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4tmi '' <br />UNIPJZD PROGRAM CONSOLIDATED FORM <br />UNDERGROUND STORAGE TAMC <br />e�mrsn w -11M^ nVlolgrr AVPDT.T0A'TTAV-TAWW TNN n'aMATTnTk1(fleefh-n twn <br />PB Or, °ACRON Pea Ono itch salt. Foran USTpe naseM ctomlro or le0w0l, o [cto ongl Ude oWend SealJonm 4 Il, ]U, 1V, Rad Ilelow) <br />430 <br />13 1. KSW PERMIT' 3.RtiNSWALPI9RMIT [j S.0 HANGE OF INFORMATION <br />fn TBt 4PORARY UST CLOSURB T. UST PH.RMANIM C:LOSURB I 31713 IL USTREMOV L <br />DATE UST PERMANENTLY CLOSM.. DAT& RMTM UST DISCOVERED: <br />� <br />L FACILITY INFORMATION <br />PAC ILITYIO tl(AUett6P USE ap) r <br />13USINWSNAME (somas VAC1LITYNAME orD9A•DolneBudnMAS) 1 nr$ C Meffl yr} iy 1 <br />L I C1.1 7jJ�`,► l <br />BUSINESS SITE ADA rid., 1 <br />Ave <br />I CITY ' n! <br />III <br />la <br />11. TANK DESCRIPTION <br />' T Nr TO d .. <br />TANK MANUFACMIU31k • <br />CONNICRJRAYlON: THIS TANK IS <br />434 <br />- ' <br />I.AaTAND•AEDNBTANK <br />, <br />UVIr1EA�„IrWI��V1/�i4.�ff� <br />2. AVB M ACOMPARTMiNFBD UNJT <br />a <br />MMEBROFOOMPARTMIiNTSMTHE UNIT <br />a <br />TANK CAP C'YCYIMtoll U LIIONE <br />III. TANK USE AND COMM <br />TANK USE ® ILMOT01tVISHtCLSPUSLINO El ll,MARIHAPURUNO to AYIATtONPURuNa <br />S.CHEMICAL PRODUCTSTORAGE ® 4.NAZARDOUSWASTE0eda nusedom S.WORGBNCYOMMMYMFUBL[amC3zsnssfdl <br />$.071,191.013142RATORFUSL 95. UNKNOWN 99.0THIR <br />435a <br />CONTENTS PETROLEUM-- Is.REOUG• tUNLRADED 13 Io M1DORACRUNLEADED 13 iS PI MIUMUNLEADBO <br />4411 <br />S.1NB$BL I3 $.JBTMM E3 GAVIATCONGAB <br />m.pE7Rd184'b1BLrmFURL 9.OTHBRPRTRAtBum <br />Mas <br />NON4ffMMZLN CI T. UEBD CHL LJ 10. BTJIANDI. _ <br />4AaA <br />13 11. OTHER NONN $BBTROLa0h1 <br />IV. TANK CONSTRUCTION <br />TYPROFTANKUL2.DOUELBWALb 9S.OWN443 <br />PRIMARY CONTA ENTt. S.PIBBROLASS 6.JNTERNALHLADDEt <br />440 <br />4eA <br />T.aTBBL4I INtiKf Q 9S.ILN 9P.OTJMR I <br />OLEt1ORME BRANSLINIM .JACKETED <br />BECONDACONTAINMENr I.STS114 3.PBtaAAE4 6.BkT <br />RY <br />4Q. NONE 9S. UNKNOWN OTHtiR <br />+4A <br />6RFILL_R6 I.AUD1BIBd4V1gUALAtARMB 2tIAtLJRAAT BBSHUT-0FFVALVE <br />+M <br />4.TANKMEE7SR IRBAIENTSJmREXEMPT�t8ROM0VBRFR.LPRSVENTION UWMENT <br />V. PRODUCT WASTE JPVWG CONSTRUCTION <br />1TPINGCCSPMTRUCTION 13lNO[JI.WMLBD DOUBLE.WAUJID, 1399.ERW <br />410 <br />49 <br />$YSTEMTYPE LPREBSURR :L RAVITT S ALBUCJTON 4.8AF"SUC710N CoRp"gm <br />•.Ptdl. ISYCORTA .ML•Nr.;. La9EEL 4. F1 a R.P LB IMID PLAIN <br />4ae <br />... 9A NONE 9S. UNKNOWN G199.07H <br />OARY.COMAI I.STEEL 4.FiiHIROLAI3 h.PIJDI1a68 tDAWDEWTIC <br />�s <br />460 <br />+ft <br />0 ".NONE u16wDWN 99 OYNER <br />PJPI tNBCONT P450aN1 P PE t. tNOLBWALL IMUBLTSYJALL13 90.NONE <br />+ <br />,��pra�a®pfd iD 7�prgtp (1� <br />).i - �. i i• Agq/IZi•FwWe.YV -�e�a.�Wn� -i .alk '.: M:'r'E•,b� y, <br />u i..,;;;'.u'+.;i-..�9�.'•. <br />YENT CONTAINMENT 1.8788E t OI I - ' 0 AB'PIC' -'- •• � 4 , <br />v <br />4seo <br />VENTSECONDARYCONTA MEN? Q t T 4.PIBER 1061[) ANOM •OTHSR(5P <br />4461 <br />VRPK YCONTAINMRNT tj i MEL 0 4-lil-BEROUM Cl 10.110IDPUM El9Q 99. BR <br />VANECONDARYCONTAINMENr 8768E 4. IQ.R OIDPLASTIC 9 OTH6 IBP J <br />4d461 <br />VMYFtPMAANSMONSUMPTYPB 1 A <br />RISER PRIMARYCONFA1NMBNT 1. STEEL 4.A9EBR 10. tD 90.IKB46 99. <br />4 <br />46 1 <br />R1113RS0WNDARY W 4 TAINMEM 1. STEEL E3 4. MOM 1310,11iON)PIASTIC C1106"ONSrumumag <br />+ <br />'..7+1 TBiNETALLED`' l.8Pi1J.aU 314.PT& PRCI R E34.CONTAU4A4tH4TSUMP <br />11a <br />vIl, UNDER DISPENSER CONTAINhMT <br />OONSTRUG7tONTYPE Lli. 4aLSWAL1 DOUBtE WAEt 13 S NO)tSFENSBRa I3 90.t R <br />4a4e <br />CONBTRUCTIONMATERIAL 1.SiBBL 0.PI09601.ASS 10 RIOIDPLASTIC 9A <br />•vrrr::L`'O•ItROS][oTVPdt49TE r��r;:�;�_ <br />STEELCOMPONWVPR09WTJON 13 2.11ACRIFICIALANDO Bl O 4, SwIMBRI)CURRARr =ISOLATION <br />it APPLICANT SIGNATURE <br />CBRTIRICATIONr I certify that this USTmymtan► IB coropalMN wish the hxwrdoam substance stored hn4 that the lafbrmalhm pmrldod her® 1a trap, accurate, <br />SPA In AIII complimsco frith leal Emulrowants. <br />APP•L10 Sl t.: ; '. • <br />4E <br />!IIIA F Sa <br />APDL NTNI�1r}8 Gxl. (APPGtC/!t>t}:TJ1EfR.4, MI <br />47L <br />UPCF UST -B - Ill REV. (1212097) <br />