Opening of Proposals - Olive WTP Solar GESC Proj No 124-050 - Schneider Electric

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Yrki RETURN Division of Land Pollution Control STATE USE ONLY TANKS COMPLETED UST Program I.D. Number r IN FORM Indiana State Board of Health �j ^ TO - . P.O. Box 7015 Date Received=..-"r ' IN �vI �f' ilndianapolis, IN 46207 Ionia LE�' (317) 243-5060' • • Notification is required by Federal law for all underground tanks that have been used to store regulated substances since January 1.1974, that are in the ground as of 4. pipeline facilities (including gathering lines) regulated under the Natural Gas Pipeline Safety Act of 1968. or the Hazardous Liquid Pipeline Safety Act of 1979. or May8,1986,orthatarebroughtintouseafterMay8,1986.Theinformationrequested is required by Section 9002 of the Resource Conservation and Recovery Act, (RCRA), which is an intrastate pipeline facility regulated under State laws: 5. surface impoundments, pits. ponds. or lagoons: as amended. _ 6. storm water or waste water collection systems. The primary purpose of this notification program is to locate and evaluate under- 7. flow -through process tanks. 8" liquid traps or associated gathering tines directly related to oil or gas production and ground tanks that store or have stored petroleum or hazardous substances. It is expected that the information you provide will be based on reasonably available gathering operations: 9. storage tanks situated an underground area (such as a barn the records. or. in the absence of such records. your knowledge. belief. or recollection. ve or above mineworking. drift. shaft. or tunnel) if the storage tank is situated upon or above the r Who Must Notify? Section 9002 of RCRA. as amended. requires that. unless surface of the floor. exempted. owners of underground tanks that store regulated substances must notify designated State or local agencies of the existence of their tanks. Owner means— What Substances Are Covered. The notification requirements apply to under - (a) in the case of an underground storage tank in use on November 8. 1984. or brought into use after that date. any person who owns an underground storage tank ground storage tanks that contain regulated substances. This includes any substance defined as hazardous in section 101 (14) of the Comprehensive Environmental used for the storage. use. or dispensing of regulated substances. and (u) in the case of any underground storage tank in use before November 8. 1984, Response. Compensation and Liability Act of 1980(CERCLA). with the exception of those substances regulated as hazardous waste under Subtitle C of RCRA. It also but no longer in use on that datc.any person who owned such tank immcdiateiy before the discontinuation of its use. includes petroleum. e.g.. crude oil or any fraction thereof which is liquid at standard conditions of temperature and pressure (60 degrees Fahrenheit and 14.7 pounds per What Tanks Are Included? Underground storage tank is defined as any one or square inch absolute). _ combination of :tanks that (1) is used to contain.an-accumulation.of "regulated sub- _ Where -To Notify?. Completed ;notification forms should be sent to .the address stances."and (2) whose volume (including connected underground piping) is 10%or ". given at the top of this page. ' , more beneath the ground. Some examplesare underground tanks storing: 1. gasoline, used oil. or diesel fuel, and 2. industrial solvents. pesticides, herbicides or fumigants. ' t -, When To Notify? 1. Owners of underground storage tanks in use or that have been out of operation after January I. 1974. but still to the ground, must notify by What Tanks Are Excluded? Tanks removed from the ground are`not subject to _taken May 8. 1986. 2. Owners who bring underground storage tanks into use after May 8. notification. Other tanks excluded from notification are: !.farm or residential tanks of 1,I00gallons or lesscapacity used forstoring motor fuel 1986. must notify within 30 days of bringing the tanks into use_ for noncommercial purposes. - Penalties: Any owner who knowingly fails to notify or submits false information 2. tanks used for storing heating oil forconsumptive use on the premises where stored: shall be subject to a civil penalty not to exceed $10,000 for each tank for which 3. septic tanks: notification is not given or for which false information is submitted. INSTRUCTIONS Please type or print in ink all items except "signature" in Section V. This form must by completed for Indicate number of each location containing underground storage tanks. If more than 5 tanks are owned at this location, continuation sheets Q photocopy the reverse side, and staple continuation sheets to this form. attached -VOWNERSHIP•FTANK(S) II. LOCATIONOF Owner Name (Corporation, Individual, Public Agency, or Other Entity) (If same as Section 1, mark box here ❑ ) So LA B e vt d M L h t e.i pc2 tl Wd ty- Wo,-k S Facility Name or Compiny Site Identifier, as applicable " 0 Vet� Street Address MCI County - S+ Street Address or State Road, as applicable <? / 5- 5 : D f,'Ve- City State ZIP Code 501A �� VL Tf l L�o60 / Count _- sy+. Jo�ep � Area Code Phone Number a-(G 2_S-(4—(7`4q9 City (nearest) State ZIP Code So,t� r3�tid sue. 146625 1 Type of Owner (Mark all that apply®) Private or . Current ® State or Local Gov't ❑ Corporate P ❑ Federal Gov't ' ❑ Ownership Indicate . Mark box here if tank s ( ) number of ;are located on land within tanks at this an Indian reservation or ❑ Former (GSA facility I.D. no. uncertain IlIXONTACT PERSON• location on other Indian trust lands • Name (If same as Section I, mark box here ❑) - Job Title -- Area Code Phone Number Frctw (� �orva+, S� ee'tN HdekJ o-I- r,e.ld 0 er�c+1o�s 2-1G1 Z -9�6U 'tIV.-TYPE-OF NOTIFICATION ❑ Mark box here only if this is an amended or subsequent notification for this location. *WCERTIFICATION, I certify under penalty of law that I have personally examined and am familiar. with the information submitted in this and all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete. Name and official title of owner or owner's authorized representative lure Date Signed WJ't(J,0V" V- SwAurr �• • ONREVERSESIDE EPA Form 7530-1(11-85) Page t