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HomeMy WebLinkAbout0 JOHN FITCH BLVD 0 �--'- 6f }-- -- - --- ��I- - -- - - ----- r- - z s 1 b A �-------1 t L---------� i i DooQ �LJIIS Sc►+E..au �E .-.' �o�£Q I S\ tt iTtiPk w wooA S�1E1wTNAX0 f � ! 1 !y� I � I Ij �i � / ✓ TtF..S��� } ► _ - Z X d. 1 Z• I 1'oTc CH I j� � �AQ A C1A O SF 1`,� j I hh � ` C o to C r-�PS.'o� �- CELT7 Al I 000 SHEA'Cla+�)�t !i I 4ei --- -- Co+.1c,WA- Coi.tC. Floo + I L �oRCH C7v Er,tis t, JLL i I P F , t Mi c TION TURN • ESZIN, CONNEECTICUT q-/I (-/(.o r T {F Lt �oup � � �i al 14 It It ! ' i i ; ii it �� �' �1 !I �+ 1 { 1 ! .( t yf r '� �ti SG.a � /• t I { 'iii — --- — — EA►� - ✓fh '"�J:�i y—_— i Z 7LY 4 cJc11Z— f�l—AK1 Yit RCtI\ ?� SUFFt'i ! ! �t iIf ii ' { f ji i► •�` ii �► �I ! r Cr j �l - CQ.tC• J� t>��ei100, i 4 We _ i l S T cos -Z-x4 - if / 'AJ \.0 1-3G W/1.L tL I i 1' ` I}{� , I,' i{ I� i! ';' {' !' ,'� '{ i i►i1 � .;fir_ j_._ - s j a �Y ERtr6Ab w I 0�ET? — jV�ALL ���.C! -V\OrA - ! 1 i Ir i Al\ffiance Alliance Energy Corp. Retail Gasoline Division 38 Commerce Street Derby;CT 06418 800-822-8602 203-735-8602 Fax:203-35-5549 November 26, 1996 Notice to all local Fire Marshals As of November 18, 1996 the assets of Petrol Plus Inc. have been acquired by Alliance Energy Corp. Enclosed you will find a copy of a new tank registration form with the business name change which the original has been sent to D.E.P. All other information has remained the same. Any questions you may have please feel fret to call me at 203-735-8602. Sincerely, Victoria Caroline Environmental Coordinator /mz cc: John Gargano ENCLOSURE UNDERGROUND STORAGE PG of STATE OFCONNECTICUT EPHM-6 Rev.ar96 2 Department of Environmental Protection �i FOR STATE A DATE ENTERED FACILITY NOTIFICATION 1 1 UNDERGROUND STORAGE FACILITIES PROGRAM "r �' 3. AGENCY USE ONLY Q - Bureau of Waste Management �- u Z - • 79 ELM STREET.Hartford,CT 06106-5127 .. B.FEE BILLED C.FEE RECEIVED FIRST 1a. ❑ NOTIFICATION SITE!D - . TEL.(860)424-3374 U OR (q b ❑ SUBSEQUENT (If checked 13202271 PLEASE TYPE OR PRINT.ALL THREE COPIES MUST BE LEGIBLE D.GRID COORDINATES E DOES FACILITY MEET NEW REQUIREMENTS X NOTIFICATION enter no-) Refer to INSTRUCTIONS FOR FILING NOTIFICATION before completing form X ) _ YES NO ONSITE NAME NO.AND STREET NEAREST INTERSECTING STREET CITY OR TOWt. STATE '�'!TUO 4. LOCATI OF FACILITYDE r t t LONGITOUDE South Windsor Sunoco 5 Jahn Fitch Blvd. Burnham St. Smith Windsor CT 41 49 25 72 37 18 BUSINESS NAME AND NAME NO.AND STREET CITY OR TOWN STATE ZIP CUDE TELEPHONE 6. MAILING ADDRESS � Alliance Energy Corp. P.O. Box 477, 38 Conm erce St. Derby CT 06418 � 03 735-8602 CO NO.AND STREET CITY OR WN STATE ZIP CODE Z 7. FACILITY OWNER O 5CIM as above ( ) ' W 8. TYPE OF OWNER X PRIVATE STATE _ MUNICIPAL FEDERAL ( G.S.A. NO. 1. to OPERATOR/CONTACT NAIII NO AND STREET 9. PERSON Victoria Carol i P.O. B= 477 338 �.aTItLrOe a7t._ _ De'py ('� 64 ' Q6 10. 