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I. • • I . l► • :1, • r•NM : -; .Vs • •: „ - <br /> Automatic <br /> Leak Detection Method: Tanks Gauging Piping and „/ <br /> Spill Prevention (Containment Basin): Yes x No . <br /> OverfillProtection: Type Shut Off Valve in Fill Pine .�ctivat�at 95%. Tank <br /> / Capacity <br /> Depth to Ground Water: Estimated 15 Feet <br /> Anchoring: Required Anchors 1& Straps Not Required / <br /> Type of Backfill: Sand <br /> All plans submitted must show at least the following information on plot plan. Give measure- <br /> ments from tanks and dispensers to:orcoemr lines. buildiros, driveways and surface waters. <br /> YES Y/a YES M/a <br /> (X) ( I Property Lines 1• (x) ( ) Vent ?!pe Termination type <br /> (x) ( ) 3ui•ldingls) � L.<...,/ (x) ( ) V•nC Pipe Size <br /> (x) ( I Tank Site :/ (x) ( ) Piping Layout ,/ <br /> (x) ( ) Product 1n Tank .✓ ( ) (x) Location of Dispensers <br /> (x) ( ) Tank 3ury Depch,/ 4164. >11 vacetvays <br /> te64. (04 Concrete Thickness over Tank ( 1 (x) Dispenser Protection <br /> (X) ( ) Tank ?111 opt ing✓ ( 1 (x) Signs: No Ssioktng-Shut Off Motor <br /> (x) ( I Driveveys Minimum Age ;or Self Serve - <br /> 16 Years Old <br /> ( ) (X) Emergency Controls l 1 (X) :0bc Kia. =1;e Extinguisher <br /> (x) ( ) Leak Detection ✓ ( ) (X) Sol: Serve Attendant Location <br /> (x) ( I Overfill ?roceetion✓ (X) ( 1 Tank Location and Clearances ----"--- <br /> (X) <br /> ✓(X) ( ) Spill Prevention oC) ( I 3ack:111 Typ f <br /> on ( 1 xnctoring J <br /> Remarks: <br /> NOT_C r: ONE COPY ITST BE P ESLV ' .4'1' SCT FOR77.7 27I. <br /> 07?7CS tSZ ONL't oc7Ld.'7 ( <br /> Review stamp Area I Stamp In Area I <br /> Process C:IIDlecad-c:aca mailad Cut <br /> I. <br /> • l <br /> Miscellaneous In!or..ac:or <br /> 1 <br />