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2018 Equipment Survey <br /> site # ( � � . k(� Address <br /> Date CA ` 11 ; � � ! Contractor name / Tech name � ,r�� `r C' <br /> Petroleum Storage Tanks <br /> Tankll Product Capacity UST or AST AST impact Barder Split Tank Striker Plate Auxllary Manifcldad / Siphoned <br /> R = Regular Unleaded Nominal Gallons What type of impact barrier is Split1 <br /> Order M = Mid Glade Nearest (000) present? (leave bunk tar UST*) TSP = Tank Striker Plato <br /> per lank P <br /> Companmonl AuxdaryTank Wnifoided ' Slphonad Tank <br /> ° Premium UST = Underground Tank B = Bollards F = Fencing Tank OSP x DropTube Cage <br /> miamlot D = Drosol ("West tardh lar AST a Aboveground Tank 1 a Inside Service Bays N = None <br /> W = Waste Oil tanks less than ., = Located away from traffic UNK = Unknovm Yes or No (it so, to what other tank) <br /> H = Heating O1 sod gaaan■) ryN = AST present, no barna+ Yes or No <br /> Yes � � No <br /> iFh � . . 2 '; o1 �, �� V� ' 1 � � � � � ! Vb Q � � No <br /> 01 3 �} ^ Yes o <br /> 4 <br /> Yes No <br /> 5 <br /> Yes No <br /> 6 <br /> Yes No <br /> Petroleum Storage Tanks Vent Cape '.. <br /> Tank X Material of Construction Corrosion Protection Uned Tank Interstitial Space OR I VIA CA '.. <br /> p On] Manufacturer Modelo <br /> DWF = Doublawall Fiberglass Intornally Lined Tank '.. <br /> SWF = Smglawail Fiberglass Isoakabk Is n•'itanaa B = Brine Does the UST Fr' Rder OPV! <br /> ens/. Fnaxrer+xa • Clatl <br /> Order DV15 = Deublewatl Steel IC : Impressed Curtest <br /> orw. 'rouu at maned D = pry have a tethered grounding H = Husky Whle Model Number <br /> por tank SW S = Bi^rJ lewaa Sicul SAC = Sac Anode VC a Vacuum cable <br /> rat R7 = Manson Bros <br /> monitor DWSP a Doublowall STIP NLt = Non-m ionic N = None NA a No Will. marafolded in space provided <br /> SWSP = Smglewall STiP Yes or Nc LINK _ Unknown Yes or Nit NO = No Vent Present <br /> CL D = Steel w1Fbrgls Chairing LINK = t nkety" <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> Product Piping Vapor Recovery System <br /> lank 0 Material of Siphon 8u] Corrosion Stage It type <br /> Construc ion P Protection Stage I Type (nom typa) Pressure Mgmt System EVR System <br /> DWF = DW Fiberglass Dous Product leave the lank INV BL = Balance CAS Hcaly Calan Au <br /> Crow SWF = SW Fiberglass me use of a Siphon Bar d are the IC = Impressed 2PT = Two Pont VA = Vacubm Assisi $eDarator EBW = EBW' VR <br /> per tank SVIS = SW $Ioa Connoolions to each lank visible' Current CP • Coaxial Poppeted VST = Vapor Systems PT = PHIL TI 7E <br /> DYIFLX x DW Flexible SV = Siphon d visible SAC = Sac Anode CN = Coastal Non. Tech VR = VR Carbon Canister OPW , OPW VR <br /> monitor SWFLX = SW Flexible SNV = Siphon bulnel Visible NtA = Non•metaibe a , VST VST Vapor Processor <br /> oppeled NEVA t Healy w E1 NA = outside of Caidomm NA = No EVR <br /> LINK = Unknown NA = Not dispensed by S+RNon NA = No Stage II <br /> 2 ,� 1vl Vapor Pot Ooes the site have a vapor pot (drop out lank)' Yes or No <br /> 3 � V y UST Monitoring System <br /> � �,�' Manufacluror Model Humber Software Var. TanELoocation <br /> VR = Vaeder Root Write Modal Number m Whie Software 4 NA = None space provided Version in space T provided <br /> s • vv �- <br /> 6 <br /> issued 12/04/2017 Page 1 Of 4 <br />