Tank Number TankNo.~ Tank No.~

E. Used OiliWaste Oil □ □ F. JP-4 □ □ G. Non-Petroleum Hazardous Substance N/A N/A

(CERCLA name and/or CAS #)

H. Mixture of Substances (Please specify) NIA NIA

I. Other, please specify. F-24 JP-5

5. Substance Compatible with Yes Yes Tank and Piping? Yes/No

6. Tank (Marl< all that apply)

Field- Field-A Manufacturer and Model constructed constructed

B. Underwriters Laboratory No. N/A N/A C. Primary Containment Material or Single-Walled Tank

i. Fiberglass reinforced plastic □ □ ii. Steel [ZJ Ill iii. Other, please specify.

D. Secondary Containment Material

i. Fiberglass reinforced plastic □ □ ii. Steel □ □ iii. Other, please specify. N/A NIA

iv. None [ZJ Ill E. Corrosion Protection (except Fiberglass reinforced plastic tanks)

i. Fiberglass coated steel □ ii. Double-walled steel □ iii. Impressed current system □ iv. Sacrificial anode system □ V. Corrosion expert determination □ vi. Other, please specify. NIA

7. Piping

A Manufacturer and Model Unknown

8. Underwriters Laboratory No. Unknown

Application for an Unde rground Storage Tank Permit • Form No 2 Date July 16, 2018

□ □ □ □ □ NIA

Unknown

Unknown

Tank No.~

□ □ N/A

NIA

F-76

Yes

Field-constructed

N/A

□ Ill

□ □ N/A

Ill

□ □ □ □ □ NIA

Unknown

Unknown

Facility ID No. q.- / 1>1.,1,."II

Revised page received

on '/Ji/1"1 /RI Httf Facility ID No. 9-102271

Tank No.~ Pipelines Located Otrlslde Tunnel

□ □ □ □ N/A N/A

NIA NIA

F-76 F-24, F-76, JP-5

Yes Yes

Field- NIA constructed

N/A N/A

□ □ [ZJ □

□ □ □ □ N/A

[ZJ □

□ □ □ □ □ □ □ □ □ □ N/A

Unknown Unknown

Unknown Unknown

Page 20of 27

VIII. FINANCIAL RESPONSIBILITY (Check all that apply)

Facility ID No. 'f-/()2,.1-1/ Revised page received

on 1,p/11,/,'1 /RI Ulllf

Facility ID No. 9-102271

Ocommercial Insurance

□Financial Test of Self Insurance

0Guarantee

D Letter of Credit

D Surety Bond

0Trust Fund

0Local Government Bond Rating Test

Oother Method Allowed (Specify) _______ _

0exempt: Ostate or 0Federal Agency

IX. FACILITY DRAWING

Include a drawing showing the general layout of the facility. This drawing should be no larger than 11 by 17 inches and preferably to scale. This drawing should show the following:

A. The property boundaries of the facility; B. Identification of streets, roads and nearby bodies of water; C. Identification of nearby facilities; D. Tax Map Key (TMK) Numbers; E. Location of bulldings at the facility; F. The approximate dimensions of the property boundaries and major buildings, G. Location of all USTs and dispenser pumps (identified by numberls consistent with the tank & dispenser pump numbers in

Sections XI and XII), and associated pipings; and H . Indication of North/South direction.

X. LOCATION MAP

Include a map showing the location of the tanks with respect to nearby landmarks. The map should indicate roads and landmarks to a level of detail such that the site would be easily located.

XI. DESCRIPTION OF TANK(S) (Complete for each tank at this location)

Tank Number J ankNo.~

1. Status of Tank (Mark only one)

A. Currently in Use

B. Temporarily Out of Use

2. Date of Installation (month/year)

3. Estimated Capacity (gallons)

A. Compartmentalized? Yes/No

Estimated compartment capacity (gallons)

B. Manifolded? Yes/No

4. Substance Stored

A. Gasoline (Specify product grade)

B. Diesel

C. Gasohol (Including ethanol blends) Specify product grade

D. Kerosene

Application for an Underground Storage Tank Permit · Form No. 2 Date July 16, 2018