1la. 11b. 12a. 12b.STATUS 13,TYPE OF 14.,.NTfl,,? 15.CONSTRUCTION -1�fROTECTION �i.1N1 GfTA78 8- 203 7'��F,f 9? CONTENTS MATERIALS a.INTERNAL b.EXT RNAL PIPING SYSTEM DETERMINATION z a. b. CONDUCTED? TANK l D DATE OF z_ TOTAL 0 EST.QUANTITY DATE CHEMICAL NAME OF PRINCIPAL tno E z z E o J z_ MONITORING QN ww 0 do a rn o^ 0 �0 0 00 0 om DATE OF INSTALLATION CAPACITY w Z c� LEFT STORED u' TANK ¢ v SUBSTANCE �¢F �- 0 w 0 r 0`i' o t ¢ �� - SYSTEM w r in O a > f O 0 w w a w o U w m N J INSTALLATION II"YES".enter'DATE" Mo.Nr. a- Gals 0 0 J (if o LAST a s W O ;not trade name ¢ Z z zO w a Q oz w mOR ( ) w` 1 m (Gals.) ¢ USED o 0 J IEnterC.A.S.No..if known) N mw� o J D cal cc ¢ o f pw a REPLACEMENT (Specilytype (ItnNOcenter"0)"1 a (Mo.,Yr.) a: o- C)n � (MoYr) from list81 Example 5/75 30 5000 X X Heating fuel #2 X X H 3 H 5/75 U NO Example 7/60 — 8000 X 8178 X 1.1,1,-Tricloroethane X X E 7 W 7/60 V — CAS#79016 B- 2 8/84 20 8000 X X kerosene X X X li 8 8/84 K= yes 7/96 U o B-3 10/88 30 8000 X X Gasoline X X AD 3 10/88 KLOQ yes 7/96 t` U w B 4 10/88 30 8000 X X Gasoline X X AD 3 10/88 KLOQ yes 7/96 B-5 10/88 30 8000 X X Gasoline X X AD 3 10/88 K= yes 7/96 20.HAVE YOU ATTACHED SKETCH OF TANKS AND LOCATION? YES an file 22. CERTIFICATION: I certify under penalty of law that I have personalty examined 22a.SIGNATURE 22b.DATE SIGNED o 2�. COMMENTS: and am familiar with the information submitted in this and all attached documents and that OZ ,..,�t...,� L,,,,� based on my inquiry of those individuals immediately responsible tar obtaining the information. ������pp�� 19. Previously stihmitteC�. I believe that the submitted information is true.accurate and complete. f,_.T - sir 1 22d I��LI�1E�V 1.8F�i +. U Penalties:any owner who knowingly falls to notify shall be subject to a civil penalty not t0 LU exceed for which noldicat on is not given or for which false information '�w j� is submitted. John 1 vice ��li+ COPY 2: SEND TO LOCAL FIRE MARSHAL UNDERW-060 D STORAGE ►o. b STATF OF EPNM-8 REV 319C or.rae.nr.l En..enerawl.l►r..«r:.rr FACILITY NOTIFICATION 2. uNoewlrouNO STQRA°E fAoxlTlg PRooRAM 3. POR STATE j A SITE LD. < ` HAZARDOUS MATEMAIS MANAGEMENT UNIT l -- lu Cop"A—,MWO-J.CT Sala tx AGENCY USE ONLY NtST r Old I.DATE 1CVD RT D.E./ C.DATE ENTERED /e.0 NOTRICATR71i - TEL,566-4M SITE 1. OR fU Ra M om. PLEASE TYPE.ALL THREE COPIlS MUST M LEONUI D.CARD COORDeeATEs It.DOES FAoLRY wr NEw REoLRMMZ.RS+ ..❑ NOTMFCATFDN 0~W) Rol..b OGTRUCfloNs POR PILENO NOTPKATIOH before wngloing feNR. X y ❑YES ❑NO LOCATION an""I NO AND STRUTNEAREST INTERSECTING STREET CRY OR TOWN STATE i l.IAT OLIDf / FF :L �'TU r at .� 4. OF FAC1UTY; III Window Stinow 5 JdM Fitch BadeAkrfl alrnh= St. SOUth Windsor CG '4a 49 25 '72 _ 32 ,y,K No.AND STREET CITY OR TOWN ISTATI ZIP CODE I nLEw1a+E 6. MAIUNG ADDRESS Petrol Plus, Inc. 38 CmmerCSS? St. oa P.O. B 477 Derby iCt 06418 031 776-7119 i ':'.