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8660 N Lower Sacramento Rd, Stockton, Ca 95210 <br /> 06/04/2021 Program: UST <br /> PHOTO 2: <br /> Pa e 2 of the ins ection re ort that does not contain any follow-up action by the owner/operator in section 5. <br /> Underground Stordg6 ort <br /> Designated UST Operator Visual Inspection Rep <br /> G OWNER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION <br /> Number the follow up actions to correspond to appropriate compliance issue�from ection 3. <br /> ® G. OWNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> 1 have reviewed the results of the designated UST operator inspection report and provided a <br /> description of the action(s)taken or to be taken to correct any compliance issues discovered. <br /> Name of UST Owner/Operato (print) <br /> UST Owner/Op ator Si n to Date Sig d <br /> 7. INSPECTIO ISTORY <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> Operator Inspection Report been completed appropriately? <br /> Attach documentation verifying appropriate service to this report.) <br /> 8. RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history reporUlog to this report. Yes No NA <br /> _rni Is the monitoring system powered on and in proper operating mode? <br /> Has each alarm since the previous inspection been responded to appropriately? <br /> (Attach documentation verifying appropriate service to this report.) <br /> Have all containment sumps,that have had an alarm since the previous <br /> designated UST operator inspection report,been responded to by a qualified <br /> service technician? <br /> I <br /> All answers marked"No"must be described by the designated UST operator in Section 3. <br /> Page 2 of 4 <br /> VICKY VANG-LEE, EHS Page 2 of 2 <br />