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2019 Equipment Survey <br /> %ow- Site Number C.' �` Date <br /> N a lank has a 4"sd fill,put down the vttem+a5on for both bu7tHs so teat n is dear that then are a buries ter ma!tsML It there is only t vapor bud■!tc:at en gas tanks :J!the mtonnatgn for Tat bullet the int lank and <br /> mark the others V for vapors arWNded p <br /> IFW i Product SpeBucketa Vapor SpB BtKkib - REMOTE FT►/Product Spill Buckets REMOTE Vapor ZjW Bueke4 <br /> Tsnk s Manufacturer Bu.W Sb■ sinpk/ MamJf.m reg OW-ket I Slnple/ Strlgle 1 <br /> Double I Was Double Manufacturer Bucket Stu I Double Msnuhgyrar Bucket$lre Slnpla I poupia <br /> CNI.EBw Ern <br /> Estimated Stat Is t`r buries Ettrnaied b 0,buoH CM.ESW Elms <br /> gan/eld Frankh^ Estimated SA, is ere bvekr Esamand Still <br /> 3 P <br /> N <br /> 'N Buhr Scglewal or <br /> SPts Butlet Sir.lewal or FeCiNo F•ankkr. Is tee bu5e' <br /> •'r Doubltwal OPN Phdi"u 0 Bue•et S:nplewal r» O J Pn,f;de <br /> rSelo C■Pa... Carserty Doubiavwd --NJ EE:J �� ButkN Sr w <br /> Mno buUrl w';n r CaoarJtf AoueNwal q�P':: (;;a.:rs tGaAo�a bait ■tf l- r ne blade'wt•ylona C•war a sem G■sons. L•toes]•r:+ y° Fgnkl- Oo�ry iGasonse SNo'D Y systemNL:Y: NA a Nt Closet p, , SW tr D'NJ,L a Ve 4J.a N- NR a U. Nc:1Jt p•02se1 St.or CJJ <br /> Vster martrfoa NF•hi <br /> Bua r' Bade! Buaet Bucae Burket Buuet V e Vaoer mindole NA s NL Evyet <br /> R a reser on R=ruonlyEucke!`7ti S s l <br /> 6 <br /> TwtiFn*Pump. <br /> d a tank has 2 Dthem Dole d be dear to Am 21 Un■leak DNeotors UD,- Overm protection <br /> Tank 1 atanlJfaeturer Yrdel urttb■r Sped Manutaebner Mod■!Number Type of LLD Type <br /> Slgr ayi <br /> FE.rE PerC gE•Fp Pet^; Bg s Bel gloats <br /> Prrn•Mpdo'-dez r space CS•_erslan f _p=Ele:Jcr,c ry+0Z Tubt JTaDPr•Jalvr <br /> G'rdar n,:9re:aa C Peed R.•Rad Jarle' a list esle•TIaI <br /> t>•'Ia-r -'e.tleo JS=va vsbta Soeed vo a VSvc,Isi VIHI •%`te N::N 4urnee• MLD a Nechani:el +:•:•Wgr•LevN E•Urr.N 41ary slim y <br /> 'JA a Nc P.:rrt iS.Jeerer Py. <br /> No a•: <br /> r,lany - } Preece.)3]RS <br /> Pvmc 1.W. 'J� N- NJa he?rJProle:or <br /> Nr.rJc L_G a bare] <br /> N.••N`L_ I Chole ALLthat apply) �• <br /> 1 { <br /> r=te �;�`,�►� �'� -�r.J �, �� L� J��� �=! yl I) BF r' NA <br /> V NF D 3P Lr"�, L4 <br /> =iP,(1+�1r i'='�-3 {,: e g t� Np <br /> BF =4 ri_z NP <br /> 'r -V -4LL NP <br /> 6 1 8F L •� <br /> Tank Sensors Fill Sumps Turtoine Sumps <br /> Tanks S TP'P P,Q S yrmp Fill Sumf Int r-w.a.:a-,ser M se,Other Sensor <br /> - �GaOa-rttee Con:ammrn-,Yoe COntIDnmen•'yoe <br /> Specdy-tut the sensor rs far <br /> C-e. .% a b'anL?acture•s Model --a••,r r..a_e: ..e• ^n a.cTr"S�.r: �5::onto tee. r: <br /> oe ,e v 4_get So Bar r- SB=Rage-ST ?a e <br /> ny - z�' s� 7 yj s� zr f CS C S <br /> CS <br /> 4 <br /> s <br /> 0 <br /> tsaued 011'2 .2„ Page 2 of 4 <br />