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Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 5. OWNERIOPERATOR DESCRIPTION OF FOLLOW-UP ACTION <br /> Number the fallow up actions to correspond to appropriate compliance issues from Section 3 . <br /> I <br /> Cci Orn fe, <br /> 6 OWNER / OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> 1 have reviewedE <br /> esults of the designated UST operator inspection report and provided a <br /> description of ttions) taken or to be taken to correct any compliance issues discovered .Name of UST O0 tor (print) <br /> (print) <br /> 2V rt PIN <br /> UST Owner/Op rator Signature Date Sijned <br /> 7 . INSPECTION HISTORY <br /> NEI <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes NCo <br /> NA <br /> Operator Inspection Report been completed appropriately? El <br /> El <br /> Attach documentation verifWng. app riate service to this report. <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm hisreport/►og to this report. Yes No NA <br /> tory <br /> x <br /> Is the monitoring system powered on and in proper operating mode? ❑ <br /> Has each alarm since the previous inspection been responded to appropriately? ❑ ❑ 0 <br /> (Attach documentation verifying appropriate service to this report.) <br /> Have all containment sumps , that have had an alarm since the previous ❑ ❑ 0 <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 />