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INITIAL SERVICE DATE <br />Construction Date:Last Repair/Reconstruction Date: <br />Last Change of Product Date: <br />Design: Other Unknown <br />Construction: <br />CRDM: <br />AST Category: <br />OWNER'S TANK ID OTHER ID INITIAL SERVICE DATE <br />Contents:Construction Dale:Manufacturer:Last Repair/Reconstruction Date: <br />Last Change of Product Date:Dimensions:Capacity: <br /> Other UnknownDesign: <br />Construction: <br />AST Category: Category 1 Category 2 Category 3 <br />49 | F' <br /> Bare Steel <br /> Coated Steel <br /> Double-Bottom <br /> UL <br /> Horizontal <br /> Bare Steel <br />I^Coated Steel <br /> Double-Bottom <br />CRDM: Dyes Ono <br />If yes, type: Release Prevention Barrier Elevated tank Double bottom tank <br /> Double wall tank CE-AST □other <br />yes no <br />If yes, type: <br />OTHER ID <br />Category 1 Category? Category 3 <br />Dimensions:___________ <br />$UL--------- <br /> Horizontal <br />Release Prevention Barrier Elevated tank Double bottom tank <br /> Double wall tank CE-AST other <br />Spill control: Earthen Dike Steel Dike Concrete <br /> None Other <br />OWNER’S TANK ID^tCO ( <br />Manufacturer: <br /> API <br /> Rectangular <br /> Cathodically Protected (Check one: A. Galvanic or B. Impressed Current) Date Installed: <br /> Concrete encased steel Stainless steel Other <br />1^.Double-Wall □ Lined inside: Date lining Installed: <br />^Concrete <br /> SwRI API <br /> Vertical Rectangular <br /> Cathodically Protected (Check one: A. Galvanic or B. Impressed Current) Date Installed: <br /> Concrete encased steel Stainless steel Other <br /> Double-Wall Lined Inside; Date lining installed: <br />Tank elevated on supports yes no <br />Support material: steel concrete other <br />Release Prevention Barrier: yes no If yes, Date Installed: <br />If yes, Type: concrete synthetic liner clay liner steel other <br />Spill control: Earthen Dike Steel Dike <br />____________ None Other <br />Tank elevated on supports Dyes ^no <br />Support material: steel concrete other <br />Release Prevention Barrier: f^yes □ no If yes. Date Installed:_______ <br />If yes. Type: ^concrete □ synthetic liner Delay liner □ steel □other <br />■1. ireri ri\\ <br />jYOtS______Contents: _ <br />_____________Capacity/^Q) <br /> SwRI <br /> Vertical