�It ' NAT4E N0.AND STREET CRY OR TOWN STATE ZIP CODE TFLEFVIONE P 7. FACIUTY OWNEII ret=1 Plus, Inc. 38 CMMNZ a St., P.O. Boa 477 1 DarbY ICt 06418 I 7119 '17r1 e. TYPE Of OWNER �PRIVATE ❑ STATE ❑MUNICIPAL ❑ FEDlRAIO.S.A.. . .W, OPERATOR/CONTACT NAhg No.AND STRUT Cm 01 TOWN STATE ;20 CODE TELEPHONE 9.PERSON Victoria Caroline 38 Cmmlerce St., P.O. Box 477 Der Ct 106418 Q031 776-7. 119 _ to 11e. 11►.120. 12 b.STATUS 13.TYPE OF 14.CONTENTS 13.CONSTRUCTION 16.►ROTECTION 17.MEGRAI DATE CONTENTS MATERIALS aiNTERNAt b.EXTERNAL 1NF1NG SYSTEM 1R. 19.FAILURE TANK 10, DATE OF TOTAL j EST.QUANTITY r- CHEMICAL NAME OF PRINCIPAL I i o b.DATE OF I (Me./Yr.l FSi� i <f IIII (fG1Fa ellrl)r l• 1f (Awe/Yr.) �E *G II Y<I 4I� � guO ��� F I�� MONITORING DE TERMINATIO N RSTAUA10N NSTALLATKM SYSTEM ICONOUCTEOTCAPACITY D TANK SU6STANCE I ay! ' OR LAST MTf) vaM M•TES'. �� USED :€t RNLACMENT A(Gale.) MA n pwrr', hM ba er 111Y-NC-.—-NO- )aIiS Example5/75 30 5000 X X Mee"fuel"2 X i X H 13 �H_ 5/75 1 U NO 1 I.I• n. iX°"�• 00 X 7 X W 7�60 U 9-2 1 8/84 301 8000 X X Kerosene X i X X IA,D_3' 8/84 ,K,L,O,Q,yes 2/89 7/96 114 ' 10/88 30' 8000 X X Gasoline X I ` X LA,D 3 10/88 K,L,O,Q yes 2/89 7/96 ' H4 10/88 30 8000 X X Gasoline IX X I ,D. 31 10/88 K,L,O,Q yes 2/89 7/96 x 9-5 10/88 30 8000 X X Gasoline (Diesel) X I X D 31 10/88 R,L,O,Q ylss 2/89 Z I i I i 19 flank tee Aug 15 1 , 1996 resul for dies@1 attached 19. �arLk Test _ I 20.HAVE YOU ATTACHED SKETCH OF TANKS AND LOCATION? 22. SIG RE 22b DATE SIGNED ® �viously Gent 22. CERTIFICATION:I das1Y w war PananY a ww vw I heea am*wiv•■wrarrd k Z 21.COMMENTS•{7 corrected - Cathodic P. "y dtd $/12/92 a w wdh aN MI9r 1W,m aubmNed rn the and Mi ateehed doeumrnte and that X t 3/30/92 rnY IrlgnhrY of lhpee rrhOrweuMS rn.rhadalNr gepomrble la dgamhnF UM 1�/ Stage II Fiberglass Piping added 3/21/94 Mwn Sher. 1 balaua trot WbMMW rnforinnron a sue accurate and compbu Zft NAME fTeoa a MM) 22d OFFICIA,TITLE(olo.rwer o.-M-4e4F J ►errM ies arlr erwnr who ano—VIV to*to nook Shan be aublM to.cnu pan.M not to rapn.e•hrarn+ a■eew 010,000 tut Beth tart fat whKh rwttKJ110n a.0 g9 p I.eHhKh te1N rrtprhrahOn Wb.~ Arthur Bogm Emecutsvle Vice President RETAIN FOR YOUR RECORDS NORTHEAST TANK SERVICES, INC. P.O. BOX 3437 • MILFORD. CT 06460 • 203.878-TEST Michael Doucette September,18, 1996 Ms. Victoria Caroline Petrol Plus, Inc. 38 Commerce Street Derby, CT 06418 Dear Ms. Caroline: The result for the PETRO-TITS II tank system test performed on September 15th, 1996 at the Snaxx Plus located at 5 John Fitch Blvd in South Windsor, CT is identified as follows: Tank #1 81000 Diesel The National Fire Protection Association (NFPA) , criteria for a tight system is a system test with a final answer of less than .05 gallons per hour. This is a calculated mathematical tolerance only and is not meant to indicate permission of a leak. The test result is as follows: September 15 , 1996 Tank system #1 Diesel showed a final answer of -.0345 Tank system #1 