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R /1 <br /> STI SP001 AST Record <br /> OWNER INFORMATION FACILITY INFORMATION INSTALLER INFORMATION <br /> Name 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 /> TANK ID <br /> SPECIFICATION: <br /> Design ❑UL ❑SWRI ❑Horizontal ❑Vertical ❑Rectangular <br /> ❑API ❑Other <br /> ❑Unknown <br /> I <br /> i <br /> Manufacturer: Contents: Construction Date: Last Repair/Reconstruction Date: <br /> Dimensions: Capacity: Last Change of Service Date: <br /> Construction: ❑Bare Steel ❑Cathodically Protected(Check one:A.❑Galvanic or B.❑ Impressed Current)Date Installed: <br /> ❑Coated Steel ❑Concrete ❑Plastic/Fiberglass ❑Other <br /> ❑Double-Bottom ❑Double-Wall El Lined Date Installed`. <br /> r <br /> Containment: ❑Earthen Dike ❑Steel Dike ❑Concrete ❑Synthetic Liner ❑Other <br /> CRDM: ❑ Date Installed: Type: <br /> Release Prevention Barrier: ❑ Date Installed: Type: <br /> 1 <br /> f <br /> AST INSPECTION STANDARD SEPTEMBER 2011 <br />