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eNw #Ap <br /> U 7C Kklf Afc-' , <br /> aaamm <br /> UNIFIED PROGRAM CONSOLIDATED FORM f s r Kr1t do <br /> t� <br /> UNDERGROUND STORAGE TANK jt <br /> OPERATING PERMIT APPLICATION-TANK INFORMATION(One fmm perusT) <br /> TYPE OF ACTION (Check one Item only. FW-an UST penaanrot c1mue m1WII0val,comPiete only this section and SediOnS I,1[,H(,IV,and IX below) 430 <br /> ❑ L NEW PERMIT j] 3.RENEWAL PERMIT 0 5.CHANGE OF INFORMATION <br /> ❑ 6.TEMPORARY UST CLOSURE ® 7.UST PERMANENT CLOSURE ON SITE D 8.UST REMOVAL 4/21 low <br /> DATE UST PERMANENTLY CLOSED: 43Oe FDATE EXISTING UST DISCOVERED: aim <br /> L FACILITY INFORMATION <br /> FACII,RY ID#(Agency Use Only) L <br /> BUSINESS NAME(Same as FACIIdTYNAME m DBA-Doing Baseness As) 3 <br /> EDATEUST <br /> esta LLC <br /> ADDRESS tm CITY too <br /> hwa 26 Linden <br /> IL TANK DESCRIPTION <br /> k#4 TA0438304 a3a TANK MANUFACTURER 433 TANKcoNFIauRATION: TTIIs TANK IS 434 <br /> Tresco Tank Joe. 0 1.ASTAND-ALONE TANK <br /> ® <br /> 2.ONE INA COMPARTMENM UNIT. <br /> rwe.e6 ial.e <br /> TEM INSTALLED 43s TANK CAPACITY INGALLONS 636 NUMBER OF COMPARTMENTS IN THE UNIT 433 <br /> 10,500 2 <br /> ITL TANK USE AND CONTENTS <br /> TANK USE 0 la"OL <br /> FuELING 0 Ib.MARINAFUII.ING ❑ Ic.AVIATIONFUELII4G 439 <br /> 0 3. CTSTORAGE 0 4.HAZARDOUS WASTEg modes uttd oiD 0 S.EMERGENCY GENERATOR FUEL IasC§zszsIXq <br /> ❑ 6. R FUEL 0 95.UNRNOWN 0 99.OTHER (specify); 439a <br /> CON77�1TS PEIR08. <br /> a REGULAR UNLEADED 0 Ie.MIDCRADE UNLEADED 016.PRa.eatn4 UNLEADED 440 <br /> DIESEL 0 5-JET FUEL 0 6.AVIATIONGAS <br /> PETROLEUMBLEND FUEL 0 9:OTHER PETROLEUM (spay): Information available a40. <br /> indicates tank is em <br /> USED On. ❑ 10.67HANOL <br /> 0 I1.OTHER NON-PETROLEUM 440b <br /> IV. TANK CONSTRUCTION <br /> TYPE OF TANK 0 1.SINGLE WALL ® 2.DOUBLE WALL 0 95.UNKNOWN 443 <br /> PRIMARY CONTAINMENT 0 1.STEEL, 0 3.FIBERGLASS 0 6.INTERNAL BLADDER 444 <br /> 0 7.STEEL+INTERNAL LINING 095.UNKNOWN 0 99.OTTER <br /> SECONDARY CONTAINMENT 0 I-STEE1 ----03 FIBERGLASS 0 6.EKTERIOR MEMBIiAFE LINER ❑ 1.JACKET® 44s <br /> ❑ 90.NONE ❑-= O <br /> 5.UNKNOWN <br /> ❑99.O'T'TER 4ase <br /> OVERFILL PRE VENTION 01.AUDIBLE&VISUALALARMS 02.BALLFLOAT ❑ 3.FILLIVBE SAUT-0FF VALVE 4u. <br /> 0 4.TANK MEM REQUWEMB 7TS I;DREME WHON FROM OVERFILL PREVENTION EQUIPMENT <br /> V. PRODUCT/WASTE PIPING CONSTRUCTION <br /> PIPINGCONSTRUCTION ❑i.SINGIJiWAI.IFD ❑2100DBLE.WALLID ❑99.OTHER 4w <br /> SYSTEM TYPE 0 1.PRESSURE 0 2 UMAVI Y 0 3.CONVENTIONAL SUCTION ® 4.SAFE SUCTION IM CCR§m6(.)