Diesel is tight. Prior to testing, tank system #1 , was gauged for water via it's four inch fill pipe: no measurable amount of water was recorded. Respectfully submitted, Michael Doucette President HDD/dmd Enclosures NORTHEAST TANK SERVICES P.O.BOX 3437 MILFORD.CT 06460 (203)878-8378 STATION _LAYOUT Date Iflr�l6 Job number Site Number Job site r Supervisor KEY KEY submersable pump . • 4" fill ® vapor recovery basket O 3" fill vapor recovery popit 0 2" fill or stickline O gate valve -_-- concrete ® .1••„e.,, AI/ Bat Who o.eld I® • • I ,© I U O Plrf I I � - i2 � yf 2 -1 81 14 ` E Data Chart for Tank System Tightness Test PLEASE PRINT 1. OWNER Prowny❑ E(. ., ' s r..f, .f AOdrsas Represeneuve Telephone Address Representatwe Telephone 2. OPERATOR t ► t r --- Jam,• •t ! , •:/ _( C.!., f � :i, / r T Name Adel0" / Telephone 3. REASON FOR TEST Fir &%Ie, 11 r t (Explain Fully) 4. WHO REQUESTED r "l �' /F' •� — ! / + r I? TEST AND WHEN Name Tale Company of Affiliation Date Address Telephone Identify by Direction Capacity Brand,Suppkor Grade Approx.Ape Steel/Flterglaas 5. TANK INVOLVED Use additional lines for marulolaed tanks ----- --- — -- --- -- - - --- - — Location Cover Fills Vents S'phhones Pumps 6. INSTALLATION DATA �/ •' PP ... North inside driveway. Concre14 Buck Top) Sin Tdehll made Drop Suction.Rarnots. Aver of station.etc. Earth;etc tubes.Remote F.tis Sze.Mamfolded Which tanks) IMske if known 7. UNDERGROUND Is the water over tna tank? WATER Depth to the water tabu / f ❑yes E No 8. FILL UP Tanks to be filled �,r -hr Data Ar,angtd by-- Name Telephone ARRANGEMENTS Extra product to top off-and run lank taster How and who to prov.aev Consider NG Le.d Terminal or other contact for notice or inquiry ---- -- ---- Company Name Telephone 9. CONTRACTOR. — -- MECHANICS. any Other contragor involved 10. OTHER --- INFORMATION OR REMARKS Addnronal information on any Items above Officials or Others to be eavrsea when testing is in progress or completed.Visitors or obsanera present during toot,etc. Tests were made on:he above tank system In soaordanee with last procedures prescribed for 11. TEST RESULTS w detalled on attached test charts with results as follows: Tank Identification Tight Leaxage lnd.caled Dots Tested 7 o t J 12. SENSOR 13.Thr in to owft that tl►ese tank systems were taxed on the date(a)shown.Tho"kx5catted as'♦Nhr meet the crfl«Ia.dabrN,.d by r CERTIFICATION tonal Floe Prolseft AWMIall1O11 Pamphlet 322. - ; - --(_ Technicians., L i Det¢.� , — �j �u '��r..J j 1-y� f r-, r r 'z: �'�l../ J r Testing Contractor or CompanY. BY: Spnatwe /NI No.of Thermal C y[ f ` /• �� !� CertlhuhOn it-•r• / 1' 1 ♦ � )h 7 r i v'' • � it � • t 1.. Sensor Address 2 Certification a 14. Name of Supplier Owror or Dealer Address No and Streatisl City State Oats of Test 15. TANK TO TEST 15a. BRIEF DIAGRAM OF TANK FIELD 16. CAPACITY From +ryy� ❑.'3_Station Chart �a 7 Nommal tapacdy __-- '• (-, 1" .'