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gyp'rROGRAM CONSOLIDATED Fio �1 <br /> UNDERGROUND STORAGE TANK' _ <br /> OPERATOG PERMff APPLICATION-TANK INFORMATION(�N,and tXpa Ubeloa)si �0 <br /> TYPE:..ACTION (Cheek OQC item poly. For UST pe�eM cloraue or ret�val, �Y this 983 5,std Noss O N O <br /> ® 3.RgA18WAL PERMIT ❑ S.CHANGE 017 INFORMATION U <br /> 1.NEW PI11i�Ff Q 7.UST PB AL PER I CIASUIts ON SITE 8.UST REMOVAL 430b <br /> 6.TEMPORARY UST CI.OSURB 43M DATE WaSMG UST DLSCOVl3RED: <br /> DATE UST PERMANEIV CLY CLOSED. <br /> FACILITY 10 (480"oy Use Only) ' <br /> FDRUSINESSSWEUme <br /> as FACILrTY Nf► DSA-Doing <br /> - ( 1 <br /> r 103 CITY , <br /> B STPB AD RE I :•:'; : �': :": ' <br /> 434 <br /> 2 TANKMANUFACT[TRBR TANK CONFiGURATR>TV:ITIIBTANKI9 <br /> `.� 1.A STAM-ALONb TANK <br /> TANK 1D# t1`` lot �2.ONE 1N A COWARTMSNTED m <br /> SY ( . °°e roe a37 <br /> �J / - ! 4 6 BFR OF COMPARTMEKI S IN THE I7N1T <br /> TB U8T SY3'i' <br /> 495 TANK CAPAGTCY IN GAI-TANS N11M <br /> � 1"1'A1.7,.nlowv <br /> .e'�3"•`o.::P. .13 <br /> �+ 9 <br /> ❑ Ib.MA1tDaA ❑ <br /> Ia.AVIATION P11BI.n�G <br /> TANKUSE 1a W=- R VEM= ' S.EIERGENCY GENERATOR FUEL l�1253BI.5(9)1 <br /> 3.CHEMI CAL PRODUCT FMRAGT3 Q 4.HAZARDOUS WASTE(inob�s thea gall ❑ 99.OT1ffit($ ify 4440 <br /> 6.OTTIERGENE TQF FH6L.. ❑ 95.UNKNOWN <br /> CON7l3NTS PE'[ROLEUM: Ia.REGULAR UNLEADED 0 S°�F11EI E11NI BADED 0 6.AVIATION E � 440a <br /> c) 3.DIESEL <br /> 138.PETROLEUM BLEND RML 139.O'IHBR PETROLEUM S <br /> 7.USLD OIL ETHANOL <br /> HANOL <br /> NON-PEIROIUM: ; <br /> 11.OTMNON PF1rROL1'.L3M <br /> jI <br /> 1STEEL.S1NGLk WALL 2 DOUBLE WALL 9S.t11 'I 444 <br /> TYPE OF TANK 3.1 iBERGLASS 6.II4TBRNAL BI,(►D4444 <br /> DIM <br /> PRIMARY CONTAINMENT arliv❑ 7,STEEL t INTERNAL LINING13❑ 93.UNKNOWN 1399.OT= S � 445 <br /> STEEL ❑3.FBBRGLASS 6.E1<78R10R b E LII�BR 7.JACT�PBD r 445: <br /> SECONDARY CON?AINMENT 90Nt7NE ❑ 95.UNKNOWN ❑99.OTHEit ib): 454, <br /> 1.AUi>1 VISUAL pI-ARMS ❑ 2.aAi7.FLOAT 3.FILL TUBB SHUT-0FF VALVE <br /> OVERFILL pAgVEN f10N FOR gaNIPTION FROM OVERFILL ftEYEN'CiON EQU1Pl <br /> ❑ 4 MEEIB �. <br /> TANK ,• <br /> ...,. .. . • ::, . . : REO .