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11/22/95--- 15:15 UST CLEANUP FUND i 912094540138 N0.456 1?02 ; <br /> Underground Storage Tank Cleanup Fund <br />' DETAILED REVIEW CHECK LIS' <br /> Cialm No: C1 Cfalmanl Name-� <br /> O <br /> Region: Priority Asaignaci: Site Nemo: /F <br /> Dato Reviewed: Olin iAddrees: � ��- <br /> Reviewr Lead Agency: <br /> Cialmant OwnS 3perator of UST <br /> Tax Identification <br /> PM <br /> ided <br /> Valid Third Party C10im <br /> C,4r'M, ........ <br /> Joint Claimant OwnetVOperator of UST <br /> Tac identification Provided <br /> F nandatil Agreement Prcolded <br /> Tax Identification Provided <br /> +��STRrrrAhfK. ,twsct�!N <br /> Tank Description, Tank Use <br /> Tank Substance <br /> S#e Map Provided <br /> Current Ownedoperator Identiffed <br /> Date SItpIfer;ks Lc <br /> iuirad <br /> Acquired Atter W1154 Reasonable Dtilgence ' <br /> Past Owner/Operator Ideni fled <br /> Other Claims For This SM Submitted <br /> :1xG+ lr: lRSl11i' :: 7. <br /> "; i �4 ,. tl�/A"' $;•;` <br /> unauthorized Release <br /> Release Reported/Confirmed <br /> hate Release t)iscawmd Confirmed r <br /> Coagcthre Acton R red f <br /> Release Eligible not a*&, overfill, etc ' <br /> Corrective Athlon <br /> Release Pdw to 1li188, CA Initiated by&WRIS ►� <br /> Corrective Athan In Compliance <br /> Parma <br /> PernOt Requftrmnte Met by 111M <br /> Permit Waiver Being Requested <br /> Perms Waiver Grained <br /> I <br /> Finanthrl Remponslbillilly <br /> Claimant In Compliances <br /> Lawsufl, Insurance Claim, Settlement <br /> Date Flied-Date Completed <br /> A <br /> t Recelved <br /> Llrl <br /> rtQ <br /> i <br /> Ori 'nal Si natute(s)' <br /> Authorized Represents0de Statement <br /> JOIAt CPatEnant Si nature s <br /> USTCFM.t>ET (Rev 1/95) <br />