regular ® ❑ T3:Diesel m ❑ <br /> T2:Premium 91 ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ <br /> Is the UDG free of damage, water, debris, and hazardous substances and all sensors located to <br /> detect a release at the earliest opportunity? El No UDC(s)at this facility <br /> UDC ID Yes No UDC iID Yes No <br /> Dispenser 01/02 ❑ ❑ ❑ ❑ <br /> Dispenser 03/04 ❑ ❑ ❑ ❑ <br /> Dispenser 05/06 m ❑ ❑ ❑ <br /> Dispenser 07/08 ❑ ❑ ❑ ❑ <br /> Dispenser 09/10 ❑ ® ❑ ❑ <br /> Dispenser 11112 m ❑ ❑ ❑ <br /> ❑ ❑ _ ❑ ❑ <br /> m Mechanical float mechanisms used in UDCs. <br /> All answers marked "No"must be described by the designated UST operator in Section 3. <br /> Page 3 of 4 <br />