Laserfiche WebLink
UNIFIED PROGRAM CONSOLIDATEWRM <br /> UNDERGROUND STORAGE TANKS •TANK PAGE 1 TANK: <br /> (Rv0 a rlank <br /> Pegs & Z <br /> TYPE OF ACTION ❑1. NEW SITE PERMIT ❑ 1. AMENDED PERMIT 135. CHANGE OF INFORMATION) ❑ 9. TEMPORARY SITE CLOSURE <br /> (Chock ane Rem onlY1 <br /> ❑7. RENEWAL PERMIT <br /> �❑ 77.. PERMANENTLY CLOSED ON SITE <br /> (SPsab'ly season- b�"Te an H) (SPe3/y rJlenga•fororal use Pn/y) LL1 e. TANK REMOVED Q <br /> BUSINESS NAME(Ssms as FACILITY NAME v OSA- �] <br /> Daq BuRnw A•1 7 FACILITY 10 s <br /> LOCATION WffHl sfTE(Lp"al) <br /> I ZC) MAW <br /> L.TANK.DESCRIPTION <br /> : <br /> TANK 10 a 472 TANK MANUFACTURER 13 <br /> COMPARTMENTALIZED TANK ❑ Ym NIC � <br /> H Nm',mlrplele me paps for each mffTww NIIL <br /> DATE INSTALLED(YEVL/p) 175 TANK CAPACITY IN GALLONS /7e NUMBER OF CCMPARTMEM$ <br /> 3 <br /> U l�au�J a] <br /> AOOITIONAL DE$CSBPTION(FW b al ufe 0*) <br /> 4TB <br /> IL:TANK CONTENTS, <br /> '.. <br /> TANK USE 179 PETROLEUM TYPE <br /> ❑ 1. MOTOR VEHICLE FUEL Cl 1- REGULAR UNLEADED "a <br /> ❑ 2 LEADED ❑ 5. JET FUEL <br /> (l7msrkeo,mmpwo PeePNtml Type) ❑is. PREMIUN UNLEADED ❑ 7. DIESEL <br /> ❑ 2. 1FUEL PETROLEUM 131. MpGRADE UNLEADED ❑ 1. ���L �❑�S. AVIATION FUEL <br /> ❑ ]. CHEMICAL PROWCT 11799. OTHER <br /> ❑ 0. HAZARDOUS WASTE(Intlueea COMMON NAME(!mm HeTrmus A4rMiela 1/IwnkaYPags) 411 CAB s(SOm Hmldb-w MawwH'k-IAWY Pave) 412 <br /> UsaOOIJ / <br /> �%. UNKNOWN <br /> M.TANK:CONSTRUCTION <br /> `. <br /> TYPE OF TANK 1. SINGLE WALL <br /> ❑ 3. SINGLE WALL WITH ❑ S. SINGLE WALL WITH INTERNAL BLADDER SYSTEM W <br /> (CJreck ons rtsm only) 02. DOUBLE WALL EXTERIOR MEMBRANE LINER Cl 95. UNKNOWN <br /> ❑ /. SINGLE WALL IN A VAULT <br /> Cl%. OTHER <br /> TANK MATERIAL-primary Mnk 1. BARE STEEL ❑ 7. FIBERGLASS/PLASTIC Cl 5. CONCRETE <br /> ❑95. UNKNOWN 44a <br /> (Check ane atm only) ❑ 2. STAINLESS STEEL ❑ 1. STEEL CLAD <br /> ❑ B. FRP COMPATIBLE W1100%METHANOL ❑99. OTHER <br /> W/FIBERGLASS <br /> TANK MATERIAL REINFORCED PLASTIC FRP <br /> -s MWWY Wk❑ 1. BARE STEEL Cl 7. FIBERGLASS/PLASTIC ❑ S. FRP COMPATIBLE W1100%METHANOL �E-1,9`5.. UNKNOWN <br /> (Check onu5 <br /> e dem wly) ❑ 2. STAINLESS STEEL El /. STEEL CLAD W/FIBERGLASS ❑ 9. FRP NON-CORRODIBLE JACKET L7'99. OTHER K, ft <br /> REINFORCED PLASTIC(FRP) ❑10. COATED STEEL <br /> ❑ S. CONCRETE <br /> TANK IHTERpR LINING ❑ 1. RUBBER LINED ❑ 1 EPDXY LINING ❑ 5. GLASS LINING ❑%. UNKNOWN 118 GATE INSTALLED u] <br /> OR COATING <br /> Cl 2. ALKYD LINING ❑ 1. PHENOLIC LINING ❑ S. UNLINED CY99. OTHER All* L'LA <br /> (CherJr one dem ordv) <br /> OTHR CORROSION /Flr heal N) <br /> PROTEECTION IF APPLICABLE Cl I. MANUFACTURED CATHODIC ❑ 7. FIBERGLASS REINFORCED PLASTIC 1195. UNKNOWN IAS DATE INSTALLED N9 <br /> PROTECTION Cl t. IMPRESSED CURRENT ,..,/ <br /> (Cheek one dem . OTHER �✓��' <br /> nKrl Cl❑ 2. SACRIFICIAL ANODE <br /> SPILL AND OVERFILL (Far bawl uses W <br /> YEAR INSTALLED 150 TYPE(Forbral we o*) 151 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 152 <br /> (Chet as uw appy) ❑ 1. SPILL CONTAINMENT ❑ t. ALARM ❑ ]. FILL TUBE SMUT OFF VALVE_ <br /> ❑ 2. DROP TUBE ❑ 2. SALL FLOAT ❑ 4. EXEMPT <br /> ❑ ]. STRIIER PLATE <br /> N. TANK L:AK DETECTION - <br /> IF 91NOlL WALL TANK(CllsckY PW apply): 157 IFDOUBLE WALL TANK OR TANK WITH BLADDER(CAeck me Ilam o eyp I54 <br /> Cl I. VISUAL(EXPOSED PORTION ONLY) ❑ S. MANUAL TANK GAUGING INTO) ❑ I. VISUAL(SINGLE WALL IN VAULT ONLY) <br /> Cl 2. AUTOMATIC TANK GAUGING(ATG) ❑ e. VAOOSE ZONE ❑ Z. CONTINUOUS INTERSTITIAL MONITORING <br /> ❑ ]. CONTINUOUS ATG ❑ 7. GROUNDWATER Cl 7. MANUAL MONITORING <br /> Cl 6. STATISTICAL INVENTORY RECONCILIATION(SIR)• Cl B. TANK TESTING _dA _ ? <br /> BIENNIAL TANK TESTING Cl W. OTHER T/I 5 IS 3 S7 <br /> V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DATE UST USED(YR/MO/DAY) 155 ESTIMATED QUANTITY OF SUBSTANCE REMAININGISe TANK FILLED WITH INERT MATERIAL? 157 <br /> gall" Ym ❑No <br /> UPCF(1/99) • • Formerly SWRC8 Form 8 <br />