|
i
<br /> mr,, � m
<br /> m
<br /> t= A,T R SQURC S .CQNTRQ BDA.9_D'.. . 10/04/85
<br /> ,
<br /> PAGE 1q ST k�. ,. R
<br /> { S _ '; . OR N " 1GAQU N, GgUNTY
<br /> FIAAD1, �1,1TANCf6 STORAGE GgrT'AINR t? INS MiIgN. qRA
<br /> r MF
<br /> t FARM MOTt�R VEHICLE FUEL TANKS, 9-ALL t)1 HER `f'ROD,UGT TANKS , 3=t�ASTE TAN} ► �+=SUMOS , 5=PITSt PONDSP LAGOONS ?� OTHERS)
<br /> rr ,�-lna�,r}, ran
<br /> � �r
<br /> , rl�;&��s„ ,�� ,
<br /> Pt (4 1)� SULAEN SCkCE)0L ;
<br /> 00 S KQST TRAC`C GA 5 76
<br /> I«,I FACILITY
<br /> MA L NG At?i�R �aS DEALER/FOREMAN/SUPERVISOR TYPE OF BUSINESS
<br /> r
<br /> _QF CONXAINERS,
<br /> W ERSULAEM CH,OOL- O N . IP/RA . 377
<br /> _ „n
<br /> ,S KO
<br /> ST
<br /> " TRAC�.Y CA" �37tz a14Qt� ` S . K.OST ,
<br /> L ; Y G A ,.... :5_ ..7
<br /> BRAG
<br /> R �TRr m5--gr;
<br /> ! III 24��IR .. CUNT GT Ppp� qN= T!"LEPHONE
<br /> masstr '„1,
<br /> l rr. m
<br /> (2 0"T $, _5—x.57 NIGHT :] SAt�f )
<br /> OWNER R ASSIGNCLI CONTAINER Nt1M[3E 1 � `� � ?� STA I"[: 10,1 R 0 rase ISN} I) CONTAINER ID NlJME3FR $ ()QOtSI1QCt93'3a(�Ql
<br /> �,C T QN
<br /> IV DES xRIP I _
<br /> A m.,rvfUNTAINER 'TYE�E
<br /> s TANK E . REPATR NONE _�� YES WHEN
<br /> r.. r ( i �, d f" '� C i d�
<br /> J
<br /> I3 { MANUFACTURER/YR OF MFG « P E R K 1 1; /19.75 m Cl�l: Pv � t.. 1 ��,tiL. L, YES IF hyf..l s YEAR OF LAST L);:�F »
<br /> C � YEAR IN�TA� 1915 OUCi" _
<br /> „ ,,,n,,
<br /> v t> 4 R�R
<br /> }) � `CAPACITY (GALLONS)' 5C? �t I01 k VI' [II dt_t: FUEL/WASTE OIL s YES CONTAINS REGULAR
<br /> TS COr1 "A1NCR,; 1 0CATE}) .GN A FARM H0 ��R>
<br /> V CONTAINER coNsrRUCT'.T0N
<br /> A , C.F , �� y .« L �At1„LTI,NG NON—Y.AULTF,U Gm 4�ffaLLlr�.�� � .�GI E _
<br /> N ,h ...,,.
<br /> }) mMATE RIAL CAR1gN STEEL
<br /> R ,LINING QINLINEi
<br /> mi « WR'�APPING UNKN0WN
<br /> ,,„ x„.. �,.,, ..., m .,.,:rm•,...,y,: ,>,n, ., , .,,_..
<br /> o rs �j
<br /> 1 t
<br /> t
<br /> M.
<br /> r
<br /> c z hk
<br /> m
<br /> 1
<br /> rte I P I N .�
<br /> C« a RER'AIRS NONE IF YES : `tFAf OF MO
<br /> 5T RECENT REPAIR :
<br /> DPTFC I
<br /> Wa\4
<br /> n�.'.1,�'a,
<br /> .,,.. wi^�'am!�4�. Jn.
<br /> 1
<br /> Ir.IN O SE1}3,� iANCC.� (°1JRRC.NTt_Y STOI.EC) IN CONTAI��C
<br /> R() Rt CaU} AR° h10T0R VEH LE FUEL
<br /> , i
<br /> w« u�
<br /> q is
<br /> Y,.
