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i <br /> i <br /> 2010 Equipn)ent Survey <br /> a <br /> Site Number >) Street �'- Gil/C'� r✓�s. Company <br /> -lf / r 9 <br /> Technician �` � City ��! � !� Phone# i <br /> Date 4l L' State Contact Name�Wl/ L,, ✓% <br /> Petroleum Storage Tanks <br /> Tank a Product Capacity UST or AST Split Tank Striker Plate Manlfolded/Siphoned Auxlla <br /> March R=Pol lmTSP=Tank Striker Plate - <br /> To T-1, M=Mid Or ads Nominal Gallons UST=Underground Tank Split Tank DSP=DropTube Sinker Plate Mam/olded l Siphoned Tank Avolary Tank <br /> Monitor P=Premum Nearest(000) AST Aboveground TmX Yes or No N=None IF.0.to,net other lank) Yaa or fro <br /> She D=Diatel LINK•Unkmvon <br /> Sketch W=Waste Oil <br /> K=Kerosene <br /> YES <br /> ( <br /> 1I E R i M P D W K '`I` YES . TSP DSP IN IUfJ[( YES C-,' <br /> ,� YES <br /> 2 R f M„'1 P D W K I (f`. VES �� TSP DSP N GNK YES <br /> e;,���Yy YES NO <br /> 3 R M 01' D W K � "� � YES TSP DSP N prnly YES NO <br /> VVV YES NO <br /> 4 R M P D W K YES NO TSP DSP N LINK YES NO <br /> VES NO <br /> 5 R M P D W K YES NO TSP DSP N IAVH YES NO <br /> YES ND <br /> 8 R M P D W K YES NO TSP DSP N UNK YES NO <br /> Petro leurh Stomgc Tanks <br /> material of Construction Corrosion Protection Lined Tank - Inlerstdial Space Method of Leak Detection Remote FIII <br /> Match OWE=Doublewan Fiberglass <br /> To Tank SWF=Sinyawell Fberglasa IC=Imprassed Current Lined Tank B•BnneAa-A02481 Ramole FB <br /> Monitor DWS=Duublewall Steel NM=Non-metallic Yesor No D•Dry CS <br /> •Continuous Statistical LO Vee or No <br /> SR. SWS=SInWewall Steel SAC=SBC Anode UNK=Unknown VC=Vacuum IM Interstitial Monitoring <br /> Sketch DWSP=Doublewon STIP N=Nona VL-Vanillas! MTG•Manual Tank Gauging <br /> SWSP=Singlewall STIP UNK Unknown N.None SR=Slaaedcel Inventory Reconciliation <br /> CLO=great Clad wrFiberglass UNK=Unknown (Circle ALL that apply) <br /> UNH•Unknown <br /> OWF SWF OWs SvVs / /� <br /> 1 1 -v-') IC NM SAC N(VNK'y YES NO UNk j,9� O VC VL N UNK AS CSL. /IM MTG SR VES <br /> DWSP SWBP CLD UNK / <br /> DWF SVyF DWS SWS i <br /> IC NM SAC N41st YES NO UN' VC VL N UNK AS CSLD 01' <br /> Iry MTG SIR YES /NO) <br /> MSP SWSP CLD UNK ���/// <br /> ::'.T� SWF DWS SWS ' <br /> 7 - IC NM SAC N UVE YES NO 11NH ( B D VC VL N UNK AS CSLD IM MTD SIR YES <br /> DWSP SWSP CLD UNK k.+� t..+� <br /> OWE SWF DWS SWS <br /> 4 IC NM SAC N UNK YES NO UNK B D VC VL N UNK AS CSLD IM MTG SIR YES NO <br /> DWSP SWSP CLD UNK <br /> I <br /> DWF SVVP OwS SWS <br /> 5 IC NM SAC N UNK YES NO UNK B D VC VL N UNK AS CSLD IM MTG SIR YES NO <br /> DWSP SWSP CLD UNK <br /> DWF SWF DWS SWS <br /> 6 IC NM SAC N UNK YES NO UNK B D VC VL N UNK AS CSLD IM MTD SIR YES NO <br /> DWSP SWSP CLD UNK <br /> Product Piping -Vapor Recovery System <br /> Tank g Material or Construction .Corrosion Protectlun Flex Connectors Stage I Type Stage it type EVR System <br /> Match OWE=Uoudowall Fiberglass iC=Impressed Culicnt Vt=Amoco VI <br /> To Tank SVVF=SInglewall Fiberglass NM=Ncn-metalar. Quantity of Flex Cbnne<lms 2PT=Two <br /> Point BL=Balance PT=PHIL TITE <br /> Monitor SWS=Snglewell Steel SAC. <br /> Sac Anode Write in number CP-Coaxial Poppeled VST=Vapor Systems Tech OPW•OPWVR <br /> Site FLX=FIestble UNK.Unknown LINK Unknown CN=Coastal N—Popperlad VA-Vacuum AsdA el NNO EVR <br /> Sketch UNK=Unknown HE-Haay wlout EVR <br /> HEVR•Heey YO EVR <br /> NA=No Stam R <br /> -� <br /> VI VST VA <br /> 1OVVF✓J SWF SWS FLX UNK IC NM SAC UN � t� CP CN PT ((/OPW 11A <br /> !�y / HE HEVR NA `-... <br /> 2e DWB SWF 8W8 FLX UNK IC NM SAC fL1NK% <br /> �OWF) SWF SWS FLX UNK IC NM EAC f MINK, <br /> u DWF SWF SWS FLX UNK IC NM SAC UNK �'- <br /> 5 OWE $WE SWS FLX UNK IC NM SAC UNK <br /> e OWE SVVF SWS FLX UNK I IC NM SAC UNK <br /> losuaa otmerlo <br /> Page 1 of 4 <br />