(3E 458 <br /> PRIMARY CONTARIIvENT 0 I.STEEL 0 4.FIBERGLASS 0 S.FLIDUBLE 0 MRIGIDPLASTIC 464 <br /> ❑ 90-NOM 0 95.UNKNOWN 0 99.OTTII:R(Specify): 464. <br /> SECONDARY CONTAD94ENT 0 1.STEEL 0 4.FIBERGLASS ..�]�,n FYtnt F ❑ 10.RIGID PLASTIC 4646 <br /> [1 90.NONE 0 95.UNKNOWN 0 99.OTHER(Specfy): 46k <br /> PHIL NOML RHINE CONf�f1'SUMP TYPE LJ I,SINGLE WALL 0 2.DOUBLE WALL ❑ 90.NONE 4644 <br /> VL VENT,VAPORRECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION <br /> VENT PRIMARY CONTAINMENT 0 1.SIEQ, 0 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE ❑ 99.GIIIFR(Specify) W. <br /> VENT SECONDARY CONTAINMENT ❑.1.STEEL ❑ 4.FIBERGLASS 010.RIGID PLASTIC ❑ 90.NONE U 99dNe1 <br /> .OTHER(Specify) a64E <br /> VR PRA4ARY CONTAINME?]T I.SSREI, 4.FffiIRGLA55 ❑ ]O.RIGID PLASTIC ❑ 90.NONE 0 99.OTHER 46an <br /> (Specfy) 4648 <br /> 464 1 <br /> VR SECONDARY CONTADAENI' ❑ I-STEEL ❑4.FIBhRGLASS ❑ 10.RIGID PI.ASiTC 90.NONE 99.OTTIER(Specify) 4Nh <br /> VENT PIPING TRANSITION SUMP TYPE 0 1.SINGLE WALL <br /> 0 <br /> 2.DOUBI,E WALL ❑ 90.NONE 4641 <br /> RL4ER PRIMARY CONTAHO&ENT 0 1.SHIT, 0 4.FIBERGLASS 0 ]0.RIGID PLASTIC 0 90.NONE 0 99.OTHER(Specify) 464j <br /> RISER SECONDARY CONTAINMENT ❑ 1.577?E[. 0 4,FIBERGLASS 0 10,RIGID PLASUC 0 9a NONE 0 99.OTHER(Specify) 464k <br /> FILL COMPONIITTS INSTALLED4Nkt <br /> ❑ 1.SPILT,BUCKET 3.STRIKER PLA'IF1B07T'OM PROTECTOR ❑ 4.CONTAIIIMF2§T SUMP asta< <br /> VII.UNDER DISPENSER CONTAINMENT(UDC) <br /> CONSTRUCTION TYPE 01.SINGLE WALL 02.DOUBLE WALL ❑ 3.NODISPENSERS 090.NONE 469. <br /> CONSTRUCTION MATFRTGT ® I.STAII. ❑ 4.FIBERGLASS El10.RIGID PLASTIC ❑ 99.OTHERS 469bc <br /> VIII. CORROSION PROTECTION <br /> STEEL COMPONENT PROTECTION 0 2.SACRIFICIAL ANODEIS) 0 4.IMPRESSED CURRENT 0 6.ISOLATION 448. <br /> IX. APPLICANT SIGNATURE' <br /> CERT MCATTON: I certify that this UST system is compatible with the hazardous substance stored and that the h3formation provided herein Ls true,acc-t,, <br /> and is fail cum ce with 1 al uirement& <br /> APPLfC "SIGNATURE ' ` DATE 4/22/2009 4>0. <br /> APPL.ICANTN eynOlds POdesta 491. APPLICANT TITLE Manager a3z <br /> LLC b CTai Las <br /> UPCIF TLCT-n-1 n <br />