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Ab_ <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS-TANK PAGE I <br /> flea. e, 8 <br /> 'TYPE OFACTION D 1.NEW SITE PERMIT Cl 4- AMENDED PERMIT Ll S.cixuGE OF INFORMATION) Cl 6 TEMP()RAAYSINE CLOSURE <br /> (Ch"A an*item 0'.Y) 07 PERMSI <br /> PERMANENTLY CLOSED ON TE <br /> ❑3-RENEWAL PERMIT (Spar mea n-f"W.r.00_I'p V, TANK R(jM0VEO 430 <br /> BUSINESS NAME(Sam.a.FACILITY NAME of DBA-Doing Dwinl.A.1 FACILITY 10 p <br /> VOL cI x c- 712. 11 <br /> LOCATION WITHIN SITE(Oplion-9 <br /> I.TANK DESCRIPTION <br /> TANKIDS TANK MANUFACTURER COMPARTMENTALIZED TANK Y.a El N­. _' <br /> 0 w 4 1,(1 <br /> It-Yes-.camolete on.p;"To fol*aCA Wmeallmool <br /> DATE INSTALLED(YIEAvMoJ TANK CAPACITY IN GALLONS NUMBER OF COMPARTMENTS <br /> -;Zl 0 13 <br /> ADDITIONAL DESCRIPTION fPw 6ocal U.e o.M <br /> K.TANK CONTENTS <br /> TANK USE 432 PETROLEUM TYPE <br /> MOTOR VEHICLE FUEL D sa. REGULAR UNLEADED 0 2. LEADED 0 5.JET FUEL <br /> C&Mpfvfo pahvieum Type? 0 lb.PREMUPAUNL*iAOEDDIESEL 11 S.AVIATION FUEL <br /> NON-FUEL PETROLEUM ' UNLEADED . <br /> DIESEL <br /> Cl 1,..MOGRADEUNLEAOF-0 13 4- GASOHOL 13 99. OTHER <br /> 0 3. CHEMICAL PRODUCT <br /> D 4. HAZAROMS WASTE(NCM*ll COMMON NAME(dramHuwtfeox Mofedalx fivownwrypago) CAS 9(fteft Ifalanf—A Mololvoll InYpetaly papep <br /> used 00) <br /> UL TANK CONSTRUCTION <br /> TYPE OF TANK ❑ 1. SINGLE WALL 0 3. SINGLE WALL WITH Q S. SINGLE WALL WITH INTERNAL F)LADOER SYSTEM <br /> XA4fk WM Rom 0"; XZ. DOUGLIWAtt- EXTERIOR MEMBRANE LONER 0 9S UNKNOWN <br /> El 4, SINGLE WALL IN A VAULT 0 99, OY'IER <br /> TANK MATERIAL-PrifTIVY 1" T. BARE STEEL 0 31 FIBERGLASS f PLASTIC 0 %.CONCRETE 0 as uNKNOvvN <br /> (Col-A one it.,Vniy) ❑ 2. STAINLESS STEEL Q 4. STELLCLADWIFIBERGLASS D IT. FRP COMPATITILF WIWI)%METHANOL ❑99.OTHER__, <br /> Rc)NrORCED PLASTIC(FRP) <br /> TANK MATERIAL-;;Z;�.IYL.Ak �C] It fRPCDMPAT0LEW/1(J0%MCTHAN OL ❑95 UNKNOIAN <br /> ,STEEL 0 3. rtJJrRGiAssrpLA&TJc D <br /> (Check one item only) B.SlAINi-ESSSIEEL E) 4.STfiELCLADWIFIGERELASSS Q 14, PAPNON-CORROO;BLE JACKET 99 4OTHER;rQ 'L LJ__-- <br /> REINFORCIEO PLASTIC(FRP) 0 lo. COATI-()STEELCDA4a I nmen4-T&e- <br /> 0 5 CONCRETE <br /> TANK INTERIOR LINING 0 1, RIJOBER NED Cl .3, EPDXY LAMING D <br /> S.GLASS LINING ®a5. UNNNOWN433 UA TF INSTALLED <br /> OR COATING ❑ LI <br /> Z. ALI(YoLINTNG UfAINC-0 0 09,OTHER <br /> (choo ono dam'wyl <br /> OTHER CORROSION t7llAili INRTALLF0 <br /> PROTEC110M IF APPLICABLE I MAIN)FACTURLOCArHooh: 0 3 FII)ERrtA-.SRIEIINFORCLOPLA3TtC El 95 UNKNOWN 434 <br /> "'�R_ "S <br /> _SS R <br /> PROTECTION 0 4, WMPRESSEDCURRENT 099. olIw.p <br /> (enock one ilom an)yi n SACRIFICIAL ANODE (for total u.e.1tyl <br /> SPILL AND OVERFILL YEAR INSTALLED TYPE(For OvERFILt-PROTECT KIN FOUIPMENT YFAR INSTALLED <br /> (4 <br /> fuhrcm as that Applyl —c' SPILL W-1 ALARM 3. FIL4.7UfJ;_S'lU7 OFF VALVE <br /> 16,2 DROP TUBE DALI.FLOAT Cl 4 EXEMPT <br /> PLATE <br /> N.'TANK LEAK DETECTION: <br /> IF SINr_LF`WALciww_(cfwk oil I"I app! IF DOUBLE WAILL TANA OR TANK VAPI BIADUER(Chock—P#Cm-;iW <br /> 01. VIrwUAL(EAPOSED PORTION ONLY) 5. MANUAL TAGAUGING(MTG) D T. VISUAL(SINGLE WALL TO VAULT ONLY) <br /> 02, AUTC)MATIC TANK GAUQW,(A I G1 011 W 6 W4 I INUVLJ:i IN I LI I S TMA IA L MUNI 1014110, <br /> 0 3 CONTINUOUSAIG U 7. GROUN(NVATER 0 3. MANUAL MONITORING <br /> 04 STATISTICAL INVENTORY RCCONCtUATION(SIR)• 0 a, TAMC TESTING <br /> BIENNIAL TANK TESTING 0 94. 0114un <br /> V.TANK CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USIE0(YRIMO(DAY) ESTIMATED 10110,AU'IrV Or SITOSTANCC REMAINING 415 TANK FIlI_Fr>'Al7v'IP4ER7 MATERIAL? <br /> —omto,nt D Yh, 0 tio <br />