Laserfiche WebLink
UNIFIED PROGRAM CONSOLIDATED FORM <br />TANKS <br />UNDERGROUND STORAGE TANKS -TANK PAGE 1 . <br />fAt9 Pages Y.r bnk; <br />TYPE Of ACTION ❑ 1. NEN SITE PERMIT ❑ 4. AMENDED PERMIT <br />(CMck ew Rem arty) <br />❑ 2. RENEWAL PERMIT (SPvrymaonkneu: uw anry) <br />❑ S. CHANGE Of INFORMATION) <br />IsF 4 W.,, • krkcal ver any) <br />❑ S. TEMPORARY SITE CLOSURE <br />❑ 7. PERMANENTLYCLOSEO ON SITE <br />G B. TANK REMOVED 4W <br />BUSINESS NAME(Samr a FAbLITY NAME w OBA -OIiN buaiaw M) <br />FACILITY IDR <br />L #Ato C eJ � �►� <br />l�z�� <br />�...•.+� <br />LOCATIOM WM1TXIN SI.E :4an47 <br />2 V <br />L <br />cad <br />66 CC a <br />I. TANK DESCRIPTION <br />AN IDR <br />ANK MANU A U EA L <br />COMPARTMENTAUZEDTANK [3 Y., ❑ Na <br />ice, a, N /J (?? / <br />4 Yn'. wmpb:a one pap ler pN mmpaaent <br />DATE INSTALL (YEA Ol� <br />TANK PA ITY W WLLON <br />NUMBER OF COMPNRTAI N <br />/� C.) C) v <br />ADOITIONALDESCRIPT (Far lucsl wa any) <br />' 9.TANK CONTENTS <br />y{�--,� TANK USE 422 <br />PETROLEUM TYPE <br />❑ 1A REGULAR UNLEADED <br />O 2. LEADED <br />❑ S. JET FUEL <br />l6j46MOTOA VEHICLE FUEL <br />( nMM14F.pRmpNh Pr'ueHvm Typo <br />0 l PREMIUM UNLEADED <br />❑ 3. DIESEL <br />0 S. AVIATIONFUEL <br />Q 2. NON -FUEL PETROLEUM <br />to IDGIUOE UNLEADEO <br />❑ A. GASOHOL <br />❑99. OTHER <br />❑ 5. CHE"CALPRDWCT <br />COMMON MANE fkam Ha[ankm MafMsh lannforypaprJ <br />CASAfk HAaerJoua M4lMeA lmnngryfeGel <br />G A. HAZARDOUS WASTE jfneIW11 <br />/aJO� <br />UuR OR <br />v <br />ZP III. TA NK CONSTRUCTION <br />TYPE OF TANK ❑ 1. SINGLE WALL ❑ 2. SINGLE WALL WTH ❑ S. SINGLE WALL WITH INTERNAL BLADDER SYSTEM <br />q� EXTERIOR MEMBRANE LINER 0 95. UNKNG'AN <br />(CAeek a Rrm ANY) Ny_y„DOUSLE WALL <br />v.'• Q A. SINGLE WALL INAVAULTE3 99. OTHER <br />TANK MATERIAL • prnMry Mak BARE STEEL 2.0. FIBERGLASS 1 PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN <br />}❑ <br />(CArck -ilrin oMO 0 2. STUNLESSSTEEL (k.D STEEL CUD WFISERGLASS [1S, FRP COMPATIBLE W1100% METHANOL 099. OTHER. <br />111 ,0...PLASTIC IFRP) <br />_ <br />TANK MATERIAL• Arwrmary Wk O 1. BARE STEEL ❑ 5 FISERGLA33 f PLASTIC ❑ a. FPP COMPATIBLE W.'100%METHANOL 0 i V!IKNO'AN <br />(Cnrak w Run PWY) ❑ 2. STAINLESS STEEL ❑ A STEEL CLAD WbFISENGLASS ❑ 9. FRP MON40RROOIDLE JACKET 019. OTHER <br />REINFORCED PLASTIC (FRP) ❑ 10 COATED STEEL <br />❑ S. CONCRETE <br />TANK INTERIOR LININGDATE WSTALLEO <br />1. RUBBER LINED ❑ 5. £POKY LINING ❑ S. GU5541NING 095. UNKNO`ANgO <br />OR COATING0 <br />❑ 2. ALKYD LINING ❑ 4. PHENOLIC LINING ❑ B. UNLINED E3 99. OTHER Fmkeal eFa pn") <br />CArek 0.0.r w) DATE INSTALLED <br />095. UNKNOWN 6N <br />OTHER, CORROSION ❑ 1. MANUPACTUREOCATHOW. FIBERGLASS REINFORCED PLASTIC <br />PROTECTION IF APPUCABIE PROTECTION 04. IMPRESSED CURRENT ❑99. OTHER (forkza/var aroyl <br />(C%Fk anF Rrm aMA ❑ 2. SACRIFICIALAHODE <br />SPILL AND OVERFILL <br />YEAR INSTALLED TYPE ffrrMW vee .W <br />OVERFILL PROTECTION ECUIPMENT: YEAR INSTALLED <br />(Ch.* afAN aPM9 <br />❑ 1. SPILLCONTAINMENT <br />❑ 1. ALARM __ ❑ S. FILL TUSE SHUT OFF VANE <br />2. DROP TUBE <br />❑ 2. BALL FLOAT _ ❑ 4 EXEMPT <br />❑ 1. STRIKER PLATE <br />- N. TANK LEAK DETECTION'' <br />V SINGLE WALT. TANK k FR Naga <br />V DOUBLE WALL TANK OR TANK WITH SLAb0E0. CAFCk anI RIm an <br />❑ 1. VISUAL MKPOSED PORTION ONLY) ❑ S. MANUAL TANK GAUGING(MTGI VISUAL (SINGLE WALLIN VAULT ONLY) <br />,F❑��1. <br />❑ 7. AUTOMATIC TANK GAUGING pTG7 ❑ S. VAD05e ZCNE yyy CCMINWUS INTER59TNL MONITtlRI,vG ' <br />❑ S. CONTINUOUSATO - (37. GROUNDWATER LT•J S. MANUALMONITORING <br />❑ 4. STATISTICAL WV!KORY RECONCILIATION (SIR) ❑ a. TANK TESTING <br />BIENNIAL TANK TESTING 099. OTHER <br />V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE <br />ESTIMATED DATEUSTUS ESTIMATED QUANTITY OF SUBSTANCE REMAINING 423 TANK FILLEOWITX INERT MATERIAL7 <br />AMOna 0Yek ON. <br />1 <br />