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FROM : J.Schetter PHONE NO. : 5306667692 Mar. 21 2005 04:53PM P3 UNIFIED PROGRAM CONSOLIDATED FOR nTANKS TANKS-TANK PAGE 1 UNDERGROUND STORAGE per tank) TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PhRMI l ® 5 CHANGE Or f-TFORMATION [3 7 P)MPORA NTLY CCLOSSD RL SITE (Check one item only) 4,40 ❑ 3 RCNBWALPER7vfIT (Sy�ityreason.,forIooaluseoety) (Specifyroason-For>ncafuae°°+1y1 ❑ $TANK REMOVED FACiLITV ill: --= ,= BUSINESS NAME(Saint as FACIixlY NAMP ar DBA Doi�S Susinaaa A-) 3 ,ARCO FACILITY#4932 431 LOCATION W1TtIIN STI'E(oviionsl) I_TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and tundrnarks shall be submittcd to the focal agency,) TANK ID# 5 a}z T K MANUFACTURER 43.7 COMPARTMFNTAL.IZED TANK Yes NO 434 UNL#a IA- b$q g XERXES if-Y-7,complete one page for cacl rgmpatlMcm. 43 436 NUMBER OF COMPARTMENTS 437 PATE INSTALLED(YEAR/MO) T ANI:CAPACI Y 1N GALLONS 20,000 I 498 ADDITIONAL DESCRIPTION(Far loud„se only) II.TANK CONTENTS TANK USE 43° PETROLEUM TYPE 440 )�1. MOTOR V>WCLE FUEL M Is. RHGULAR UNI.F.ADED 0 2. LEADED ❑5 JET FUEL (Ifmarkw gwgdc Petroleum Type) ❑lb. PREMIUM UNLEADED ❑4. DIESEL ❑6. AVIATION FUI-1, [12. NUN-FUEL PETROI.EIJM ❑ Ic. MIDGt2ADE UNI,FADED [3 4, CiASOHOL ❑99,OTHER 441 CAS#(from Haxardmin Materials ldveMory page) 442 ❑3. CTi1:MTCAL PRODUCT COMMON NAME(from Hazmdous Malerials lmrrstory PW) ❑4. HAZARDOUS WASTE GASOLINE 8006-61-9 pecluden Used 0i0 ❑95.UNKNOWN III_ TANK CONSTRUCTION TYPE OF TANK 1. SINGLE WALL. 3. SINGLE WALL WITH I�j 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chock ono juin only) EXTERIOR MEMBRANE LINER ❑95, UNKNOWN 212. DOUBLE WALL Q 4, %IGNLE WALL IN VAULT ❑O. OTHER TANK MATERIAL-primary cask ❑1. BAIZE STEEL 03. FIBFRGLASS/PLASTIC [15. CONCRETE ❑95. UNKNOWN 444 (Check one item only) ❑2. STAINLESS STEEL Q 4, STFF..L CLAD W/FMERGLASS ❑8 FRP COMPTIBLE W/I00%METHANOL. 1199.OTHER REINFORCED PLASTIC(FRP) TANTO MATERIAL eoondery tank 0 1. BARE STFVT. ®3. F1BEP.OLASS/PLASTIC ❑5. CONCRETE ❑95. UNKNOWN 445 (Check one item only) [12. STAINLESS STEEL [14. STEEL CLAD W/rTBFR(II.AS.S ❑S. FRP CON97MLE W/I00%METHANOL ❑99.OTHER REINFORCED PLAS'T'IC(TRP) 1110.COATED STEEL ❑S. CONCRETE TANK INTERIOR LINING ❑I.RUBBER LINED ❑3.EPDXY LINING b S.GLASS LINING 0 95 UNKNOWN 446 DATE INSTALLED 447 OR COATING Q 2 ALKYT)I,ENING ❑4 PIIFNCILIC LINING M 6 UNLINED ❑99 OTHER (Check one item only) (t°or local use only) OTHER CORROSION ❑1 MANUFACTURED CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑95 1.)NKNO WN 449 448 PROTF.CMON IF APPLICARLF. PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER 0&&one item only) ❑2 SACRIFICIAI.ANODE (Por local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(Ioeol use on(y) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apyly) ®I SPILL CONTAINMENT 2005 OPW ®1 ALARM C)3 TILL TUBE SHu't'OFF VALVE ®2 DROP TUBE 2Q05 QPW ®z BALL FLOAT ❑4 EXEMPT ❑3 STRIKER PLATE IV.TANK LEAK DETECTION(A description of the monit.d.,wvtpan shall be wbmitted to the 1c 1 ayeocy.) IF SINGLE WALL TANK K:neck ou thatepp)y) 153 IF DOUBLE WALL TANK OK TANK WITII BLADDER 454 (Check one item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑1 VISUAL(SINGLE WALL 1N VAULT ONLY) ❑2 AUTOMATIC TANK GAl I(;ING(ATG) ❑6 VADOSF ZONE 2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑.9 TANK TP.STTNC: (SIR) BIENNIAL.TANK TESTING 0 99 OAR IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE;IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) S55 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 4G6 TANK FILLED WITH INERT MATERIAL? 457 gallons ❑Ycs © No w