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Jan 28 03 07: 51a RRobertson 2094)72-3176 p. 6 01/14/2003 11:22 2094 33 FIFTH FLOOR t�Al2t no t % ��GGG o00111.Q UNIFIED PROGRAM CONSOLIDATED FORM ( TANK. TADIS1902 t FRIft UNDERGROUND STORAGE TANKS-TAIS { y li�AC K. FAOOOQ03 Iwopaperwk) (� 11� TYPE OF ACTIONP4ge a of 7 l ❑ INEW SITE PERMIT ❑JAMFNDEO PEfU.IIT �SCIfANOE OF INFORMATION ❑L'CEMPORARY SITE CLOSURE IChuh ANY I--o.4y> 7 P2RMAVEN'TLV CLDSED ON SIT;, i(a)tra6'weo4lMy torrJl'- 5mm Ines 5d IRENEWAL PFKMI7 ar.`.. `... ..n^ •b �� ( t: -P+�" F ` +70 , .y-": �3. Q g TANX REKOvED HUSIT:ESSNAME(SmunFAMLmNAME«o0,%-Dcinseoros.+a) FAC)LITYID: NORMS 76' � FA0000483 Pit0232519 4 ITH I 1 -1 LOCATION WITHIN SITE(Opliro.dl 1;;3 E VICTOR RD A.LOD1 alI PHONE 1.TANK D FVCRIPTION(A scaled plot plan with tht loeseion orme LIST.ymem ineladwg tmiming4 and h11dm4rks;halt be whreieaed to the local agrnry.) TANK iD11 Tank#: 2 4)2 TANK MANUFACTUREK ns COMPARTMENTALIZED TANK rQ Y. D No +34 TA0251902 Irv.,...w ane p+�r-Vteccp m DATE IN ALL ( O) a33 TANK.CA ACITY IN GALLONS 414 NU>dESL•'R 1 COrifPAR1;yLN .n) 12 000 ADDITIONAL DESCRI71 ON(Fa 14-1*cc*) +3F TL TANK CONTENTS TANK USE a�a, PETROLEUM TYPE 440 ® L.MOTOR VRNICL.E FUEL t+.REGULAR UNLEADED ❑2.LEADED ❑S.JET PUEL (1f *<daemykceF-1—Tyv1) 10.PREMIUM U4'LtiADED ❑I.DICSEI_ ❑b.AVIATION FUEL Q 2.NON-FLEL PETROLEUM le MIDGRADEUNLFAOED Q a.GASOMOL Q 7i,OTNER Q A.C MEMiCAL PRODUCT CoM ON NA. E6oaell—dow xeen:.41�. I mats:.,—,y P81.0 442 ( e�vac 1 ❑CHAzARDOUSWASTE f MAA.Uw at) 95.UNKNOW N ID.TAN K C0N5TRUCTION 'TYPE OF TANK ❑ 1.SINGLE WALL C)3.SINGLE WALL WITH ❑S.SNGLE WALL WITH N'CERNAL BLADDER SYSTEM A4) (Ckek olw acne alyl EXTERIOR MEMBRANS LINER ❑95,UNKNOWN Z.DOURLT WALL ❑4.SINGLE WALL IN VAULT ©99,OTHER TANK MATERIAL-prIMAry lank I.BARE STEEL FIBERGLASS/PLASTIC ❑S.CONCRETE ❑91.UN KNQVTV 4+4 (Choc k one hem any) Q 2.STAINLESS STrnSTEEL CLAD W/FMVZIkGLASS ❑a.FRP COMPTISLE W/100%METHANOL RENFOItCEO PLASTIC(F1U') C]91,OTHER TANK MATERIAL-/et06dary I-k ❑ I.BARE STEI-L C7.1.FIBERGLASS BLAS TSC ❑S.CONCRETE ❑95 UNKNOWN 443 1C4etk wc:rr...only) C]Z.STANLKSS STEEL ❑d.STREU CLAD W/FIBERGLASS ❑LZ.FRE COMPTIBLF Wit 0091.METHANOL REINFORCED I'LASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTIIER ❑ 5.CONCRETF TANK NTUIOR LINING ❑1.RUL ASft LINED Q 11,EPDXY LINING ❑5 CLASS LINLNG ❑95 UNKNOWN 44o DATE NSTALLED 41 OR COATING (Chaek one+nn Y) Q 2ALKYOLNR4G ❑6PNENOUCLINNG ❑6UNLNED ❑99.OTNER (rploul mo4Ny) OTHERCORROSION ❑1 MANUFACTURING CATHODIC 0 3 FIBERGLASS RENFORC£DPLAST)C Q PS UNKNOWN -1 OATS INSTALLED 4.9 PROTECTION fF APPLICABLE PROTECTION (G sL n.a kmodr) ❑ [2 Z SACRIFICIAL ANDD(; 4 IMPRESSED CURRENT C]9907HER Fer)a,.l ro<oldy) SPILLANDOVEItfJI-L VCI.R INSTALLEew TYFE(foea(ueenty) 43t OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED eft (C?wk A Ik+1 appy) � I SPLLL CONTAINMENT � L ALARM ❑7 FILL TUBE SENT OFF VAL' [� 2 DROP TUBE ❑ 2 BALL ❑a EXEMPT ❑ 3 STRIKER PLATE FLOAT IV,TANK LEAK DIE'fECTION(Aev nlianBroc"imenFmw-sl. bnr*,miieiaaheb"yerzy.) IF SINGLE w ALL TANK(Check+Il a4c.pply) 411 IF DOUBLE WALL TANK OR TANK WITH BLADDER 434 ❑ I VISUAL(EXPOSED PORTJON ONLY) ❑5 MANUAL TANK GAUGING(MIG) (a:k ox Nan ant,) C 2 AUTOMATIC TANK GAUGNO(AIC) Q 5 VADOSE ZONE Q 1 VISUAL(SINGLE WALLN VAULT ON LY) [] 3CONTNVOUSATG Q 7GROUNDWATER ®2CONTINUOUS INTERSTITIAL MONI[TORING Q 4 STATI571CAL INVENTORY RL-CONCILIATION ❑It TANK TESTING 3 MANUAL MONITORING (SIR)BIENNIAL'TANK TESTING C)99 OTHL•R V.'2-A\K CLOSURE INFORv1AT10N)PE ANENT CLOSURE IN PLACE ESnMATED DATE LAST US20I VR/MO/DAY) 4ss ESTIMATED QUANTITY OF SUBSTANCP REMAKING 434 TANK FILLED W)T71 R4L•RT MATER)ALY 437 ❑Yes ❑No UPCF(12/99 revised)