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lu <br />ic <br />Ute PWKMAM CONSOf,WATED FORM <br />UNDBRSROUND S SUGE TANK <br />OPMATING PERMIT APPLICATION -TANK INFORMATION (onixm pa Us( <br />TYPEOFACTION (L." w* om km oar. Form UST pamm;m ck me oe nm nk oo Otto WY"weti00 trod Sadao(L- II. III- TY. Inld 1X 410 <br />1. NM PERMTI 0 3. RENEWAL PERMITEj S. CIIANUR OF RNPOR,MATION <br />6. TEM Y UST CLOSURES 7. UST PERMANENT CLOSURE ON SITE S. UST REMOVAL <br />DATE. USI'PERMANENTLY CLOSED: BATE DUSTINO UST DISCOVER.M. <br />L FACEL11TYINFUROUTJON. <br />FACILITY ID * Imo` Um 0*) <br />BUSINM NAME (Sam1e is AGILITY NAME or DBAMDolog Baia= As) <br />BUSIPOW SITE 113 <br />CTIY I <br />II�'PA ON <br />TANK ID 0 4M <br />TANK MANUFACTURER <br />TANK CONFwuPAT10ftC THIS TANK ISI 4m <br />�i o.�iC1QEtNACOMPARTiNTIDUNIT. <br />'A STAND-ALONE TANK <br />DATE SYSTEM INSTALLED 4" <br />TANK AC IN GALLONS 436 <br />NUMBER OF IN THE UNIT 437 <br />-ULTANKV=ANDCX9fTZM <br />TANK USE Ie, morK ft VENIN F{IE'tB40 ❑ 111L MARINA rUEIJNIO 0 le- AVIATION FUR 240 <br />3. CH13WAL FROOIC'T STORAGE 0 i. HAZARDOUS WASTE Wd.b UmWO4 05, EMERGENCY GENERATOR FUEL PW JIMIX41 <br />4m6. 0TItEE OI NERATOR FUEL. O F!. UNKNOWN 99.OTHER M, <br />CONTENTS PETROLEUM: E7 la. REGULAR UNLEADED Q la MIDURADE UNLFJIDEt3 IIs Lrtak ABED 40 <br />❑ J. DTEaI. ❑ 3, JET "Am- <br />UELE3 <br />E30. PETROLEUM BLEND njEL 4, OTOR PET144EUM Nom <br />❑ 7. USED OIL ❑ 10 ETHANOL <br />I I. anum NON-PBTRALEUM 41(4 <br />IV. TANXComnvtlCVON <br />TYPL:OF TANOC 1. SINGLE WALL. W2 DOUBLE WALL 9S 40 <br />MAAARYCONTAVOMW U 1. STEEL WJ.rmEROLASs 66VnIMNALBLADOUt 444 <br />7. STEEL « INTERNAL LININO 4f. UNKNOWN Q 99.O HER 444 <br />3ECONDARY CONTARVAENT I. STEEL . FtBERGt" 6. EXTE TOR. MEMBRANE L INER7. JACI-MM 40 <br />4o. NONE K UNKNOWN Q 99. OTHER 1 44% <br />OVlEWX <, PREVENTION L AUDIBLE A VISUAL ALARMS 2. BALL FIAiAT WL FILL TUBB SHUT4FF VALVE <br />O 4• TANK MEETS mors PDR E3abwrM FROM OVERKLEQUIPMENT <br />y�PfRViEENTTION <br />Vi t W PUMCOM � UCTION <br />PIPMC TRUCTLO.'R 1.SENGI.E-WALLE>s 2.DOUBLE WALLED ".ontEx <br />SYSTEM TYPE I. PRESSURE L3 2. GRAVITY 0 1 CONVENTIONAL SUCTION( 0 4. SAFE SUCTION IR CCR � <br />PRIMARY CONTAINMENT u . STEEL. 4 & FLEXIBLE 10. RIGH PLASTIC <br />Q 9a NONE ".UNKNOWN 99. Y. <br />LNWff•w <br />SECONDARY CONTAL STEL 14 FLIPUBLE I0. RLOID PLASTIC <br />E3 90. NONE UNKNOWN Q ".OTHER I 44` <br />MMNGITVROINE ENWAINMENT SUMP TYPE I. SINGLE WALL L DOUBLE WALT. 94L moms � <br />VL VEff, VAPOR RE �: , AM Rn= / PUL PIP$ I''JMG C i9 _r <br />VENT PR04ARY CONTAINMENT U I. STEEL C FIBERGLASS U 10. RLOID PLASM El 90. NONEU 944 OTHER o 46 yi <br />VENT SECONDARY CONTAINMENT El I.STEEL 4. FIBERGLASS Q 10, RIGID PLASTIC 90, NONE 13 9%OTHER OpwAW 4w, <br />ww <br />VR PRIMARY CONTAINMENT I. $TEEa. 4. Lit A55 10. ROM MASTIC 9Q NONE 994 OILIER t3pd1y1 <br />1 <br />VR SECONDARY CONTAINMEYf tj I. STF,F2. 13 4. !:'IIIERGL.AS4 10. RIOIO PLASTIC NONE E3 99.OTTIER OF=*) 4601 <br />VENT FIFIN G TRAM SITIONI SUMP TYPE _ ti 1. SINGLE WALL Q 2. DOUBLE WALL NONR <br />RISER PRIMARY CONTAINMENTL. STEEL4. FIBERGLASS E3 10. RXHD PLASTIC U 90. NOWN U 99. (ILTIER (Sllft*l 4" <br />39 464H <br />RDER SECONDARY CONTAMMENT 1. STEEL 13 4. F18ERGi ASS I0. RK#ID PLASTIC 9p. NONE 13 99.OnIER r3f=61 <br />1 <br />FDL- COMPONENTS INSTALLEDL DL CKE[ sTTILAyB�pptATI�Iwrmm PRunwTC 4 <br />3q C ON TAIL WVCT SUMP aslrc <br />SPILL <br />Eip. <br />.,,, ".... _ •TTr f/i4ii►�O�Ik +�AI� ,,1vv�e) .,; •,=•- ,., ,.. <br />� <br />YPE 1, SRIOLB WALL. 0 2 WALL s. ND O1S$Fr`i3P is (] 90. NONE rt9r <br />CONSTRUCTION TIE- <br />CONiSTRULTION MA 1. STEEL WCFMERGLASS 0 IM RRiB] l9AXM EJ 99.0TH6it1 <br />(DEIN AlI asmi; .. <br />jTT+EL CG MKWNT MW -TION E3 3. SACRIFICIAL ANOOSM E3 C IMPRESSED CURRENT b 130LJ1T10P1 4a <br />TTG:-APlLICAM, SIGM <br />C'PRTIFICATlONt 1 emrWy tW LNt UST tyInII b com pullob ww1 Lie bmmwdm mabom a wo d ad *d lie bmbn mdm In id+ir It Lie« mennsie. <br />and Im Rd camolafte with had noody"madL <br />APPLICANT` smNATURE <br />DATE t <br />l <br />AMJCANT NAME (print} <br />APPLICANT TITLE <br />J <br />UPCF UST -e- III <br />_ Rsr:(t?t3f171 <br />