Ill □

07/1942

400,000

No

No

NIA

□ N/A

□

Tank No.~ Tank No.~ Tank No. F-ST~

0 IZI □ □ □ [{]

0711942 0711942 0711942

400,000 400,000 400,000

No No No

No No No

NIA NIA N/A

□ □ □ NIA NIA NIA

□ LJ □

Pipelines Located Outside Tunnel

0 □

31,665

No

No

NIA

□ NIA

□ Page 19 of 27

VIII. FINANCIAL RESPONSIBILITY (Check all that apply)

Facility JD No. 'f- /4 U1I Revised page received

on t,/11,,,/,1 /Rf Hnt Facility ID No . . 9-102271

Ocommerc1al Insurance

0Financ1al Test of Self Insurance

0Guarantee

0Letter of Credit

Osurety Bond

0Trust Fund

0Local Government Bond Rating Test

Oother Method Allowed (Specify) _______ _

llJExempt Ostate or llJFederal Agency

IX. FACILITY DRAWING

Include a drawing showing the general layout of the facility. This drawing should be no larger than 11 by 17 inches and preferably to scale. This drawing should show the following.

A. The property boundaries of the facility: B. Identification of streets, roads and nearby bodies of water, C. Identification of nearby facilities, D. Tax Map Key (TMK) Numbers; E. Location of buildings at the facility, F. The approximate dimensions of the property boundaries and major buildings, G. Location of all USTs and dispenser pumps (identified by number/s consistent with the tank & dispenser pump numbers in

Sections XI and XII), and associated pipings. and H. Indication of North/South direction.

X. LOCATION MAP

Include a map showing the location of the tanks with respect to nearby landmarks. The map should indicate roads and landmarks to a level of detail such that the site would be easily located.

XI. DESCRIPTION OFT ANK(S) (Complete for each tank at this location)

.. ,. Tank Number T~nkNo.~

1. Status of Tank (Mark only one)

A. Currently in Use

8. Temporarily Out of Use

2. Date of Installation (month/year)

3. Estimated Capacity (gallons)

A. Compartmentalized? Yes/No

Estimated compartment capacity (gallons)

B. Manifolded? Yes/No

4. Substance Stored

A. GasoUne (Specify product grade)

B. Diesel

C. Gasohol (Including ethanol blends) Specify product grade

D. Kerosene

Appl ication for an Underground Storage Tank Permit - Form No 2 Dale July 16, 2018

[Z]

□ 07/2010

2,000

No

No

NIA

□ NIA

□

PflT• - ..... Tank No.~ Tank No.~ Tank No.;

[Z] [l] [Z]

□ □ □ 05/2006 09/2011 0612006

4,000 59,500 236,579

No No No

No No No

NIA N/A NIA

□ □ □ N/A N/A N/A

n □ □

Tank No. __

□ □

NIA

NIA

N/A

□ NIA

□ Page 23 of 27

""" Tank No. Z, Tank Number . Tank No.~

E. Used Oil/Waste Oil □ □ F. JP-4 □ □ G. Non-Petroleum Hazardous Substance NIA NIA

(CERCLA name and/or CAS #)

H. Mixture of Substances (Please specify) NIA NIA

I. Other, please specify. F-24 F-24

5. Substance Compatible with Yes Yes Tank and Piping? Yes/No

6. Tank (Mark all that apply)

Steel Tank Steel Tank A. Manufacturer and Model lnslitute/STI-P3 lnsbtute/STI-P3

B. Underwriters Laboratory No. UL-58 UL-58

C. Primary Containment Material or Single-Walled Tank

i. Fiberglass reinforced plastic □ □ ii. Steel [Z] 0 iii. Other, please specify. NIA N/A

D. Secondary Containment Material

i. Fiberglass reinforced plastic □ □ ii. Steel 0 IZl iii. Other, please specify. N/A NIA

iv. None □ □ E. Corrosion Protection (except Fiberglass reinforced plastic tanks)

i. Fiberglass coated steel □ ii. Double-walled steel IZ] iii. Impressed current system [Z] iv. Sacrificial anode system □ V, Corrosion expert detenninalion □ vi. Other, please specify. N/A

7. Piping

A. Manufacturer and Model Unknown

B. Underwriters Laboratory No. Unknown

Application for an Underground Storage Tank Permit• Form No 2 Date July 16, 2018

□ [ll [Zj

□ □ NIA

Unknown

Unknown

--Tank No.~

□ □ N/A

NIA

F-24

Yes

NIA

N/A

□ □ N/A

□ □

□

□ □ □ □ □

Unknown

Unknown

Facility ID No. 'f-~]:l.1/ Revised page received

on ~ / 11,/ l'i /RI J.f,JII

Facility ID No. 9-102271

... Tank No.~ Tank No. --□ □ □ □ NIA

N/A

F-24

Yes NIA

NIA

NIA

□ □ □ □ NIA

□ □ □ □

□ □

□ □ □ □ □ □ □ □ □ □

Unknown

Unknown

Page 24 of 27