•uC�Y:�VA�E Old::: <br /> ' <br /> PiPTNf!CONS[YtUCTTON 1.gJNGIFiWALLED Do[18L&WALLl3D OfEI� N . SAItEgUCITON,r�1CCR4a5t5( Il as <br /> SYSTEM TYPB PRMURE ❑ 2.GRAVITY 3.CONVENTIONAL SUCTiO ❑ la RIGID PL IC <br /> PRRAARY COI4'i'AINMENT -STEEL F>B�GLASS O 8.PLExl13LR 464u <br /> '❑ 9a NONE ❑ 9s.UD1LOiOWN ❑ 99-s. 13 10.RIGID PLASTIC. ' <br /> SECONDARY CONTAINMn.. STEEL <br /> p18ERGLA85 4544 <br /> u 9a NONE S.UNKNOWN 99.OTia <br /> npE 1 SnvGTE WAIL DOUBLE ) r c•t': ;, <br /> PIPING(IIJRBII�IB CONT SUMP G iTSTRUCTT(°I <br /> AA�MBN7' <br /> ar : Tr NE'.. 99.UTilfdt(Span <br /> -APE?RRECO:.,. . :: :AND�S•ER 7:F 'p�. <br /> VENT :., Y CONTAEdA4EN r p i.STEEL FIBERGLASS 1a.iut3ID PLASTIC 4f <br /> VENT SECONDARY CONTAINM>�17 i.STEEL FIBERGLASS 10.RIGID PLASPiI: 90.N 94-OTHER(Spaoity) 4644 <br /> VR pR�MAftY CO AINMBNT 1,ST>�i, <br /> 1?IDERGLASS ❑ to RIGID PLASTIC m NONE 99:oTlielt(Speai(y) 484 i <br /> 90.NONE 99. <br /> VR SO1aDARY W AII�NT <br /> 1.STt�. $ f0.IerGII"i,PI.ABII� <br /> ECtYrtlER(SI��.: a6 6�t <br /> 2-DOL78LE WALL 90.NONE <br /> P LSANBdTTON TYPE 7.SII4GLE VN t <br /> RIS1s7t PRIlbSARY coxrION S t.5T EEL 4, pLpSs ❑ 1p.RiGA1 FLasTic 90.NONE 99.tYtESBR(SpY). <br /> 9a NOTE 99.OT»R(spacifY) ` <br /> RISER SECONDARY CONTAINMENT <br /> 1.STEEL FIDflRGLpSs lo.RIGID PLASTIC 1 <br /> FiIL I.SPILLlrUCKET 3.STRI�i i,IPI.ATElBOT70M1°RA t• :;r ;'rr:S-'s''y <br /> COAIPONLN'iSIIVSTALLED - _ _ '..,,:...•.�>.-.: :', <br /> .. "• 2.DOUBI.II <br /> •:. ..' ' '• 1.SING[B WALL WALL 3.NO DIBpENSERB S96p <br /> 1a RIGID PLASTIC <br /> a:ICINID'pLOCI'rON TYPE 99,OTHER(S .:.. - <br /> 1.STEEL ry�r :5y;61 t£r;;:: <br /> CON571ktIC'RONMIATBRIAL PlBERGE,!► ••'. '%';i, �,;�''''`,`�.:.-f''. :.f': ••?•T"�: •;';'"�% a'r�"` •-,•.,.s.�'•::' <br /> {I�A01 <br /> ST>16L COMPONENT PROTWrION 102,SACRIFICIAL ANODB(S) ❑ 4•II CURRENT ❑ <br /> •. '6.1SOLATIDN <br /> �'' -.. argils Is°true.aaearate, <br /> GiaRTIFICATION:I y ST ay w9th!6e hatardot+s MbW me IWVW and Rat t"in�rasatioe <br /> and Tu11 470 <br /> APPLICANT SIGNATURE DATE / <br /> [/TrfLE <br /> APP477.471' LICANT <br /> APPLICANT NAME / '0I / �► c f' �� <br /> Rev.(1312009) <br /> UPCF UFT-B-112 <br /> ZL 'd 60:91 600Z L 2nV O16199V6OZ:xe3 IOd 30 NdA <br />