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`LIN IF]EDPROGRAMCOOLIDATEDFO <br /> NS �. TANKS <br /> UNDERGROUND STORAGE TANKS-TANK PAGE i Mo pM9,s Pe;tarx, <br /> Page <br /> _ 41 <br /> ❑ B.TEMPORARY SITE CLOSURE <br /> TYPE OF ACTION 1.NEWSITE PERMIT LAMENOEO PERMIT E] S.CHANGE OF INFORMATION) 8. <br /> T PERMANENTLY CLOSED ON SITE <br /> (LIIKkOM ifam ONN 77 <br /> O 9.RENEWAL PERMIT rsgoly a>aan-brlwluae aNYl (SpecRycMyrAarfaW°+..NYI ❑ /,TANK REMOVED 130 <br /> FACNTY ID/ { <br /> BUSINESS NAME(Same as FACILITY NE a Doi <br /> OBA- rp B`I'MI+a N) <br /> AM ±' <br /> LOCATION W1THM SITE(OPeonap <br /> a1 <br /> L TANK DESCRIPTION FWp <br /> TANK MANUFACTURER e f"�^� LOMPARTMEHiIt ' lab we p+qa <br /> 2ETANKfor aaNswm❑ int <br /> TANK 10Y - /e 1m �^ ry(�LaM <br /> 'SP-05v50 C L ^ d <br /> TANK CAPACITY IN GALLONS NUMBER OF COMPARTMENTS <br /> RATE INSTALLED(YEAP/MO) <br /> ADDITIONAL DESCRIPTION(Forlx>I.+a nM'1 <br /> . R.TANK CONTENTS <br /> TANK USE 433 PETROLEVMTYPE _ ❑ S. JET FUEL <br /> Al . REGULAR UNLEADED ❑ 2 LEADED <br /> K� 1.MOTOR VEHICLE FUEL /�' ❑ B. AVIATION FUEL <br /> (Y neC.oaWeu Rfmlam Typ) A10. PREMUM UNLEADED �]. GEBEL 099. OTHER <br /> ❑ 2. NON-FUELPETROLEUM O 1c MIOGRADE UNLEADED O 4. GASOHOL <br /> GS/Qlam NaaN4aa Mafenal+lnwnfarypa4e) <br /> O 0. CHEMICAL PRODUCT COMMON NAME(A9m H]t.N4ai M>ten>la M""m Peg) <br /> O 4.HATAROOUS WASTE ryaHall+ <br /> U+M On <br /> 17195 uss III.TANK CONSTRUCTION <br /> TYPE OF TANK ❑ L SINGLE WALL ❑ 1 SINGLE WALL WITH Cl 1. SINGLE WALL WITH INTERNAL BUDDER SYSTEM <br /> EXTERIOR MEMBRANE LINER 095. UNKNOWN <br /> (CAaak Roe$am OfM 2. DOUBLE WALL 01. SINGLE WALL IN A VAULT 099. OTHER <br /> TANK MATERIAL-p^nlary lank ❑ 1. BARE STEEL 5. FIBERGLASS/PUSTIC B. CONCRETE ❑95. UNKNOWN <br /> ❑ <br /> (CMcx ate Mem aHyl ❑ 2.STAINLEBB STEEL O1. STEEL CUD WIFIBERGlASS ❑ /. FRP COMPATIBLE WIl4p%METHANOL 099. OTHER <br /> REINFORCED PLASTIC IFRPI <br /> TANK MATERIAL-aam�waF+lank 1. BARE STEEL P4q ]. F18ERGLASSIPLASTIC O /. FRP COMPATIBLE Wl1C0%METHANOL 095. UNKNOWN <br /> (check we item aql ❑ 2. STAINLESS STEEL Cl 4. STEEL CUD WIFIBERGIASS O 9. FRP NON-CORRODIBLE JACKET _ ❑99.OTHER <br /> REINFORCED PLASTIC(FRP) 010, COATED STEEL <br /> O 5.OOBORETE DATEINSTALLED <br /> TANK INTERIOR LINING O 1, RUBBER LINED ❑ ]. EPDXY LINING ❑ 5. GU55 LINING [3 95. UNKNOWN 433 <br /> OR COATING 2 ALKYD LINING ❑ 4. PHENOLIC LINING O B. UNLINED 099. OTHER (Fakaal Ma 4r 1 <br /> OATEINSTALLEO <br /> (On.cx axle demo 1 BHQT 4U <br /> OTHERCOROSIO 1.MANUACTUREOGTHOOIO O ]. FIBERGLASS REINFORCED PLASTIC <br /> PROTECTION IFA PPLICABLE PROTECTION O 4. IMPRESSEOCUARENT O . ` <br /> ( Dory, <br /> (CMeakaM item Palyl O 2,BACRInCIALANODYRARINBTALLE <br /> D TYPE(F4rbol ma aHyl OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED <br /> SPILL AND OVERFILL <br /> eCx al fpat apPfy) () CI1 ALARM . O ].FILL TUBE SHUT OFF VALVE <br /> ICA '�1. SPILL CONTAINMENT Y� <br /> �LZ DROPTUSE _x5IL-L O 2. BALL FLOAT O 1. EXEMPT <br /> �]. STRIKER PLATE <br /> TANK LEAK DETECTION <br /> IF DOUBIE WALL TANK OR TANK WITIBUDOER kone item en 1: 1 <br /> IF SINGILEWALLTANK CMckaONala ): S. MANUAL TANK GANGING(MTC) 1 VISUAL(SINGLEWALL IN VAULT ONLY) <br /> ❑ ���� <br /> ❑ 1, WSUAL(EXPOSED PORTION ONLY) - � B VAOOSE 2041E � 11Y2. CONTINUOUS INTERSTITIALMONITORING gQ-�J'G ' <br /> 02. AUTOMATIC TANK GAUGING NT G) T GROUNDWATER O ]. MANUALMONITORING <br /> Cl 0. CONTINUOUSATG B. TANK TESTING <br /> 04. STATISTICAL INVENTORY RECONGUATION(SIR) <br /> BIENNIAL TANK TESTING 099. OTHER <br /> V.TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE <br /> ESTB.IATED GATE LAST USED(YPJMOMMYI ESTIMATED QUANTITY OF SUBSTANCE REMAINING <br /> A5 TANK FILLED WITH INERT MATERIAL? <br /> 9aWe O Yea ON. <br /> Fo"elry SWRCB 1`01T <br /> CUPAFORM(4199) <br />