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o 0,Cp, <br /> llesighate UndergroundOperator Visual <br /> Tank eCtion Rep°� <br /> d VST Visual In p <br /> t3• �t5 ,.. <br /> Date las <br /> Has ING ANE) MAINTENANCE No NA perforrnel fie: <br /> Hr 16i <br /> 2 rn hth,,? system certification b Yes ❑ 3/14/23 V oo'�Lrti"a��'ssess <br /> Has spill been completed within the past �coo <br /> n <br /> PE Ha of the?nta�ner testing been completed within the past Q ❑ 3/14/23 Sdro �11y f <br /> �� ertill n° <br /> Prevention e ° <br /> the Past 36 quipment inspection been completed within a ❑ ❑ 3/22/22 DeooPLiL� �;d• <br /> F <br /> Has se months? �a STP r <br /> '. 36 months dart cont ment testin <br /> Has ain g been completed within the past ❑ ❑ ❑ 6/21/22 dAt?5ens°tns <br /> tank tightness <br /> "1—131BL;n oved S Sot <br /> ti►nefr testin / <br /> acnes? I been completed within required ❑ ❑ N/A <br /> Rem ed se en` <br /> Has line tightness to [ enddebt <br /> timefr sung been co g S�b <br /> aures? mpleted within the required ❑ ❑ 1 0 I N/A Qos�1e e on <br /> n Other Test/ <br /> Maintenance: ❑ ❑ 0 N/A <br /> Other Test/Maintenance: <br /> ❑ ❑ 0 N/A 15 job <br /> Other Test/Maintenance: eS�inS� <br /> 11330 N/A T <br /> - 1�• FACILITY EMP <br /> , Have 11 ; <br /> EMPLOYEE TRAINING Yes <br /> a. nclividuals taut faciii ,e, t No <br /> employee trainin g �h '1'ployee duties received the req!�ired fail ty <br /> 13. COMMENTS within the past 12 months? Q 4 <br /> This section may be used to record comments or observations that are not current cOmplian <br /> deficiencies. II pe <br /> ADDITIVE STP-HYDRO SUMP LOW LIQL on <br /> 1. L8 ADDITIVE STP-HYDRO SUMP LOW LIQUID ALARM on 8/24/23.See attached work order dated 8/25/ Ce <br /> UID ALARM on /28/23 and 8/30/23.See attached work order 23 Lg L' <br /> -DF z <br /> 2. Initial Secondary containment testing on 6/21/22.Retest completed on 10/26/22. dated 8/30/23 <br /> 3. Employee trained on 9/21/23. See attached employee training roster.Jr <br /> Pf <br /> (� ° S�,MP Sen j u r t�P� ►tiur (� <br /> I <br /> f <br /> All answers marked`No"rnust be describedb <br /> y the des/gnatea USTo <br /> /17 <br /> Section 3. <br /> Page 4 of 4 <br /> �� <br /> COS TCO-0038.09/21/2023 <br />