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L nd Storagel A=f)CC O� nvr <br /> Undergrou or ViSUai 9. UST SY <br /> Designated UST Operat pGTION a issues from Section 3. List below <br /> tJp since the <br /> 9 N OF FOLLpW-{e comPlia <br /> RlpT10 roPria to by a qL <br /> 5. OWNER/OPERATOR DESC inspectio <br /> Number the follow up actions to coRespond to aPP <br /> �is the c:,r <br /> Containr <br /> I <br /> Are all s <br /> the earli <br /> Is the s, <br /> free of <br /> Spill C <br /> 6. OWNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS provide <br /> a <br /> [Name <br /> have reviewed the results of the designated UST operator insp <br /> e .tion report and p <br /> escription of the action(s) taken or to be taken to correct any colnpliance Issues discovered. <br /> of UST Owner/Operator(print) <br /> r- <br /> UST Owner/Operator Signature Date Signed Ld�e <br /> Uoc <br /> 7 <br /> Y <br /> . INSPECTION HISTORY <br /> Has each follow-up action of Section 3 from the previous Designated UST 2S NO NA <br /> Operator Inspection Report been completed appropriately? <br /> Attach documentation vefifyinqappropfiate service to this report.) u u n <br /> 8. RELEASE DETECTION ALARM HISTORY i <br /> Attach a copy of the alarm his report/log to this report <br /> ►° - No NA <br /> 1 <br /> wITo <br /> `a 1 II] CK I z a Ck li] n� K <br /> LoCC) ❑ <br /> t <br /> r <L F <br /> -ItL4wCL'7 �T 4 J > 11 ' 0.C1 <br /> rnl <br /> CK U O N E-� I E-• CK 0: )K <br /> 0W O O (J] fj 1j FjZ '� tiSf1r1 <br /> z l i 01 z n. Ck O <br /> r� zzcr �H u 2 rWW 3`� �ni 41 <br /> �, j <br /> (n --I [ `� <br /> ~ nin �i <br /> a.. <br /> L w�Ho w a �� � o * ~'� <br /> W4 <br /> T W <br /> ' T <br />