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Attachment 5 <br /> STI SP001 AST Record <br /> OWNER 1NFORMAHON FACILITYINFORMATION INSTALLER INFORMATION <br /> Mame Name Name <br /> Number and Street Number and Street Number and Street <br /> City,State.Zip Code City,State,Zip Code City.State,Zip Code <br /> ANK ID <br /> SPECIF'ICA'FION: <br /> Design: ❑ UI. ❑SWR! ❑ 1lorizontal ❑Vertical ❑ Rectangular <br /> ❑API ❑Other <br /> ❑ Unknown, <br /> Manufacturer: Contents: Construction Date: Last Repair/Reconstruction Date: <br /> Dimensions: Capacity: Last Chane of Service Date: <br /> Construction: ❑Bare Stec; ❑Catliodically Protected(Check one:A.❑Galvanic or B.❑ Impressed Current)Date Installed: <br /> ❑Coated Steel ❑Concrete ❑Plastic/Fiberglass ❑Other <br /> ❑ Double-Bottom ❑Double-Wall ❑Lined Date Installed: <br /> Containment: ❑Earthen Dike ❑Steel Dikc ❑Concrete ❑Synthetic Liner ❑Other <br /> CRDM ❑ Date Installed: Type: <br /> Release Prevention Barrier: ❑ Date Installed 1'ype, <br /> TANK ID <br /> SPECIE ICA'1'ION: <br />