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4219 E. Morada Ln, Stockton, Ca 95212 PR0524617 <br /> 07/07/2021 Program: UST <br /> PHOTO 2: <br /> 1/4/21 monthl desi nated o erator re ort missin follow-up action by owner/operator <br /> Fr Underground Storage Tank <br /> esignated UST Operator Visual Inspection Report ttf <br /> ER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION <br /> r the follow up actions to correspond to appropriate compliance issues from Section 3. <br /> 6. OWNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br /> 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) ✓AA._. <br /> UST Owner/Operator Signature Date Signed <br /> II cl <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 verifying a ro riate 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 /> I <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 <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 /> VICKY VANG-LEE, EHS Page 2 of 2 <br />