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ra6 <br /> � eF <br /> S <br /> Underground Storage Tank C� � 50 <br /> Designated UST Operator Visual Inspection Report <br /> a J% <br /> � �5 <br /> yob to <br /> �d 5� <br /> 5. OWNER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION `pe_�repa�,% da <br /> Number the follow up actions to correspond to appropriate compliance issues from Section 3. �e a Qv n <br /> n� eC, nta�n <br /> �c <br /> yQ �° ec. <br /> wog <br /> a\1 sc <br /> oe eat <br /> e <br /> S� <br /> E <br /> WNER/OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS �- <br /> e reviewed the results of the designated UST operator inspection report and provided aription of the action(s) taken or to be taken to correct any compliance issues discovered. <br /> Name of UST Owner i Operator (print) <br /> UST Owner/Operator Signature Date Signed <br /> 7. INSPECTION HISTORY <br /> FHa each follow-up action of Section 3 from the previous Designated UST Yes No NA <br /> rator Inspection Report been completed appropriately? <br /> ch documentation verifyingappropriate service to this report.) <br /> S. 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 /> each alarm since the previous inspection been responded to appropriately? <br /> [Has <br /> Attach documentation verifying appropriate service to this report.) ❑ ❑ave all containment sumps, that have had an alarm sincethe previouesignated UST operator inspection report, been responded to by a qualifiedervice technician? <br /> All answers marked "No"must be described by the designated UST operator in Section 3. <br /> Page 2 of 4 <br />