<br /> w
<br /> Y
<br /> p{,, ::�kA'.`.dxn n1p f fi,Su.u,i:G'.,..., w'M�+ ,n,',kaot x,w,w,mrMnfn far, �,dq+m a,µ/],,. Fuaia, +w x . +««,x w r•+ ,1 u,.
<br /> r
<br /> 3
<br /> 4
<br /> ,
<br /> :
<br /> Y f
<br /> ., ..,.... ,...,,,
<br /> t
<br /> mm
<br /> r
<br /> r-
<br /> ,
<br /> I ,
<br /> ,
<br /> plt4 111( I a 3
<br /> 1
<br /> ,:,.:. ....,,,,....ten rr '•x..- .'!":* ,:.:.:. .;.:
<br /> ”
<br /> �P,AGE IE)F,t STATE WATER RCSOURCES CONTROL
<br /> �3C)ARO
<br /> HAZARDOUS SUBSTANCE STORAGE CONTAINER INFORMATION FOR 1N ,�€:gA(�1.17 �� ��C?I,��ITY
<br /> ( 1 FARM MOTOR VEHICLE FUEL TANKS : 2-Al. l. OTIIEK PRODUCT TANKS , 3=FAST} T/tPal�Sr 4=SUMI�S, a=PITSx PON}��a, LAGOL7NS �' OTHERS )
<br /> STr TE B0AR0 A
<br /> ? aha OWNER ASSIGNED CONTAINER NUMBER :_:, .. 5.. „ . . ..... ... .. .....I.N, . . „I.,i U
<br /> s IV + DES RIPTIgN
<br /> s, ,,, „O hd,1 A: t�f R;;. T Y, _, :, .: T,A N K.,� „ _..,;. „ ,,.., _, N: _, E.,_.. �P A., E. .,... ,,,, ,,,._
<br /> Nq,NE . IF .YEa WHEN
<br /> Ram C1ANUFAt�TQRER/YR OF MFG. PERKINS /I981 F . E URRENTLY USED YES IF NCI, YEAR OF LAST USC =
<br /> Ce YEAR INSTALLED 181 G . STORES PRODUCT
<br /> _ H . MOTOR VEH CLE FU L/tdAST L m NO..
<br /> U . CAPA TY tALLONS) m x ()04u,._ _,m,�.. „ T C: . .
<br /> 1` I
<br /> IS 'Ct1Pd"TAINER' V.,OCATED ON A FARM NO
<br /> V CONTAINER .CONSTRUCTION
<br /> A . T'�IICRCNESS`� 1"p '' GAUGE B VAULTING ( NON—VAULTED C . WALLING STNGRmE
<br /> MATERIAL' s C IR13QN `STEEL „ ,,, ..
<br /> UAT. ,.
<br /> C . LINING �' UNLINED
<br /> F # aRAPP>INE1 t UNKNOWN.
<br /> VI PIPING
<br /> A , AOOVEGROOND PIPING B. UNDERGROUND PIPING I SUCTION
<br /> r R A, _ +
<br /> C. REPAIRS e NONE IF `SES YEAR OF MOST RECENT EP IR
<br /> A M, m ...
<br /> VIIiLARC DCTECTIUN "
<br /> �TgCK IP�VCNT.CIRY
<br /> VIII CHEMICAL CCIHPOSITION OF SUBSTANCES CURRENTLY STORED IN CONTAINER
<br /> NONE
<br /> i
<br /> i
<br /> „ . _..
<br /> r
<br /> ti
<br /> .... ... . ..... „ ..,.,,
<br /> 777777777
<br /> 7,,. ,.-:,. , ,x> <,.r..,,.: ., .,; "., xx�s;gpe,.r:�r,aYc\S„'k aFr"f� ooa!$rr`i�fa�+f�Ai .wF.. ,...n�...a4aaf.4r�w;a,u,,.k..,,....;.yc«, Fa•m.m.:x`�u*.`Mae,xw^sa Rirs et,.. _...,_„�_�s.w,•.,.K cr.. ,ukq'' nR9..G1„ a,.m,,,ad.Mia`•"aA,.r,dr•r .,,;,
<br /> 7
<br />
|