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Underground Storage Tank <br />Designated UST Operator Visual Inspection Report <br />TESTING AND MAINTENANCE Yes No NA Date last performed <br />Has monitoring system certification been completed within the past <br />12 months? <br />171 r 11/19/20 <br />Has spill container testing been completed within the past <br />12 months? <br />171 IN 11/19/20 <br />Has overfill prevention equipment inspection been completed within <br />the past 36 months? <br />171 r-i r <br />11/08/18 <br />Has secondary containment testing been completed within the past <br />36 months? <br />1171 ili 1--1 11/08/18 <br />Has tank tightness testing been completed within required <br />timeframes? <br />1-1 1-1 171 <br />Has line tightness testing been completed within the required <br />timeframes? <br />1-1 Ir Fri <br />Other Test / Maintenance: 1-1 Irl 171 <br />Other Test / Maintenance: ri 1E1 171 <br />Other Test / Maintenance: in r 1171 <br />FACILITY EMPLOYEE TRAINING Yes No <br />Have all individuals performing facility employee duties received the required facility <br />employee training within the past 12 months? <br />Iri <br /> <br /> IEl <br />13. COMMENTS <br />This section may be used to record comments or observations that are not current compliance <br />deficiencies. <br />All answers marked "No" must be described by the designated UST operator in Section 3. <br />Page 4 of 4