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0 -0 'o Cl) <br /> Iv zT = CI) 0 <br /> o 0 O zt <br /> N Underground Storage Tank <br /> C) poG <br /> o Designated UST Operator Visual Inspection Report m N D <br /> M _ <br /> > <br /> r pWNERIOPERATOR DESCRIPTION OF FOLLOW-UP ACTION v o <br /> nate compliance issues from Section 3- m U) <br /> umber the follow up actions to correspond to approp a m <br /> 0 <br /> _0 �. <br /> m (D <br /> o r <br /> C7 <br /> CD <br /> o rn <br /> cn <br /> 1 <br /> o <br /> N +� <br /> C v <br /> i <br /> C r <br /> CQ N <br /> l Z) <br /> CD <br /> 07 <br /> I � Q <br /> 0 v <br /> � n <br /> CD <br /> s. OWNER 1 OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS o D <br /> I have reviewed the results of the designated UST operator inspection report and provided a -CD <br /> 0 o <br /> description of the action(s)taken or to be taken to correct any compliance issues discovered. w <br /> CD <br /> o <br /> Name of UST Owner/Operator(print) 0 <br /> vikas Patel C\ <br /> UST Owner/Operator Sig ture Date Signed <br /> 5/24/2021 ' N <br /> 0 <br /> N <br /> 7. INSPECTION HIS ORY <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 veil in ra a nate service to this re ort, <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? 0 <br /> Has each atarm since the previous inspection been responded to appropriately? x <br /> (Attach documentation venfying appropriate service to this report,) <br /> Have aif containment sumps, that have had an alarm since the previous <br /> designated UST operator inspection report, been responded to by a qualified ❑ x <br /> service technician? <br /> All answers marked°No"must be described by the designated UST operator in Sectio <br /> n3. � <br /> 0 <br /> 0 <br /> Page 2 of r <br /> � o <br /> v <br /> c <br /> coCD <br /> 0 � <br /> o - - __ cn <br /> N_ <br /> Cn <br /> W <br /> v <br />