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1 <br /> �..�,,,� Minnesota Pollution Aboveg ro u n d Sto rage Ta n k <br /> � Control Agency <br /> 520 Lafayette Road (AST) P ro g ra m <br /> St.Paul,MN 55155-4194 <br /> Major AST Facility Permit Application <br /> Pursuant to Minn. Stat. § 115.03, subd. (1)(e)(3)and Minn. R. ch. 7001, a permit is required for the aboveground storage of liquid <br /> substances at a major facility.A major facility is one where the total liquid storage design capacity of all tanks, including indoor tanks, <br /> is one million gallons or greater. <br /> Instructions <br /> 1. This permit application is to be used for: <br /> . proposed new major facilities <br /> • non-major facilities that intend to expand liquid substance storage to one million gallons or greater <br /> • re-permitting of existing major facilities <br /> 2. This application form should not be used for permit modification requests; a separate form is available at: <br /> http://www.pca.state.m n.us/pu blications/t-a3-26.doc. <br /> 3. For new and expanding facilities, a permit must be issued by the Minnesota Pollution Control Agency(MPCA)prior to initiating <br /> tank construction. It is recommended that this application be submitted at least 90 days prior to initiating tank construction. <br /> 4. For permitted facilities, this application must be submitted at least 90 days prior to expiration of the current permit according to <br /> Minn. R. 7001.0040, subp.3 and Minn. R. 7001.0020.H. <br /> 5. Answer all questions, except for questions limited to facility types(new,expanding, or existing)other than your own. Answer <br /> questions in the blocks provided. If more space is needed, enlarge or create additional blocks, or add information at the end of <br /> the document on additional pages. <br /> 6. Answer questions using information that is currently available.Where an answer to a question is unknown,would require <br /> further testing or assessment, indicate"Unknown". <br /> 7. Even if the information requested has been submitted to the MPCA at some other time or in some other form, please include it <br /> here in order to verify that it is up to date. One exception would be if a specific document is requested which was previously <br /> submitted; in this case, reference the name of the document and date it was submitted. <br /> 8. To add rows to the tables to accommodate more information or more tanks, click on the last box in the table and hit the Tab key <br /> or use the Table-Insert-Rows above or Rows Below function. <br /> 9. The application must be signed and certified by the appropriate authorized company representative as defined in Minn. R. <br /> 7001.0060. <br /> 10. Submit: <br /> • a signed paper copy of the completed application <br /> • all required attachments <br /> Submit to: Aboveground Storage Tank Program <br /> Attn: Beckie Olson <br /> Minnesota Pollution Control Agency <br /> 520 Lafayette Road North <br /> St. Paul, Minnesota 55155-4194 <br /> I. General <br /> This permit application is for(check one): <br /> ❑ A proposed new major facility("New") <br /> ❑ A non-major facility that intends to expand liquid storage to one million gallons or greater("Expanding") <br /> ❑ Re-permitting of an existing major facility("Existing") <br /> Company permit contact: <br /> Last name: First name: <br /> Address: <br /> City: State: Zip code: <br /> Email: Telephone Number: <br /> t-a3-25 <br /> 4/4/07 Page 1 of 8 <br />