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?IPitiG INFCRrRTION <br />TANK: I <br />iRNKA <br />I TAKK# S I TRkKT <br />?157ARCE frG1 <br />�! 721 <br />�Zf 6, ti <br />;JSP:NSER to TANK <br />5TSTEM TYPE • <br />I �` <br />CC':57=UCilGN °� <br />I Oi� "'ltiitf•�/:�.f% T <br />IIETECTION SYSTEM <br />Lz <br />LEAK <br />WkUL <br />;OC: M.TE:.NCL Me..:RTIBILITY with <br />e <br />FRP <br />C^.RRCS;CN PROi.CTION <br />(f <br />Systema Type; suction, pressure, and ;ravity <br />°* tcrstruction: single -walled, doLele-walled, liner -trench, etc. <br />^* Material Type; steel -iron, stainless-steel, fiberglass, etc. <br />25. Piping (cross-sectionst diz;ram, including comectiors to tank " dispensers). <br />Double will piping or _ Secondary containment (Trench liner, etc.) <br />(;) Product tine (leak detector or automatic shut-off on <br />pressurized piping). <br />,Z (2) %lent and vapor recovery lines if not designed to <br />/ prevent the entrance of standing fluids. (Ball float valve) <br />(3) Kanways and other single vatted pipe fittings on a <br />double-walted tank, if not designed to prevent the <br />entrance of standing fluid. <br />3M <br />27, tate ;later Resources Control Scard "Facility (A)" and "Tank Permit (B)" application forms svbenitted. <br />29. Plan review and operating per -it fees paid. <br />29. Monitoring and Response Plars subr„itted. <br />.J. LII� Procf of financial responsibility on file. <br />.1. what is the approximate depth to ;round water: <br />(in:lute source cf information - borehole logs, monitoring vett data, water <br />studies, etc.) <br />.2. ✓ Total n n'oer of tanks on site after installation: <br />Any existing tanks to be rercved or abardoned? Y.S No ( ) if yes, submit State '.later Resources <br />Control Board "Facility Permit (B)" application form. <br />.». / Responsible party(ies) shall susit a •Letter of Co=itaent• prior to the <br />/� installation of new tanks. (Applies to sites with doc•.mented soil and/or groundwater contamination) <br />.S. ! County/City Fire district and Building Department notified. <br />REKAR"KS <br />....../ae4- Ai4,4 �tJ—t r Cr4--r? cxr-7 "'�tJ�..r!.lv�. ,l3E ,! !aF'..✓.Q?.. �::E.,f1S.?''..- <br />....... ................. <br />PW <br />... .;�,p G .ii.....va:?r ".9.".ra?: ;;6, ..�..... Z.l-r—:ocvE''�..:®e�esd..... <br />... A.XAF.".'Q. .:��D!!:!! .N .Er'%�4:..! ... ./..`�..sZ../'�. L:L:E!�._.7.:... . <br />....... <br />®vE.�#7c.,L /�iei.�vE�-r^ra.�( �4.E�V"/2.�,Fa�r-.-nit_-'rl. �-s�rv�r�- L',E .a'�ISTA�,c.� so •-r'r�E <br />.4AJ4 0-Ae- s 7 <br />7 <br />