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12/07/20'01 08:12 6127845236 CHETS SHOES?,, p <br /> All information requested below must be provided on the plans or described below unless not <br /> applicable. Incomplete information will result in the plans being returned. <br /> Check all that apply: Dispensing Bulk Storage Loading Rack <br /> Capacity: 1. IDOO 2• 1000 3•- 4. <br /> Product: I. A- 2. `O` 3. 4. <br /> Construction l 2 3. 4. <br /> ��ft �. <br /> llsA <br /> piping(material): Vent Lines Dispensing Lines—AJ A <br /> 'Type: bull Sezv'� Self-ServicOpen to Public riva,Dike <br /> Dimension: � � � Dike construction <br /> Loading Rack Construction: N- A <br /> Are tank locations shown on plans? Yes No <br /> Are all buildings shown ou the plans? Yes No N/A <br /> Are property lines shown on the plans? Yes No <br /> Are overhead power lines Shown on the plans? Yes No N/A <br /> What are the tank dimensions' - <br /> Are emergency controls shown on the plans? Yes No N/A <br /> Describe overfill protection. 6� <br /> Describe.spill prevention <br /> Uej. -- <br /> Describe material under tank(s). , ,, A-0— <br /> Describe vent pipe termination and heigh 1 Z' 4 cxje— <br /> Are dispenser locations noted on plans? Yew No N/A <br /> Is the piping layout shown on plans? Yes_L M! No <br /> Is required signage/labeling shown on plans? Yes No <br /> Are any LP tanks within 20 feet of or in the drainage path of proposed tank(s)? Ye` No <br /> Are fire extinguisher locations noted on plans? Yes No <br /> Will there be a canopy above the tank(s)? Yes No_. <br /> Page 2 of 2 <br />