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Underground Storage Tank <br /> Designated UST operator Visual Inspection Report <br /> . OWNER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION <br /> Number the folJow Lip actions to correspond to appropriate compliance issues from Section 3. <br /> . OWNER 1 OPERATOR ACKNOWLEDGEMENT F 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 e oi: UST Owner I Operator (print) <br /> UST Owner/Operator Signature - -- Date Signed <br /> 7. INSPECTION HISIVRY <br /> Has each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> Operator Inspection Report been completed appropriately? 0 Ll E <br /> /Attach documentation verityjpg. apqrop1 a e service to this r ort. <br /> . RELEASE DETECTION ALARM HISTORY <br /> Attach a copy of the alarm history reportflog 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? � �1 ❑ <br /> (Attach documentation erifyi-ng appropriate er i 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 /> All answers marked 'No': must be described by the designated UST operator in Section 3, <br /> Page 2 of 4 <br />