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FROM : J. Schetter PHONE NO. : 5306667692 Dec. 02 2005 02:44PM P3 <br /> Ak <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS 5u S/��1 <br /> UNDERGROUND STORAGE TANKS- TANK PAGE 1 <br /> (Two pages per tank) <br /> Page 1 of 2_ <br /> TYPE OF ACTION ❑ L NEW PERMIT ❑ 4.AWNDED PERMIT 05,CRINGE OF INFORMATION <br /> ❑ 6.TEMPORARY'fANK CLOSURE 4)0. <br /> (Check ow item only) ❑ 3.RENEWAL Prm RM I'l _ -undated info request a f=1 7.PERMANENTLY CLOSED ON SITE <br /> (Specify reason) (Specify re►ann) ❑ K.TANK REMOVED <br /> f BUSINESS NAME(Same u FACILITY NSM or DDA-boing Busi-net's As) 3. FACILITY ID: <br /> Arco Facili No, 00595 <br /> LOCATION WITHIN SITE.(optional) <br /> 431. <br /> 1.TANK DESCRIPTION <br /> (A scaled lot plan with the location of the UST system includingbuildings and landmarks shall be submitted to the ltx;al afienc ) <br /> TANK <br /> 7 rill# 432. TANK <br /> yWArN UFACTURER 433 COMPARTMENTALIZED TANK Yes No aa4. <br /> 1'-UNL XERXES rt-Y.8"'wmplete one ve*e fur eaah anmp¢rtmenr <br /> DATE INSTALLF() 435 TANK CAPACITY IN GALLONS 436. NTJMBFR OF COMPARTMENTS <br /> (YEARYNK)) 437. <br /> 12/01/1984 12 000 <br /> ADDITIONAL DESCRIPTION(Por Local i u ady) <br /> 436. <br /> IL TANK CONTENTS <br /> TANK USE 439. PETROLEUM TYPE <br /> 1. MOTOR VEHICLE FUEL ®la REGULAR IJNLEADrD C12. LEADED p 5, JET FUEL am <br /> ((rellecked,eumplete Peerolevm Typo) ❑1 b. PREMIUM UNLEADED ❑3. DTFSEL <br /> ❑6. AV1.41"IVN GAS <br /> ❑ 2. NON-FUEL PETROLEUM ❑Ic. MIDGRADE UNLIiAVED ❑4. GASOHOL ❑99,OTHER: <br /> ❑ 3. CHEMICAL PRODUCT - <br /> COMMON NAME (liom Itarardous Mareriaia Ynvenb7 pA(:C) 771- C%A$#(ji0(U Huaardova Materials rnvecttory page) 442. <br /> ❑ 4. HAZARDOUS WASTE GASOLINE <br /> (I=Iudes Used oiq 8006-61-9 <br /> ❑ 95.UNKNOWN <br /> 111.TANK CONSTRUCTION <br /> TYPE OF TANK 1. SINGLE WALL ❑3 SINGLE WALL Wr'I'H Exrr R1UR <br /> (Check one item only) MEMBRANE LINER ❑5' 5TNGLT?WALL WITH INTERNAL BLAL)DhR SYS'Em 445. <br /> ❑9S. UNKNOWN <br /> 2, 1)VUBLE WALL ❑4. SINGLE W ALL IN A VAULT ❑99. OTT ITR <br /> TANK MATERIAL.-prime y tack ❑1. BARE STEEL ®3. FIBERGLASS/PLASTIC Q 5, CONCRETE 93.UNKNOWN . <br /> (Chock one item only) []2, STAINLESS STEEL ❑4. S ELiEL(1 AD W/FIEERGLASS ❑8. FRP COMPATI BI,TT-, ❑99.OTHER: <br /> REWFORCED PLASTIC(FRP) W/100%METHANOL. <br /> TANK MATERIAL-racondary tank ❑1. BARE STEEL ®3. FIBERGLASS/PLAST-1C­----0 S. FRP COMFTIBLE W/100%METHANOL ❑95.UNKNOWN 445. <br /> (Check(me item only) ❑2, STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS <br /> ❑9. FRP NON-CORRODABLT•:3ACKtr Q 99, <br /> REINFORC17r)PLASTIC(PRP) LJ10. COATED STEEL <br /> 5. CONCRETE <br /> TANK INTERIOR LINING 0 1.RUBBER LTNFI) 4 EPDXY LININ13 ❑5.GLASS LINTNG 95.UNKNOWN 446. DATE INSTALLED 447, <br /> OR COATING ❑2 ALKYD LINING [I 4.PHENOLIC 1,.INING ®6.UNL]NM ❑99.01,141ER <br /> Check one item only' <br /> OTHER CORROSION ❑I.MANUFACTURED CATHODIC ®3.FIBERGLASS RETNFORCrD PLASTIC ❑95.UNKNOWN 1149, t1AI E INSI"ALLED "0. <br /> PROTF.CTTON PROTECTION [--14.IMPRESSED CURRENT ❑99.OTHER <br /> If A >licbbte ❑2.SACRTRCTAI_ANODE <br /> SPILL AND OVERFILL YEAR INSTALLED 450. TYPE 451. OVERFILL PROTECTION FQUTPMENT: YEAR INSTALLED 452. <br /> (Chcwr zilthatapply) ®1.SPILLCONTAINMFNT 2004 01nV ®1 ALARM 2004 El 3.FILL TUBE SHUTOFF VALVE <br /> 0 2.DROP TUBE -2004 OPW M 2.HALL FLOAT 2W4 ❑4,E>TMP'I <br /> ®3.mw4R PLATE 1999 opW <br /> IV.TANK LEAK DETECTION <br /> (A description of the monitoring program shall be subrniUM to the locnl agency.) <br /> IF SINGLE WALL TANK 453. IF DOtJBLF W A1;1,TANK OR TANK WITH BLADDER 414 <br /> (Check all that apply) (Check one item only) <br /> ❑1. VISUAL(EXPOSED PORTION ONLY) ❑5.MANUAL'TANK GAUGING(MTG) 111-VISUAL(SINOLE:WALL.IN VAlI17 ONLY) <br /> (]2,AUTOMATIC TANK CA U(' (ATG) ❑6.VADOSEi ZONE ®2.CONTINUOUS INI ERSTI RAL MONITORING <br /> ❑I.CONTINUOUS ATQ ❑7.GROUNDWATER ❑3.MANUAL MONITORING <br /> ❑4.STATISTICAL 1N VIiNTORY RECONCTI,TATION ❑8.TANK TESTING <br /> (SIR)+RTENNIAI.TANK TESTING ❑99- OTKPR <br /> V. TANK CLOSYYRE IINF'ORMATION/ PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DAI V.LAST USED(YR/MO/DAY) 4�3 LS'I"IMATED QUANTITY OF SUBSTANCE,Rli"MAININC, 456. TANK FILLED WITH INERT MATERIAI17 457 <br /> .....__- Iyallons ❑Yes 0 No <br />