BILLING 2008 - Laserfiche WebLink

Home Browse Search

TNMM PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANS: OPERATING PERMIT APPLICATION-TANK INFORMATION (Onefmmper UST) TYPE OF ACTION (Check rote aenr mph, Fora 11ST elostve or removal,cmnplete mth•this section and Secnom I,11,171,/I:andLYbelaul 430. '® 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION 6.TEMPORARY UST CLOSURE 7.UST PEF&LANENf CLOSURE ON SIM El S.UST REMOVAL DATE UST PERMLANENITLY CLOSED: 'Alp I DATE EMSTING UST DISCOVERED: ,3m I. FACILITY INFORMATION FACILITY ID#(dgemr Use Onlr) 02I I _ _ 1' BUSINESS NAME(Same as Faeilip A7a .As) s BUSINESS SITE ADDRESS Im 1 Cfil loe. H. TANKDESCRIPTION TANG ID / / 432. TAHG MLANIUFACTL> Jit TAN:CONAGtTRATION:THIS TANI:IS 43, ❑ 1 AST.ANU-.�LONETAlA cmd�auews•C«arh '/Gpt(i(.rJIJ e�i.0/ 7.0MIN.A COMPARTTUNTEDLTIIT fs u diethemii. DATE UST SYSTEMI INSTALLED 435_ TANGC.APA,=IN GALLONS 436. WJHEl6F COMPARTNENfS IN THE UNIT Jr. AI9,:OF Z®o s 1 Z 0-c.:,-c7 III. TANK USE AND CONTENTS TANGUSE R Ia.MOTORVIIRCLEFOEIDIG 13Ih MARINA FUELING ❑ is?kIATIONFOFiING 439 3.CCHlMCALPRODUCTSIORAGE 0 4.HAZARDOUSWASTE(klal*rU dM) 0 5.EMERGENCY GENERATOR FUEL[mc.F15nl.*)1 0 6.0111MOENERATORFLEL 0 95.UNKNOWN ❑99.OTBNR(Speeify): 43% CONTENTS PEIROLEU1,1 O Ia.REGULARI1NEADEU O Ic.MIDGRAIEUNIIRADID Wilp.PREWUMUNLEADED JJo 0 I DIESEL ❑ 5.7ETFLEL 0 6.AVIATION GAS O3 PETROLELWBIE40FLIEL 09.OTEERPETROLEUM(SpecLh): JJm. NON-PETROLEUM:0 7.USED OIL 0 10.ETHANOL ❑ II.OTHERNON-PEMOLEM( ): ' IV. TANK CONSTRUCTION TYPE OF TANG 0 1.SINGLE WALL Iff 2 DOUHI.EWALL 0 95.UNKNOWN Jt3. PRMIARY CONTAINMENT V I.STEEL 0 IFIBERGLASS 0 6.INTERNALBLADDER 0 7,STEEL+TNTMNAL LRWG 0 95.UNENNOWN 0 93.OTHER(Spmty): 444. SECONNDARYCONIAINMIENT ❑ I.STEEL jW3.FIBERGL.ASS 0 6.E\7ERTORM WBP_ANEI.IER 0 7.TACIXTED it( 0 90.NONE 0 95.LNIKIOWIN 0 99 OTHER( OVERFILL PREVENTION 0 I.AUDIBLE.@ VISUAL ALARMLS 0 2.BALL FLOAT i.FILL TUBE SHUT-OFF V.AL\T J" 4.TANKIIMSRPQtMgAqTSFOROMWUONFROZ, OV712 FmmNTONE T_TM T V. PRODUCT/WASTE PIPING CONSTRUCTION APING CONSTRUCTION 0 1.SINGLE WALL IL 2,DOUBLE WALL 0 99 OTHER _ _ Jm, SYSTEM 13 I.PRESSURE q.GRAXTrl ❑ 3.CONVENTIONAL SUCTION 0 4 SAFESUCITONN3CCRI3636(a%311 J58 PRTNLARY CONTAINMENT 0 1.S[EEL 4.FIBERGLASS 0 S.FLECIBLE ❑ 10.RIGID PLASTIC J61. 0 90 NON; _ 95.UN.NOWN_ ❑ 99.OTHER(SpcciQ-1: J� SECONDARY CONTA)NNENT 0 I.SIHEI. 0 4.FIBERGLASS 0 &FNEXIB E ❑ 10.RNGIDPLASTIC 4" 0 90 NONE 0 95 IN04OWN 0 99.OTHER(Sp.c-). `. PPTNGTURBINE CONTAINMENT SUMP TYPE 0I.SINGLE\WALL IR 1DOUBLEWALL 090.140NE 461d. VI. VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT 0 LSf1EL 104.FIBERGLASS 0 10.RIGID ELASTIC 0 90.NONE ❑ 93.OTHER(Speedy')' Jbkt. VENT SECONDARY CONITABibfNT 01-STEEL 4F1BEIZOLASS Oto RIGID PLASTIC 1390.NONE 099.0TIffiR(spe-4): ,tiltl. VR PRIMARY CONTAINMENT 0 1.sTEEL @ 4.FIBERGLASS 0 10.RIGID PLASTIC 0 90.NONE 0 99.OTHER(Splcify): , t VR SECONDARY CONTAINMENT 0 I.STEEL ®4.FIBERGLASS 0 IO RIGID PLASTIC 0 90.NOPE 0 99.OTHiR(Specifp): ufii. VENT PIPING TRANSITION SUMP TYPE 01.SINGLE WALL 192.DOUBLEWALL 090.NONE 11 JJWR PRIMARY CONTAINMENT R 4.FIBERGLASS 0 10.RIGID PLASTIC 0 90.NONE 0 99 OTHER(Speat): ,61 1. RISER SECONDARY CONTAINMENT 0 1.STEEL [IF 4 FIBERGLASS 0 10.RIGIDPLA.S7TC. 0 90 NONE 0 99.OTAER(Spmty): J L FILL COMPONENTS INSTALLED IMLSPIUBUCIXT 3.STRUMR PLATEr1101701A PROTECTOR 0 4.0ONTAINNENT SLWP 47r.-- VU. acVII. UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE _❑ 1.SINGLE WALL Cl 2.DOUELE WALL 0 3.NO DISPENSERS 0 90 NONE 46% CONSTRUCTION MATI]HAL 0 L.Sl"MEL �4.FIBERGLASS 0 10.RIGID PLASTIC 0 99.OTHEt(Speeify) i6Q. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION 2.SACBIFU AL.ANOM(S) 04.AIPRES=CURRENT &F 6.ISOLATION JJs IX. APPLICANT SIGNATURE CERTIFICATION-. I rertifv that this UST system comPatibl with the hazardous substaum stored and that the information Provided herein is true, accur e d in I rnm iao with r iremenis. h APPLICANT SIGNATURE DATE J^ APPLICANIT NAME(pmt) t..lUp APPLICANT ITD-E UPCF UST-B Rev.MaW7)-U7 1 1 www.unido¢org