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UNUUD PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK r s <br /> OPICRATING PERMIT APPLICATION-TANK INFORMATION o4I4t ram va U <br /> OFACT14N (Chak am Ilam ady. ForwUSTI ckmd or m=vmL aompldbe cdy aw Sectian Sad s4id- r.1.IL DL TVf wd Ix 430 <br /> I.NEW PERMIT a 3.RENEWAL PERMIT ❑ 3.CHANGE OF INFORMATION <br /> 6b 71$MPORARY UST CLOSURE 7.UST PERMANENT CLOSURE ON SITE 0 E.LIST REMOVAL <br /> DATE UST PERMANENTLY CLOSED: DA-MMUStINOUSTDISCOVERM. <br /> 1 FACILM, Q!T A'l'iON <br /> FACILITY ID E(Item Um Onty) <br /> BIMBOMS NAME( ACII FIf NAME or ORA-DoWg Humus As) <br /> BUSINESS S <br /> 771 TANKD 'TION <br /> TANK ID 0 TANK MANUFACTURER TANK Cd TION:TARS TAN[IS 434 <br /> 1.A SrAMD/ALONE TANK <br /> Z ONE OPA GOW/41[TME?tfEp UNIT. <br /> 6t4d� <br /> DATE UM STALLED TAMC IN GALLOKS 4M W Flt OF COMP IN l'HE UNIT 437 <br /> u,ri VA K iMCONTZWS <br /> TANK USE Q 1 i MOTOR VEHICLE FUELING IL MARDIA FU L.aMo C 1 la AVIATION FUELM 4" <br /> 0 3.CHEMICAL PRODUCT STORAGE 4.HAZARDOtlS WASTXlbdvda VAdOn C3 3,EMERGENCY GENERATOR FUEL IHrC J=10WI <br /> ® 6.OTM GE ERA70K Ft1E1 ". 90.OiLtE3R r 4m <br /> CONTENTS PETROLEUM: ® I&REGULAR UNLEADED 0 1€.MIDGRADM UNLEADED ❑ 16S PZEMIUM UNLEADED 440 <br /> 0 3.oIESEL E3 L JET FUEL. 0 d.AVIATION CLAS <br /> la S PMTROL.EUM BLEND FUEL Q 9.OTHER PE'TIOXIM Ispicifyx 4*k <br /> NON•!�'iRClLZUM;ff 71 USED OIL t0.unwaOI= <br /> I I.QIHEIR l kAt-i 1 171D1 EUM 440b <br /> TY�..,TAMC ONSt"1RUC1`ION <br /> TYM OFTANIC E3 I.SINGLE WAIL Ila DOU NA WALL E3 41 UNKNOWN443 <br /> PRIMARY CONTA04MEKT L3 I.STEEL X3.FMUGLASS E3 E.tNTERNAL BLADDER 444 <br /> 7,STEEL•INTERNAE LINING a".UNKNOWN ❑*_OTHER <br /> SECONDARY CONTAINMENT 1.STEEL R3.FIBERGLASS 6.EXTERIOR MEMBRANE LINER U 7.JACKETED 443 <br /> 9ML NONE 4S.UNKNOWIM El 44.OTHER Ckmc6w Oft <br /> OVERFILL PREVENTION I.AUDtBLB!YISUALALARMS ULRAIIFLOAT V 3,FILL TUBE SHUT OFF VALVE <br /> 0.1.TMMC MEETS FOR EJtJDLFTTON FROM OVERFIM PREVENTION EQUIPMENT <br /> PIPING COTBTR41CY1[7FI i.SINOMWAL.LED 7WIDOURIA.WALLED ".OTHER iE0 <br /> SYSTEM TYPE 13 L PRESSIRF GRAVITY 0 3.CONVENTIONAL SUCTION 4.SAFE SUCTION f2l CCR +M <br /> PRIMARY CONTAINMENT U.I.STEEL 4.FMERQL.AS3 Ll IL FL6X=X E3 I&RIGID PLASTIC 4M <br /> ❑90.NONE 4s.UNKNOWN O 44.OTH 1: •a'd <br /> SECONDARY CONTAINMENT 13 1.57M 4.FIBERGLASS EJ S FLEXMA E3 10.RIGID PLASTIC-12 46#► <br /> 90.HONE 4S UNKNOWN 13 44.UrNPx Y. ,fi4Q <br /> PaQiGMURBINECONTARHMENTSUMP TYPE U 1.S"KliEWALL Ll 1DOUBLE WALL l9eft NONE <br /> V L Y q,l VAPORRZC0VZW ANDRISBRIfULPIPEPEmmCON 'RUCTION <br /> VENT PRIMARY CONTAINMENT I.STEEL 4.FIBERGLASS Itl.RIGID PLASTIC 404 NONE 44.O1TIEIt OP-00owe <br /> 44YM1 <br /> VENT SECONDARY CONTAINMENT 1.STI:ET 13 4.Fi •tt E3 LOS RIG®PLASTIC 40.NONE E3",OTHER(Sp.*) <br /> mom <br /> VR PRIMARY CONTAINMEXT tj 1.STE61 13 4.F18ERdL ASS E3 I0.RIGID PLASTIC 404[BONEE3 44.07mit RSseeilyl oft <br /> U VR SECONDARY CONTAINMENT I.STEEL 4,FIRE XILASS IGS RIGID PLASTIC 40.NONE 49.GTHEIt(Spv rfi'I <br /> 400 <br /> TIP WO TRANMTION SUMP TYPE Q I.SINGLE WALL 0 L DOUBLE WALL 40.NpMIB 4Nk <br /> ISM PRIMARY CONTAINMENT 1.STEEL 4.FIEMLA33 LOS RFGJO PLASTW OM qNH 044.WHIR op4etlyi 4" <br /> ItSE.R SECONDARY CONTAINMENT L STEEL 4,FMFItGLASS 10.R96m NOW 94,OTHER Opmelfy) *% <br /> 41-t <br /> MJ.COMPONENTS INSTALLED Iffl.SPILL BUCKET3.3TLtBCELt PLATIVOUT'TOM P03TOCTOR tj 4.COWAINMENT SUER 431Ls <br /> CONS RUCTION TYPE 1.SIVW E WALL 071DOUBLEWALL E3 3,No DEPENSElts NONE 4i94 <br /> CONSTMUCTION MATERIAL I.STEEL 4. WROLAW Q 10.RIGID PLASTIC U 99.OTHEROMM <br /> $TRELcoSIPOFt npRotia rioN E3 LSACRIFICIALANOOM 0 4.IMPRESSED CURRENT a IL ISOLATION <br /> CL':iMFWA77QR1 1 cso dml L!!Is t3T raISISw Is compW*wIA w bmr m rbp4 5Irr41d md ARIL do Irt.W.11rt5 RrnrNis balm Ir t�S[�ifllt. <br /> ad L fid amowkwo w1&had reew"AmalmL <br /> /12PL.IRrAPIC SIGNATURE DATE � 4A <br /> :. . APPt.ICANT NAME fpwl API LICANT ITLLE il liq [ I Z�n m <br /> UYCf UST-11-1I4 Fe+r,ii1l1 71 <br />