—`! Tank Manulaclurer is Cheri Identity by position--------_--- Gallons '� Company Engmeenny OJta By mustaecurate '• �� Chaffs supplied won Brand and Grade available _ caPaCAy chart Jvable _ _ _. Other Gallons Total Gallons 17 FILL-UP FOR TEST Ganons as Reading Slick Water Bottom r before Fr11-up —in -m Inventory _ to Gallons Tank Diameter t 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK _Water in lank Lrnets)being tested with LVLLT _ • a, , , tt See manual sections applrcaote Chuck below and record procedure in tog 127) L✓High waist table d1 lank excavation use maximum allowable test Pressure rot an teen 19 TANK MEASUREMENTS FOR Transfer total to line 25a Four pound rule does not apply to doublewalled links . TSTT ASSEMBLY — Complete section below 21. VAPOR RECOVERY SYSTEM 0 Stage I L_;Stage If Bottom of tank to grade' _ In �] Add ao•-for-r•probe easy _ 30 In. 24b. COEFFICIENT OF EXPANSION 1 la faun pound rule requrfed7 yea '`�. No l_-7 Total tubing to assemble—apptusrmald In RECIPROCAL METHOD i 20. EXTENSION HOSE SETTING Type of Product 2 Height to 12"mark from oomom c 1 tank - rn. ; Tank top to grade' rm. Hydrometer Employed M / Ealand nose on suction lube 6"or more Temperature in Tank 7 Pressure at Dollom all tank PSI Alter Circulation ......... ....... ..:...:..'.... -- •f below lank lop ._----_..._. in 'II Fill q Temperature of Sample •F a Pressure at top of lank P S 1. DrDe edemas above rape.taw lop of hU 22. Thermal-Sensor feeding shot circulation r argils rf 1 Depth of burrst rn. •F Observed A-P I.Greedy � ` Between sj 23. Digits par•F d1 range of expected change Reciprocal • t� �•• Pepe a �/ digits Tank dr. in. COEFFICIENT OF EXPANSION (Complete after circulation) i,•. 3 �y `) �= s' ; 24a. Corrected A P I.Gratify Taa/quantlty in Reciprocal Volume change in Water is" on full tank(16or 17) this lank per IF Observed A P I Grandy Transfer to Line 26a. NOTES. Hydrometer employed....... H Observed Sample Temperature •F 24c. FOR TESTING WITH WATER ses Table C 6 D h Corrected A P I.Gravy h Water Temperature Cher Circulation @ 60•F,From Table A......... — Table C •F Coefficient of Expansion Coefficient of Ill The above calculations are to be used for dry*oil conditions to for Involved Product Table 0 establish a positive pressure advantage.orwhen using the four pound From Table B _ rule to compensate for the presence of subsurface water In the tank Transfer COE to Line 25b Added Surfactant? ❑Yes ❑No Transfer COE to Line 25b. area. Refer to N F.P A. 70. Sections 2.12.4 and 2-7.2 and the'lank 25• (a) Is (b) _ (c) gallons manufacturer regarding allowable system test pressures. Taal quantity In Coefficient of expansion for Volume change In this tank �- full tank(16 or 1?) involved product per If ,,11 26. (a) G tl1:: s 5 7� I rC:C:%C✓ S U O�(9 0 1-- 7 Tnl*leC�'l C U f Volume change per IF(25 or?ab) Digits par•F In teat Volume change par digit red 27 sY..TrrYf+ II n "••sl•• 3t A■,Jar 39 .. JIIIN•aa MJIN wu..Yrar,l.. :Iwar,.w..aw,ul,ra I.rl`rh Y.W.flf • LOL OF R)f POMOIN.lS ummx Now'a ih 4N INl iKiOaw fYa flNa{ r„•art 1' baaNNr,a,.la•a•r 29 lwsaa..N 32 w.r>. 