Laserfiche WebLink
UNIFIBD PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> OPERATING PERPE T APPLICA'T'ION-TANK INFORMATION(chic ram,per usT) <br /> TYPO OF ACI70N (Chtkaoa iWm a*. Far as U33 peaolsam alaslry ar«moval,a mpleta only ft section and Sections L U.IQ.Iv,and IX below) 410 <br /> Q I.NEW PERMIT Q 3.RENEWAL PERMIT ® $.CHANGE OF INFORMATION <br /> 6.TEMPORARY LIST CWSURB n 7.UST PERMANENT CLOSURB ON SITS S.UST REMOVAL <br /> DATE NIST PERMANENTLY CLOUD. 43041 DATE EXISTIN4 UST DISCOVERED: 434 <br /> I. F'ACE,ITX INFORMATION <br /> FAaL TY LD!(derecy um o*) _ r <br /> BUSINESS NAME(Sams m FACILTPYNAME er MA-Doft 9nsfams Aa) <br /> pteft BMT dba AT&T CaMxr& UEW12 <br /> BUSWW SrMADDRW CITY 164 <br /> 343 Narlh Sew hmpiff Sheet Stooicmrl <br /> IL TANK DZSCREMON <br /> TAMC ID E 4n TANK MANUFACTfIREit 41) TAt4ICCONF100RATION,THIS TAMC O 4m <br /> VE042L=1 MCK)ERNWLD ®A.ASTAND-ALUIB'TANK <br /> 132.OWE EN A COMPAtTa MM UNIT. <br /> M rw In Talk. <br /> DA USl'SYSTT,M INSTALLED 475 TANK CAPACITY IN GALLONS 4 NUMBER OF COMPARTMENTS IN HE UNIT 437 <br /> 1903 250M I <br /> HL'TANK USE AND CONTENTS <br /> TANK USB 0 IL MOTtb!VEHKIB FIffi.IIIG © Ib.MAR IA FUEL N0 0 Ia.AVIATION FUBLW 419 <br /> 0 3.CddWAMI.PROMICE STORAGE ❑4.111AlARDOOB WASTR OW66.U-ML) ® S.Em=ENCY OEN6RATOL FUEL itw pusr.s(c)I <br /> 0 6.OTMER OENDLAWK FOIE. 0 9S.uNKmmm ❑99.Oym pori • 4». <br /> CONTE M PHTROLNM Q IL REDUNARNB98ADED 0 la kQDORAD6 UNLEADED Q 1I4 PREIMM UNLEADED 446 <br /> ®3 DMUL 0 3.IST PUI L 0 6.AVIATION GAS <br /> S 1!8771OL8UIM EN END FUEL 9.OTTNER PErROLBUW 440. <br /> NON-PETRONB[At: 7.VBBD ONL 10.1T1IMMO <br /> Il.OTHER NON�E7AOL1Ii11�{ 440b <br /> IV. TANK CONSTRUCTION <br /> oFTANK E3 LXNGLB WALL W z DOUBLII WALL 0 9S.UNKNOWN 441 <br /> PRI)AARY CONtTAROOK N I.STEEL u 3.FIBERGLASS ft.INTERIM B1.AD111>jl 444 <br /> 7.SrIML+2TTHINAL,LOOM 9S.UNKWIWN99.071IER 444' <br /> SBCONDARY CONTAUDAWr L STEM 3.t Lsa 6.mmm10R MOMEANE U NER 0 7.TACKL f g5 415 <br /> so.NONE "- NS t$ mW <br /> 0199.QTl�ll 445. <br /> OVERFILL PREVENTION L AUDIBLE! ALAA2 HALT.FE OAT 3.P[L.LTIIOB SLiVF�1FF VALVE 4" <br /> 04.TANIGNEfb I=VOROTIOU FILM OVWtF1LLMEV6KIION <br /> V. PRODUCT/WASTE PIPING CONSTRUCTION <br /> MM oOelSnUl MC N E3 1.SUNOrsWAUM W 2.0011I1e-WAUZZ) !9.07I�R 40 <br /> 9YSTIIN TYPE L FRESSURB l ONtAYTfY 3.CONV®TTL MAL SUCTION( 4.3AFH SUCTION cCa 454 <br /> FIbtARYCOKFANDAEff t.STEEL, 4 L9UiNVZSS S 1?[.6iCIHLE lO.RIGIDPLASI7C 4w <br /> 90.140NR 0 W.UNKNOWN ❑s9. 46e6 <br /> 81100tDART OOHTAINLONTT 1.S77IEL E3 4,PLHHROLAW 0 S.mmam 0 la.RIGID PLASTIC 4" <br /> 13 40.14M 93.IAiDIOWN Q 99 O71111R 464a <br /> rrgK/ftatH m COKEA�TT Sm4pT PE 1.SNIaO181vAU 1.DDUBIA WALL 0 90.NONE 46" <br /> VL VENT,VAPOR RECOVERY AND WSW I=J4 PIPE PIPING CONSTRUCTION <br /> VINT 1412dARY OOMTA2110NT 0 i.STEEL 4 IQ WW PLA3TIC Cl 901M 99.01TIER(SP-i W 464* <br /> 464e1 <br /> vWr SICONDARY CONTAD44INT E3 J.MHS u 4.rmmoLAst 12 I0 00.NONE 9a.ORt4ER(spemry) 461 <br /> VRINKMARY AII ANT El 1.S78B1 E3 tP[LIRRO mBW1DA.AS= N so.NOMB 13 99.On=4 ftM 464 <br /> "91LL <br /> YKNEXIMARYCONTANOWIT 131.57881. 4.FMBROLASS 10.RR)IDNASTIC ".NONE 0 99.01LIER(Spwfy) 464 <br /> 46111 <br /> PTPIl10 1. WATt1771 1.OOUBLA WALL 0 ".NONE <br /> NITSIIR PRIIAARY CONTA14dPIT 0 I.STRIL U 4.9L310.MIDYL.AWM U 90.NONE 99.0771ER fSpuft) 46N <br /> B1S19t SBCONOART OONTAA4aff 1.fnmL IA 4.MEROLA63 Q 10.R 90_NON@ U 99.0'HEK(Sp-ry) 46* <br /> 46441 <br /> ML COMPONEM INSTALL® 3.LVILMW 1113.mum R ATSMOTTOM PROTECTOR 11 4.COWALNMGNT S11MP 451; <br /> VII.UNDER DISPENSER CONTAINMENT(U <br /> TYPE Q 1.l WALL 7.DOUBLE WALL ® 1.NODNSIWaERS 090.MOND 4f% <br /> cmamu nm MATERIAL 11.1{7HlR 4.Fl[!NalOL ASS Ia RE1fD PLASM 99.OTiE7L 46%- <br /> ` <br /> VIIL CORROSION PROTECTION <br /> STt9h7.00iavNoffPROTBCEM ❑2.$AQ<WLCIAL ANOOH(S) 0 4.DA92 W CURRENT ® 6.ISOLATION 44s' <br /> IX, AP CANT SIGNATURE <br /> CZJff FICATWN:L tcrft flat/h4 srhslaaea stored mad that the Into}mulcted herelo I$tree,aeewsie, <br /> and III RA <br /> 4'10. <br /> APPLICANT SR3KATUR8 DATE <br /> 1002009 <br /> Steven J Hall Mans , EH&S <br />