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d <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS-TANK PAGE ' <br /> ft-ile!ms vel tomb) <br /> h®®tin � pt <br /> TYPE OF ACTION ❑T.NEW SITE PERMit 0 e, AMENDED PERMIT ❑S.CHANGE OF INFORMATION) ❑ 6. T EMPORARV SI It CLOSURE <br /> (Ch4cA Go*moral") Q T PERMANENTLY CLOSED ON SITE <br /> ❑3.RENENVAL PERMIT <br /> lSpadtymaaon-rorlocal weeWty) (Specilycnedlpe.At,low uanonyJ Of,. TANK REMOVED 430 <br /> BUSINESS NAME(Sams as FACILITY NAME a DOA•Doing Bw:1e»All-P&_C-kb'C, M, nj FAC0.ITY @ F kkl <br /> Tjs <br /> zflT <br /> LOCATION WITHIN S17E(Oprionag 431 <br /> • 1 <br /> 1.TANK DESCRIPTION <br /> TAMC 100 TANK MANUFACTURER <br /> COMPARTMENTALIZE()LANK pt Vee ❑ No <br /> mYea'.complete ona ps to1 each romn,nmem <br /> DATE INSTALLEO(Y@J1 O) TANK CAPACITY IN GALLONS `J ' 4 NUMOLR Of COMPARTMENTS <br /> l � <br /> 000 <br /> ADDITIONAL DESCRIPTION(For focal Ise entA <br /> It.TANK CONTENTS <br /> TAra(USE 437 PETROLEUM TYPE <br /> KrL. MOTOR VEHICLE FUEL ❑Ta.REGULAR UNLEADED ❑ 7. LEADED C) S.JET FUFt <br /> l6od,carnptele Posnateum typo) ib.PREMIUM UWL6AOED <br /> 3- ❑ 3. DIESEL ❑ 6.AVIATIOMI F VEL <br /> ® CHEMICAL PETROLEUM ❑Tr..MIDGRAOE UNLFADED ❑ GASOHOLER❑99. OTH <br /> ❑ 7.CHEMICAL PRODUf.T <br /> ' COMMON NAME(lnrtW Ea440044s Meleriah tmenwry page) CASs(from ltalsrgooa Molon4/3 fmmNory Pape) <br /> ❑4. HAZARDOUS WASTE trhu.des <br /> Wed 00) { <br /> 111.TANK CONSTRUCTION <br /> TYPE OF TANK .t] T. SINGLE WALL ❑ 3. SINGLE WALL 11TH D S. SINGLE WALL WITH INTERNAL BLADDER Sv STEM <br /> (Chock ono Reala.-W �fLl 2. nOUOLE WALL EXTERIOR MEMORANE LONER 0 95UNKNOWN <br /> /e' D 4, SINGLE WALL IN A VAULT <br /> ®99. OT*LER <br /> TANK MATERIAL•primay 1,61h 1s7( I BARE STEEL (_./ I F0ERGIAS5 r PLASTIC 0 s.CONCRETE ❑OS UNKNOVM <br /> f6noca a-ahm poly) J❑�2. STAINLESSSTEEL ❑4, STEEL CIAO WFIBERGLASS ® 0. FRP COMPATIBLE WIWI)%METHANOL ❑99.OTHER <br /> A EINTORCED PLASTIC(FfIP) -- _ <br /> TANK MATERIAL-soconJary lank ❑ 1. BARE STEEL ❑3. fIBC:RGIASS t PLASTIC ❑A.FRPCDMPATI0LEW1ID0%METHANOL ❑95. UNKNO�A1}N^ <br /> (check one dom onry) ❑ 2.SIAINiESS 51 EL ❑ 4.Si FEL CLAO WIFIDERGIASS () 9, FRPNON-CORROOIBLE JACKET 99.OTHER_J_O �,,_te�tt <br /> REINff_E <br /> ORD PLASTIC(FRP) J�90 COATED WJLC <br /> STEEL AYnt,(�f x <br /> ❑ S.CONCRETE _.. ff--tt .. <br /> TANK INTERIOR LINING 'L] I, RUDDER t)aE0 ❑ J. EPDXY LINING IJ S.GLASS ONK1G ❑BS. UNt4NOV M43a UA TF INSTALLED <br /> OR COATING O 2.ALKYDUNITAG 4. 1114ENOL.K.LINING UMAINEO ❑09,OTt1ER - <br /> _(Chock one if.m anyl _ _.� _.. ._ (�OIMDr TIBER- <br /> HER CORROSION D 434 <br /> PROTECTION IF APPLICABLE OAYEtNSTwaLEO <br /> OT1 MArAJFACTUR60 CATHODIC G J. FlBERGLnSS REW4FORCEO PLASTIC ❑9.',. UNKNOWN <br /> PROTECTION ❑ 4, K.IPRESSEDCURRENT O 0. OTIW..R <br /> _ <br /> (Crake amj1pm OWlyn) 2. SACRIFICIAL ANODE _ `^ _ _ __ _-_(FnrkUtusW Ottry/ -•_!' <br /> SPILL AND OVERFILL YEAR TNSTALLEO TYPE(F0,Wce1 o34*,4y) OVERFILL PROTECT ON FOUIPMENT.YFAK INSTALLED f <br /> __ <br /> (GWecx as 041 apply) <br /> ,TR� <br /> 1P� ' SPILL CONTAl-11 __. �l �_1 KI, ALARM , L.J 3. FILL TUOt=5141,11 OFF VALVE i <br /> 19.2, DROPTL)Bf. Lj,11RL.�J... �Y._• _ 7. DALLFLOAT Cl 4. CxEMPT <br /> Q J. inlrir(!PIJt/! (7 _ PPI <br /> ;11' '^)V.'TANK LEAK nEmnow. <br /> IF SINGLE WALL TANK(Cbeca od th_a1 apps): IF DOUBLE WALL TANK OR TANK VSITN BI,ADOER_(C_Aerk ont',Tem onrY)� <br /> ® 1, VWUAL(EAPOSCO PORTION CWtY) • ❑ 5. MANUAL TANK GAUGruG(.MTC( ® I. VISUAL(SINGI.E WALL III VAULT ONLYI �. <br /> AUTOMATIC TANK OAL)i51NCi(AI{,I t O6. VAnO:•I:lvuL- Cls4IINUVUaINILN5h11ALMUTAIU1UltU <br /> 0 3. COUT0a1JOUSATG ❑ 7. GROUNDWATER ❑ 3. MANUAL.MONITORINO <br /> ❑ 4. STATISTICAL K4VENTORY RECO/ICR.IATION(SIR)• O 0. TANK-TESTING <br /> BIENNIAL TANK TESTING ❑9% OTHM <br /> V.TANK CLOSURE INFORMATION c PERMAAIENT CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USEO(YRrM(NDAY) ESTIMATEDOU.Lt1:1TVOTSUDSTPNCkAEMAtNBIC. 4?S TANNFILtE(1Vtn:HLnrEwTMar`RIAL' <br /> _ pmwnl D Yea 0 No __� <br />