17 fafaf 35 36 37 MR r•..�)hN1 fYbM bfaa! .o. ir.r. AY.NIf f, C,J - f.�M r•a rrr 1 r YO^ `� a„Ya aaY f•fY« ,ti.N •Y.• b•.Y. rlrr arl r la.af.N laaw Il•a, laaYNY• tnafYaawY _ �Y, tiaYO a.y.a tiwq ti,a1 Aasw,Y,•1 AMa•o ,J CYagpa.- Gar,a,Y,w �a0 of 41N-,OAfI ) -rcf f , L) A I fad.( + r G '1? ,„ 6+ !C-f U, L / v) Z�U :•lil ttJ tZ fib• r lf,a.>r `1. a I.vl *'F° i11 tt � •If% 080 G J (JC-f u G�J c c�[ J + �.�' / Gr1 01�D (2: ♦v?•; Ura! +rr rc1`/•1 -c_rl`l Ui/U C•'.. `/`/ �c';f Cyr' C?t Z }Ub5 U?g �/u tL•?7 CSC,/i CU i-02U r Z'iJ o i t Cl .r i/r ir .l , t� t 1 r, ',•l U �•�'� ;O? ' l r, l Jr� a Z I—U77 //O FO — oi(, -co? C)/77 It •> t/! o y ' o?� I J,� +u 'l -ate, 'C�e I C/yS' c/er5� c,V0 Ire ' rt 4 I)Ls,l Or",I/ C-•?a,� f. rt •? c/^�� ili r7yU (: � t J3 �,�`lh -f_Uh II`-'?3 I r �2 09 L) t O 1C•a/i) ra7 -f r, 't.vtl —C al I'' C ,? t I C) J �U4tJ I t re +G4 'Ci,tf L,•f J u s I?v lO tULi U / t r I /CIa// C•:� 1 , i 1< Q ���.� 40a L) c t U ) l 1 . '�,e +ice,7 C ••eJ ? fU4•U 04.) '!.1 'a�?7 +'Ct 'r •',?7 If /r T7U +CI• C) �Jc.; i / "rv4 C_'t,• — C,c {'+ r rty6cj U s ' t; ,• I. �f 30 403'� o io3 i Cam)Z i C.G a_ , 1 I 1 P-T Tank Taf Data Chart 2 N q.M,aaponNbary of u a O.O«rb.«op«YY W ms Addilb I O / a„a rb Irowa OanOW f f n,.m nr wan.Hflp hyN fNe w to NNmw r«r w.ga ara Ana brr a maars of r r 1/ arce,N+q b u,o hataalw tall Ga«u N e,aahfM or a.,pwonit«a aM.na OOfIJMW Want no«laer paw.Anb MI I MAK~M 1"q n01 wwaW b,nacn0 Ov aa.rOww•«a n a 1—OI ma,rocMaO IwrO al ma p«Iaq Of a I." f,f.am IMa1N CamrN«,n NK«p«YYI Opa{a0i rswla am ON raapOf,lA•Mf Or haMar br any WY W«ao,.e..O err f f«IVok—cla."s, Taf. pp0 M•+O„ma'N Tana a„0 pooVP hanoM f frYam„Y fawa ma.«u tayNnaY S•p,«wa of Taan. .—__--_... .aM accoro,rp w"/1a4 Taal GM«4 r w,aggnq OT DYa — `1 1 NORTHEAST TANK SERVICES, INC. P.O. BOX 3437 a MILFORD, CT 06460 • 203-878-TEST Michael Doucette September 10, 1996 Ms . Victoria Caroline Petrol Plus, Inc . 38 Commerce Street Derby, CT 06418 Dear Ms. Caroline : The result for the US TEST 2000/P tank test performed on August 15th, 1996 at the Sunoco Station located at 5 John Fitch Blvd. in South Windsor, CT is identified as follows: Tank #3 -18,000 Diesel The xi offal Fire Protection Association (NFPA) , criteria for a tight system is a system test with a final answer of less than . 05 gallons per hour. This is a calculated mathematical tolerance only, and is not meant to indicate permission of a leak . The test result is as follows: August 15th, 1996 Tank #3 Diesel liquid portion showed a final answer of +. 