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* System Type; suction, pressure, and gravity
<br />** Construction: single -walled, double -walled, Lined -trench, etc.
<br />*** Mater al Type; steel -iron, stainless-steel, fiberglass, etc.
<br />-sectional diagram, including connections to tank and dispensers).
<br />16Y� Piping (cross
<br />V Double w�all� piping or _ Secondary containment (Trench liner, etc.)
<br />(1) Product line (Leak detector or automatic shut-off on
<br />pressurized piping).
<br />(2) Vent and vapor recovery lines if not designed to
<br />prevent the entrance of standing fluids. (Ball float valve)
<br />_ (3) Manways and other single walled pipe fittings on a
<br />_ double -walled tank, if not designed to prevent the
<br />entrance of standing fluid.
<br />!7, State Water Resources Control Board "Facility (A)" and "Tank Permit (B)" application forms submitted.
<br />!g, Z, Plan review and operating permit fees paid.
<br />� � ✓ �'�f r i"9� L' '�C- (30,41 Ri C;77 e,4 e � Ge .� Tiet% d1f�
<br />!9, Monitoring and Response Plans submitted. C 7(,l.
<br />;0, Proof of financial responsibility on file.
<br />�1, What is the approximate depth to ground water: P5
<br />(include source of information - borehole Cogs, monitoring well data, water
<br />studies, etc.)
<br />;2. Total number of tanks on site after installation: `i
<br />__��Any existing tanks to be removed or abandoned? YES C ) NO If yes, submit State Water Resources
<br />Control Board "Facility Permit (B)" application form.
<br />;4. _NjkResponsible party(ies) shall submit a •Letter of Commitment• prior to the
<br />installation of new tanks. (Applies to sites with documented soil and/or groundwater contamination)
<br />—5. _ZCounty/City Fire District and Building Department notified.
<br />— 6. REMARKS
<br />----------------------------------------------------------------------------------------------------------------------------
<br />----------------------------------------------------------------------------------------------------------------------------
<br />---------------------•----- ------ ---------
<br />Fe—
<br />;23 7
<br />INFORMATION
<br />TANK# TANK# TANK#
<br />TANK#
<br />N�
<br />t
<br />0J,TANCE from
<br />to TANK
<br />DISPENSER
<br />•MANUFACTURER
<br />SYSTEM TYPE
<br />��.
<br />CONSTRUCTION **
<br />Nd L)
<br />MATERIAL ***
<br />/B
<br />LEAK DETECTION SYSTEM
<br />100% METHANOL COMPATIBILITY with
<br />FRP
<br />%
<br />CORROSION PROTECTION
<br />* System Type; suction, pressure, and gravity
<br />** Construction: single -walled, double -walled, Lined -trench, etc.
<br />*** Mater al Type; steel -iron, stainless-steel, fiberglass, etc.
<br />-sectional diagram, including connections to tank and dispensers).
<br />16Y� Piping (cross
<br />V Double w�all� piping or _ Secondary containment (Trench liner, etc.)
<br />(1) Product line (Leak detector or automatic shut-off on
<br />pressurized piping).
<br />(2) Vent and vapor recovery lines if not designed to
<br />prevent the entrance of standing fluids. (Ball float valve)
<br />_ (3) Manways and other single walled pipe fittings on a
<br />_ double -walled tank, if not designed to prevent the
<br />entrance of standing fluid.
<br />!7, State Water Resources Control Board "Facility (A)" and "Tank Permit (B)" application forms submitted.
<br />!g, Z, Plan review and operating permit fees paid.
<br />� � ✓ �'�f r i"9� L' '�C- (30,41 Ri C;77 e,4 e � Ge .� Tiet% d1f�
<br />!9, Monitoring and Response Plans submitted. C 7(,l.
<br />;0, Proof of financial responsibility on file.
<br />�1, What is the approximate depth to ground water: P5
<br />(include source of information - borehole Cogs, monitoring well data, water
<br />studies, etc.)
<br />;2. Total number of tanks on site after installation: `i
<br />__��Any existing tanks to be removed or abandoned? YES C ) NO If yes, submit State Water Resources
<br />Control Board "Facility Permit (B)" application form.
<br />;4. _NjkResponsible party(ies) shall submit a •Letter of Commitment• prior to the
<br />installation of new tanks. (Applies to sites with documented soil and/or groundwater contamination)
<br />—5. _ZCounty/City Fire District and Building Department notified.
<br />— 6. REMARKS
<br />----------------------------------------------------------------------------------------------------------------------------
<br />----------------------------------------------------------------------------------------------------------------------------
<br />---------------------•----- ------ ---------
<br />Fe—
<br />;23 7
<br />
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