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Jun . 9. 2004 2:09PM WLght Environmental 832-5152 No•2486 P . 4. <br /> 0h/nr/21917,4 r16:oa 209 FLOOR .E 05 <br /> FLZATVN1FTED PROCAIW CONSOLTYtATED FORINT <br /> TANKS <br /> �1 1v`� <br /> TINDERGROUND STORAGE TANKS- TANK PAGE 1 V���`R ISI <br /> (Fwo Pape&pal'unlc) <br /> . . <br /> Page <br /> �_Of <br /> Q <br /> ❑ 1,NEW PERMIT ❑ 4.AMENDED PERMIT 1.7 5,CHANGE OF INFORMATION ❑ s.TEMPORARY TANK CLOSURE no. <br /> y) ❑ 3.RrNSWALPERMI7 _. -.. �...,, ... ❑ TPERMANENTLYCLOSEDONSTPR <br /> (Spteiryreomlo Ispe>yrea9ea) )e9.TANK REMOVED <br /> ME(SomaeE IUTYN fG. nun, °ins IonsN] 3.fU. _^I INSl E(0mwrcq . .,.... <br /> q31. <br /> :Lo <br /> ' rM,ry I�1111 i�' " L'1' 11'TZSGRI;P�ZtS]V; MI� r. ; <br /> ao-n"n:: .(ASealep;ploEplxdu7th the loblR[oR'.ofnB4US7s�s(dnmclVdmYblild3fng5,zndlandzryglkq�xdslYTibSubrtnaW' 'tq�(ydllo7Fe'lagmd Ip a .. <br /> tt'7�c TANK MANIIFAC:TURER COMPARTMENTALIZED TANK ❑Yaa No 4c4 <br /> #'�' 515 7 31 ( �J OYMt) tl'Tn,"mmpbeowRgGfa °nck ngM�a. <br /> DATE INSTALLED 435• 1 ANK CAPACITY IN GALLONS ^� NLIMBER OFCOMPARTMENTS <br /> (YEAR/MO) <br /> nJ� d�a <br /> ADDITIONAL DESCRll'TION(Forkaal.wy Als <br /> I aTAi <br /> � C6IIFiTENTS' <br /> TANK USE 449. PETROLEUM TYFL" ',: <br /> L MOer0R VEHICLE FUF,L 1]In. REGULAR UNLEADED n 2. LEADED []p. JET FUEL <br /> �I'eucekM mmpine val9kum Type) <br /> 01b. PRl T4NM UNLEADED )irl D[ESEL Q6, AVIATION GAS <br /> ❑ 2. NON-FUkILPETROLRUM ❑)F MIDGRADE UNLEADED ❑e. GASOHOL ❑N-OTHER! <br /> ❑ 3.CHEMICAL PRODUCT COMMONNAME(c rl GLfenrdn,s mmmah lnveemrypoge) 441' CAS1F(5 111=4wa mom;de lmcmmypo) W --744n- <br /> [) 4. HAZARDOUS WASTE <br /> Rnelu9m(Jsd 0il) <br /> ❑ 95.UNKNOWN <br /> 111.; ANKCONS 1727{CT3ON <br /> IR 05 SINGLEWA. <br /> TYPE OF TANK I7 I. SINGLE WALL (]J. iWOLB WALL WITH BXMUOLL WTTH NTEeNAL BLADDER SYSTEM 440 <br /> (Check a ane iam an%) MEMBRANR LINER }t)'95 UNKNOWN <br /> ❑2 DOUBT 1 WALL ❑a. SINGLEWALL WAVAULT 0 99 OTU'R <br /> TANKMATERIAL-P,k-Drank I.BAREST EL 133.PIBER(3LISS/PLR-7rT, ❑5. CONcluliE ❑SS.U OWN 444, <br /> 02. STAINLESS STEEL El 4, STEEL CLAD W/FIBERGLASS C3 B. PRP COMPATIBLE []9%OTHER: <br /> RISNFORCED PLASTIC RP) W/I00%METHANOjy <br /> TANK MATERIAL-sewcdary bNc I, BARE,STEEL 3. 618EROLASS/PLASTIC iff'! PRP COMPTLBLE Wf100%MGTHANOL 95.UNKNOWN q49� <br /> (Check one lm mly) ❑2, STAINLESS STEEL❑4, STEEL CLAD W/FIBERGLASS ❑9, VU NON-CORRODABLE)ACKRT ❑W.OTHER <br /> REINFORCED PLASTIC(FRP) 13 i, cOATED.=EL <br /> jp s. CONCRETE <br /> TANKINTERIOR IJNfNU 1.RUBBERLINID [J 9.EPDXY ENING ❑5,0LA&SJ.IN.ING 95.L1NKNAWN 4, DATE INSTALLED w7. <br /> OR COATNG LJ 2-ALKYO LINING ❑A.PHENOLIC LINING 13 6.UNLINED 099,OTHIM <br /> (Check ofro foul <br /> OTHRR RROSOWN 1.MANUPACTURBD CATITODIC ❑3.FIBERGLASS REINFON('.SO PLASTIC �.UNKNOWN oq6� DATE INSTALLED 449. <br /> PROTECTION PROTECTION ❑4.IMPRESSED CURRENT- 99.OTHER <br /> fA Reahk 2,sAcRipiciAL ANODE _ <br /> SP ILL AND OVERFILL YEAR Wb7ALLED 410, TYPE q. 451. OVERFILL PROTECTIONE EQUIPMENT; YHARINSTALLED 492. <br /> (Check all dul apply) ❑1. CONfAINMEM• 11 I.ALARM ^„ !�FAJ.TLR1E 5 TOFF VALVE <br /> 02.DROP _ ❑2 ❑4 <br /> TUBE ,..- LL FLOAT <br /> _ a) <br /> 3 STAfKGR PLATE EXEMPT J!/ <br /> ' � �� ,- ,(f#Aave+fpnon.o€Rle mohltbrinR pram&}all he.c�mrtL'cd(tPthe lacaLuPjcncy) :: -' > . <br /> 1F SINO[,F WALL TANK 43L IF DOU LR WALL TANK OR TANK WITH BLADDER 46° <br /> (Check on that apply) (Cheek aro liemonly) <br /> ❑).VISUAL(Rla"5D PORTION ONLY? ❑9.MANUAL TANK CLAUGEN43(MTO) ❑1.VISUAL(SINGLE WALL IN VAULT ONLY) <br /> ❑2. AUTOMATIC TANK GAUCINO(ATG) 06.VADOSE Z" ED CONTNLgUSNTaRSTITIALMONITORING <br /> ❑3.CONTINUOUS ATG ❑7.GROUNDWATER ❑3.MANUAL MONITORING <br /> ❑4.STATISTICAL INVI1NTORY RECONCILIATION ❑x,TANK TESTING <br /> (SHR)+BI ENN[ALTANKTESTNG El 99. OTHER <br /> ` AQA`IOS1FE Iv ORMA �oI„PERM- .A. VLrrCg-LO/S°TEINY-LACE <br /> ESTIMATEDDATELASTUSED(yM " ESTIMATED SUBfANCERSMA�ING �TWRFILLED WITH <br /> PTH INERT MATERIAL? <br /> Eb4p-r ^ (A)Qf6r ' AYE. <br /> ❑ No <br /> UPCF hwfwrc-6(1/49)-1/4 <br /> http://www.uitidmLorg Rev.07A6100 <br />