565818 Tank #3 Diesel liquid portion is not tight. Tank #3 Diesel ullage portion is tight. Tank #3 Diesel is not tight. Heavy sales of Diesel at this station cause the necessity of constant delivery. This does not compliment non circulating tests, as there is always temperature change beyond allowable limits. We recommend the test be performed as a PETRO-TITS II overfill tank test. Respectfully u fitted, Michael Doucette President NORTHEAST TANK SERVICES P.O.sox 3437 MILFORD,CT 08480 (203)878-8378 �..f ;:. .. STATION LAYOUT µr. Date Job` number I Site Number ! Job site .. S r Wii+�lo T Supervisor f ,. KEY KEY 4" fill submersable pump. O 3" fill ® vapor recovery basket O 2,, fill or stickline ft vapor recovery popit . - concrete O gate valve �. . -hb- ✓PtI wP�l. MOw�T�r ' A//? 660 PC 1 N ahlro 1 1 1 • • I ;®1 1 S/ Txs ,0 7 w a +N ,OPERATOR: SIGNATURE: DATE; -------------------- -------------------- -------- ******* C U S T O M E R D A T A ******** JOB..NUMBER : 000240 ,CUSTOMER (COMPANY NAME) : PETROL PLUS CUSTOMER CONTACT(LAST, FIRST) : CAROLINE VICTORIA ADDRESS - LINE 1 38 COMMERCE STREET ADDRESS - LINE- 2_ CITY, STATE DERBY, CT 7 R- CODE_ (XXXXX XXXX) PHONE NUMBER (XXX)XXX-XXXX 735-8602 ******* C. O M.M.E. N T L I N E S ******* ******* S I T E D A T A ******** SITE NAME. (COMPANY. HAM) SUNOCO SITE CONTACT(LAST, FIRST) ADDRESS- - LINE-1 5 JOHN PITCH BLVD. ADDRESS - LINE 2 C=f. STATE- S. WINDSOR, CT ZIP CODE (3cx=XXXX) PBONE_ NUMBER (XXX)XXX-XXXX GROUND WATER LEVEL (FT) 0 NUMBER OF TANKS 1 LENGTH OF PRE-TEST (MIN) 30 LENGTH_ OF TEST. (MIN) 360 Ii i i III ******* T A N K D A T A ******** TANK, NO. TANK NO. TANK NO. TANK NO. 2 3 4 TANK DIAMETER (IN) 92 LENGTH (FT) 24. 44 VOLUME (GAL) 8000 TYPE EG FUEL LEVEL (IN) 42 FUEL TYPE DIESEL 2 dVOL/dy (GAL/IN) 126.68 CALIBRATION ROD DISTANCE 1 10.65625 2 26.95313 3 41. 93750 4 56. 93750 5 74.93750 INVOICE #dc000240 TEST DATE: 08/15/96 NORTHEAST TANK SERVICES, INC. P.O. BOX 3437 MILFORD, CT 06460 (203) 878-8378 TANK STATUS EVALUATION REPORT ----------------------------- ***** CUSTOMER DATA ***** ***** SITE DATA ***** PETROL, PLUS SUNOCO 38 COMMERCE STREET 5 JOHN FITCH BLVD. DERBY, CT S. WINDSOR, CT CONTACT: CAROLINE VICTORIA CONTACT: PHONE #: 735-8602 PHONE #: ***** COMMENT LINES ***** CURRENT EPA STANDARDS DICTATE THAT FOR UNDERGROUND FUEL TANKS, THE MAXIMUM ALLOWABLE LEAK/GAIN RATE OVER THE PERIOD OF ONE HOUR IS .05 GALLONS. TANK 0: DIESEL FUEL 2 TYPE: RATE: .565818 G.P.H. GAIN TANK IS NOT TIGHT. ------------------ �.,...,•_ S�uanuma�___. T s m". 46 `UNDERGROUND STORAGE PG i of j STATE OFCONNECTICUT �uY EPHM-6 Rev 5r94 A DATE ENTERED 2.r—�— Department of Environmental Protection _= ,. 3 FACILITY NOTIFICATION UNDERGROUND STORAGE FACILITIES PROGRAM AGENCY USE ONLY FOR STATE Q zz Bureau of Waste Management I B FEE BILLED C FEE RECEIVED FIRST 79 ELM STREET.Hartford,CT 06106-5127 r -=r r 1 a ❑ NOTIFICATION --- f TEL.