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01/08/2004 08:23 209468 FIFTH FLOOR PAGE '9 gg ®u - 31 UNIFIED PROCRA,M CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS-TANK PAGE I (Two pages p.er tack) TYPE OF ACTION 1,NEW PERMIT ❑ a.AMENDED PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY TANK CL ISU RE 4.10. (Check one item only) ❑ 3.RENEWAL PERMIT ❑ 7.PERMANENTLY CLOSED ON SITE (specifyrenxon) (Sbacifyreawn) ❑ 9.TANKREMOVI-D BUSINESS NAME(Same W FACILITY NAMG wDBA-Doingltwinese As) 3. 1 FACILITY ID: ji""�lj (,r,AS 5TA,T1 0 t LOCATION WITHIN SITE(Opt!.. 4.-1 a 'P i I io1 1 '1 11 r III i 1 -� (❑ t,��1 1 ' ''.Y�k�L�WDESCRjl' I 111 A''sc�kdplotpla>cl:.wlLkitkl4,lacaLionoftFieU�uTsystoiil.includin �ut(dings'Audlandm�rks�ShalCbc'sabffiitt�dtotllcl00sl,agency) TANK ID/,. n 432- TANK MANUFACTURER 'U3• COMPARTMENTALIZED TANK LJ Yes NO Baa. V X E R'x-.S If'IYri,"cor plete one page ibr=1 compnnmem. DATE INSTALLED 435• TANK CAPACITY 1N GALLONS 436• NUMBER Of COMPARTMENTS 417 (YEAR/MO) AFFX 05- 2-00 7-0/ 000 ! - ADDITIONAL DESCRIPTION Gar local oso only) 431• 'I AI�EIC'coNTETFTs sl ;.1 ( - TANK USE 43% PETROLEUM TYPE 443. X1. MOTOR VEHICLE FUEL pg Ia.RBGULARUNLEADED ❑2. LEADED d 5. JET runQfahecked,complete Petrole im Typc) r0 lb.PREMIUM UNLEADED ❑3. DIESEL ❑6, AVWfLON 43AS ❑ 2. NON-FUELPETROLEUM ❑Ic, MIDGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER: ❑ 3. CHEMICAL PRODUCT COMMON NAME(from H=&.Materials Inventory page) 441, CASA(from Hsmtdoas Materials Eavectoryloge) ❑ 4. I'IA2ARDOUS AVASTE (Inelada Used Oil) ❑ 95.UNKNOWN ' l 61 A TYPE OF TANK ❑1. SINGLE WALL 0 3, SINGLE WALL WITH EXTERIOR ❑5. SINGLE WALL WITH INTERNAL BLADDER SY STEM 44=- (Check ow item only) MEMBRANE LINER ❑95. UNKNOWN Z.DOUBLE WALL ❑4. SINGLE WALL INA VAULT ❑99. OTNL•R. _ TANK IMATERL9L-prunoryrank _BARE STEEL 3.FIBERGLASS/PLASTIC D 5, CONCRETE ----595 UNKNOWIN 4a (Geek one item Bal) ❑2. STAINLESS STEEL ❑4_ STEEL CLAD WIFIBERGLASS ❑S. FRP COMPATI,BL1i ❑99.OTHER, REINFORCED PLASTIC P) W1100%METHANOL TANK MATERIAL-seconutary Mnk 1,BARE STEEL W. FIBERGLASS 1 PLASTIC ❑S. FRP COMPTIBLE W/100%METHANOL ❑95.UNKNOWN 44:7 (Check one item only) ❑2. STAINLESS STEEL❑4. STEEL CLAD W/FIBERGLASS ❑9.FRP NON.CORRODABLE JACKET 1]99.OTIdER _ REINFORCED PLASTIC(FRP) ❑10. COATED STEEL 5. CONCRETE TANK INTERIOR LINING ❑1.RUBBER LINED 3.EPDXY LINING El S.GLASS LINING 0 95.UNKNOWN 446. DATE INSTALLED 447 OR COAT 140. ❑2.ALKYD LINING ❑4.PHENOLIC LINING ❑6.UNLINED ❑99.OTHER Checkon ircm ant - OTHER CORROSION 0 I.MANUFACTURED CATHODIC ❑3.FIBERGLASS REINFORCED PLA$TIC ❑95,UNKNOWN 44,,1. DATE NSTPJ.LED 4sl PROTECTION PROTECTION ❑d.IMPRESSED CURRENT ❑99.OTHER (If A film 1c) ❑2..SACRIFICIAL ANODE - SPILL AND OVERFILL YEARINSTALLED 4sa TYPE 43t, O RFILL PROTECTION EQUIPMENT; YEAR INST1ILLED 42 (Check all that apply) L SPILL CONTAINMENTZ 1.ALARM =❑3,FILL TUBE SHUT OFF VALVE.__ 2.DROP TUBE 2.BALL 4.EXEMPT 19 3 STRIKER.17LATV a(A'descei 11atl;olseh>"monitarin . ror irks&all;besabtnt3;w'tha:lacaEageac .�. IF SINGLE WALL TANK ' IF DOUBLE WALL TANK OR TANK WITH BL DER 45' (Check all that apply) (Check one item wily) ❑1.VISUAL(EXPOSED PORTION ONLY) ❑S.MANUAL TANK GAUGING(MTO) ❑1.VISUAL(SINGLE WALL IN VAULT ONLY) ®2,AUTOMATIC TANK GAUGING(ATG) ❑6.VADOSE ZONE ❑2.CONTINUOUS INTERSTITIAL MONITORING ❑3.CONTINUOUS ATG ❑7.GROUNDWATER 3.MANUAL MONITORING ❑4.STATISTICAL NVFNTORYRECONCILIATION [18,TANK TESTING (SIR)-BIEINNIAL TANK TESTING yam❑99.OTHER 1�1TC'IX.QSO,R�i,�IIV'�t?'LiAIC> �::1. ..{.....�� '.....111,,.�.... i.i„� .. �.,...��,. �.- ...�l ,.. . r„�.r.r:�� .. 1..... ..:.��•„�, , ..� :', 1 . .� ,rr,r .11 ,.." ..'.I�� ESTIMATED DATE LAST USED(YR/MO/DAV) 455• ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456' TANK FILLED WITH INERT MATERIAL? 451 1 ga))otls D Yet ❑No UPCF h%fwrc-b(1/99)-114 httpt/hvww.unidocs.org Rev.02/16100