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Livermore -Pleasanton Fire Department <br />3560 Nevada St., Pleasanton, 94566 <br />(925) 454-2362 Fax; (925) 454-2367 <br />ABOVEGROUND TANK CLOSUREHREMOVAL PLAN <br />General Information <br />1. Name of Business: <br />Site Address: <br />Tank Owner/Operator Contact Person: <br />EPA ID #: <br />2. Property Owner: <br />Owner Address: <br />3. Tank Removal Contractor: <br />Address: <br />Phone: <br />4. Required attachments: <br />❑ Plot Plan <br />TANK INFORMATION <br />5. Tanks to be closed: <br />Phone: <br />License Type: ID #: <br />Tank <br />No. <br />Tank Size <br />(gallons) <br />Tank Contents <br />(including both current and <br />former, if different) <br />Materials of <br />construction <br />Age of Tank <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />6. Total number of aboveground tanks at this facility (prior to this closure): <br />7. Length of underground piping being closed under this plan: <br />8. Have tanks or pipes leaked in the past, and/or has there been spillage during filling or dispensing <br />activities? <br />❑ Yes. Describe: <br />❑ No <br />❑ Unknown <br />Page 1 of 3 CM.3.5 AST Closure Plan <br />Rev. Date: 9/30/2016 <br />