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IRW • UNIFIED PROGRAM CONSOLIDATED FO G lGI u�N 8�� TANKS PS�li UNDERGROUND STORAGE TANKS - TAN PAGE 1 (Two pages per tank) Page_of TYPE OF ACTION ❑ I.NEW PERMIT ❑ 4.AMENDED PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY TANK CLOSURE 430. (Checkooeimmanly) ® 3.RENEWAL PERMIT ❑ 7.PERMANENTLY CLOSED ON SITE (Specify reason) (Specify reason) ❑ 8.TANK REMOVED BUSINESS NAM E(Same,as FACILITY NAME or ORA-Doing Business As) 3, FACILITY ID: Ryder Transportation Services#1071 LOCATION WITHIN SITE(Optional) 431. 3633 Duck Creek Drive I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID#/ 432. TANK MANUFACTURER 433, COMPARTMENTALIZED TANK []Yes ® No 434. 4 it.� Trasco If"Yes,"complete one page for each compartment. DATE INSTALLED 435. TANK CAPACITY IN GALLONS 436NUMBER OF COMPARTMENTS 437 (YEAR/MO) 10/31/1990 4,000 ADDITIONAL DESCRIPTION(For local roe only) 439. II.TANK CONTENTS TANK USE 439. PETROLEUM TYPE 440. ❑ 1. MOTOR VEHICLE FUEL ❑la. REGULAR UNLEADED [12. LEADED ❑S. JET FUEL [\evJ (if choked,complete Petroleum Type) ❑Ib. PREMIUM UNLEADED [13. DIESEL ❑6. AVIATION GAS bT � / Al2. NON-FUEL PETROLEUM ❑to. MIDGRADE UNLEADED El 4. GASOHOL 99.OTHER: MD6 R D /L ❑ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials lnwMory page) 441' CAS#(from Hazardous Materiels Inventory page) 442' AM4. HAZARDOUS WASTE Motor Oil Includes Used Oil) ❑ 95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑I. SINGLE WALL ❑3. SINGLE WALL WITH EXTERIOR ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443. (Check one item only) MEMBRANE LINER [195. UNKNOWN ®2. DOUBLE WALL ❑4. SINGLE WALL IN A VAULT ❑99. OTHER TANK MATERIAL-primary tank ❑1. BARE STEEL ®3. FIBERGLASS/PLASTIC 05. CONCRETE 095.UNKNOWN 444. (Check one item only) ❑2. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE ❑99.OTHER: REINFORCED PLASTIC FRP W/100%METHANOL TANK MATERIAL-secondary tank [11. BARE STEEL ®3. FIBERGLASS/PLASTIC ❑8. FRP COMPTIBLE W/100%METHANOL ❑95.UNKNOWN 445. (Check one item only) ❑2. STAINLESS STEEL [14. STEEL CLAD W/FIBERGLASS ❑9. FRP NON-CORRODABLE JACKET ❑99.OTHER REINFORCED PLASTIC(FRP) [110. COATED STEEL ❑5. CONCRETE TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING [15.GLASS LINING [195.UNKNOWN 446, DATE INSTALLED 447. OR COATING ❑2.ALKYD LINING [14.PHENOLIC LINING ❑6.UNLINED ❑99.OTHER Check one item only) OTHER CORROSION [11.MANUFACTURED CATHODIC ®3.FIBERGLASS REINFORCED PLASTIC ❑95.UNKNOWN 449. DATE INSTALLED 449. PROTECTION PROTECTION ❑4.IMPRESSED CURRENT [199.OTHER fA licable ❑2.SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED 450. TYPE 451. OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452. (Check all Haat apply) ®1.SPILL CONTAINMENT _1990 ®1.ALARM ❑3.FILL TUBE SHUT OFF VALVE ❑2.DROP TUBE [12.BALL FLOAT ❑4.EXEMPT ❑3.STRIKER PLATE W.TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK 453. IF DOUBLE WALL TANK OR TANK WITH BLADDER 454. (Check all that apply) (Check one item only) ❑ 1. VISUAL(EXPOSED PORTION ONLY) ❑5.MANUAL TANK GAUGING(MTG) ❑1.VISUAL(SINGLE WALL IN VAULT ONLY) ❑2. AUTOMATIC TANK GAUGING(ATG) ❑6.VADOSE ZONE 19 2.CONTINUOUS INTERSTITIAL MONITORING ❑3. CONTINUOUS ATG ❑7.GROUNDWATER ❑3.MANUAL MONITORING ❑4. STATISTICAL INVENTORY RECONCILIATION ❑8.TANK TESTING (SIR)+BIENNIAL TANK TESTING 099.OTHER V.TANK CLOSURE INFORMATION/ PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455' ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456' TANK FILLED WITH INERT MATERIAL? 457. gallons ❑Yes [3 No UPCF hwfwrc-b(1/99)-1/4 www.unldoCLorg Rev.02/16/00