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, ,•s , I',I -�` �►,, f F ,, � � Tank <br /> ,.& „d Storage <br /> COX <br /> ,3 s , - and rerator Visual Inspection <br /> Re <br /> ated UST P o,,.- <br /> .r ,,�, !,. �f Sign <br /> pESCRipT10N OF FOLLOW-UP ACTION Des�gri <br /> �PE/tAtOR and to appropriate compliance issue <br /> ` F• f R o rodow up actions to corresp s frog Se M\NSP <br /> VST arid <br /> in <br /> � � � �• • . � <br /> 9. %j tie the <br /> a evious C <br /> .r ince the alified sei <br /> 5 by a qU for dam <br /> to spection inmeni <br /> a <br /> s the coote�tStir <br /> Goma\gym <br /> 0 <br /> the e,0\eS*, F <br /> a spill cI <br /> Is <br /> the of obstr <br /> free <br /> 6 OWNER/OPERATOR ACKNOWLEDGE::::::::: <br /> WtEDGE <br /> �'►" I'have reviewed the results of the MENT <br /> description of the action desi OF 1 NSPECTION RESU� <br /> Name of UST (s)taken gnated UST operator it TS <br /> Owner/0 °C to be taken to correct Pection r <br /> Aerator(print) any com <br /> UST Owner/0 pliance is U d <br /> Prov. <br /> Aerator Signature es dis a <br /> c0vered <br /> 1 NSPECON HISTORY <br /> j Has each folio _ date Signed Is 1 <br /> w uP action of S dE <br /> Operator Inspection ecfio <br /> Attach 01 pe <br /> Report been n 3 from t \ <br /> urnentation v com i he previou <br /> 8. REL enf p eted s pe <br /> E4S rn a r st <br /> EpET ap ro ri pp opriate gnated U <br /> E p <br /> Is heck a co ofth ailON ALgRM HISTOR ervice to th s re ort S r Yes No 1 <br /> monitori arm hist Y NA j <br /> Has each star ng since, <br /> powere ory rePorf/io9 to <br /> tt, m si don this r <br /> Have all ocr mVf?since, 11,prE?V* insar d t n proper operatpc� <br /> designat contain tfytn9 a p °tt°n be Ing mod 2 Ye i 1 <br /> SeNic ed dST o Sumps t °'°ropriafe en res e' ❑s No NA <br /> e technician Aerator inspe�at have had asen', e t°this ded t° apPro r <br /> Allans� tion repo n Cl <br /> alarm S/0, reports p Lately? <br /> ersmarked No �' been respo �� the pre�loU <br /> ❑ ❑ r <br /> mc,st be d tO by a I <br /> deScrtbeabYth qualified EJ <br /> design e ❑ <br /> at d U ❑ � <br /> E , SrOperatorins <br /> \ ectron 3 <br />