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Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 5 . OWNER/OPERATOR DESCRIPTION OF FOLLOWuUP ACTION <br /> Number the follow up actions to correspond to appropriate compliance issues from Section 3 . <br /> in 1l bvcKz+ AW itl) SCt�. du.� gd �or <br /> . .� `J <br /> ComOtte . <br /> 8 . OWNER I OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> I 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 ! Operator {print) <br /> UST OwnerlOperat ignat r Date (Signed <br /> "1 d <br /> 7 . INSPECTION HISTORY <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 verif ng apptopriate service to this report. ) <br /> 8 . RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history report/log to this report. Yes No NA <br /> 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 ❑ El 0 <br /> designated UST operator inspection report, been responded to by a qualified <br /> service technician ? <br /> 9 . UST SYSTEM INSPECTION <br /> All answers marked 'Wo " must be described by the designated UST operator in Section 3. <br /> Page 2 of 4 <br />