(860)424-3374 LU SIT` D.GRID COORDINATES E DOES FACILITY MEET NEW REQUIREMENTS? OR 13202271 '\�?,� PLEASE TYPE OR PRINT.ALL THREE COPIES MUST BE LEGIBLE y Y b 7NOTIFICATION SUBSEOUENT enter no Of checked. Refer to INSTRUCTIONS FOR FILING NOTIFICATION before completing form. ^ ❑YES El NO enter _ _ P 9 LOCATION SITE NAME REET NEAREST INTERSECTING STREET CITY OR TOWN STATE 5.LATITUDE LONGITUDE 4. OF FACILITY 7 South Windsor sur>K,)pp 5 John FitCh Bpul 0 1' 77 27 1 A '1 BUSINESS NAME AND!!NAME _, AND STREET CITY OR TOWN 0M Z P CODE TELEPHONE 6. MAILING ADDRESS i Alliarm $wxgy lomp 36 Fast __-- _ ( ) co1 NAME • NO AND STREET SwftF Z TA NNE — 068 z 7 FACILITY OWNER o Alliance Energy Corp. 36 Elkst Tndustrial Road - --- ) ( 203) 8-6%8 w 8. TYPE OF OWNER i LX PRIVATE L] STATE U MUNICIPAL I-1 FEDERAL(G.S.A.NO. ). (n i — - -- --- — — OPERATOR/CONTACT NAME NO.AND STREET CITY OR TOWN STATE ZIP CODE TELEPHONE 9. PERSON Victosi"a Caroline 36 East INdustrial Road ( ) 10. 11a 11b. 12a. 12b.STATUS 13 TYPE OF 14 15.CONSTRUCTION 16.PROTECTION 17.INTEGRAL 18 19.FAILURE CONTENTS MATERIALS INTERNAL b.EXTERNAL PIPING SYSTEM DETERMINATION b. CONDUCTED? TANK I.D. DATE OF i TOTAL o EST.QUANTITY I DATE c~i CHEMICAL NAME OF PRINCIPAL CO o E Z z E � z DATE OF MONITORING z N CAPACITY w z t`t o m w U o o L�O o INSTALLATION _ 0 LEFT STORED I w TANK Q o �o SUBSTANCE J �Q U fL� a ,� o� o w O� &o �� om' INSTALLATION SYSTEM (If"YES",enter"DATE" ' u) I O l > . o Lu ¢ wa m (Mo./Yr) x o (Gals.) o o ag (If any) o LAST aw a O (not trade name) w O O m ==N Z ? w Q a w i ti w OR and attach results). ? z�,,�1 (Gals.) w USED (' — Enter C A.S No rf known) m w z a a z o Q —uu d in ~ u REPLACEMENT (Specify type If"NO",enter`NO" �� s o� =J ( m—a on ¢o ¢o on ow 0. ( P fYYP ( ) ¢ (Mo.Nr.) J o LL di (n o a 3 v a (n a (Mo.iYr.) from list B) Example 5/75 30 5000 X X Heating fuel#2 X X H 3 H 5/75 U NO Example 7/60 — 8000 X 8178 X 1,1,1,-Tricloroethane I X X E 7 W 7/60 U CAS#79016 B23 1 N 30 8000 X _ yes X yes'4—o 8000 Y Mesel L__X_ 1 .11 Yes yes Bea—>--9�97 6000--- x Kerosene — 20.HAVE YOU ATTACHED SKETCH OF TANKS AND LOCATION? ® YES 22.CERTIFICATION:I certify under penalty of law that I have personally examined 22a.SIGNATURE 22b.DATE SIGNED and am familiar with the information submitted in this and all attached documents and that z 21.COMMENTS: Ker'o tank Ehvi.rcn piping DW unlined. Site has based on my inquiry of those Individuals immediately responsible for obtaining the information, X O �f 1 spill conttairm t & 1 9 see previous nob tl-on uuu,I believe that the submitted Information is true,accurate and complete O T'50h for. test results ti Lr u 3 �5 Penalties:any owner who knowmgty falls to notify shall be subject to a civil penalty not to 22c NAME(Type or Print) 22d.OFFICIAL TITLE(of ow o-_ � LU L representative). U) I exceed S10.000 for each tank for which notification is not given or for which false Information Is submitted. 1Ctoria Caroline Wvironmental Dioector COPY 2: SEND TO LOCAL FIRE MARSHALL �- �J O O . u� J<trD 0 0 0 0 0 "U ej cr fis-f e ki�1j. s", A\ffiance Alliance Energy Corp. 36 East Industrial Road,Branford,CT 06405 800-899-8602 203A88-6068 Fax:203A88-3065 September 19, 2005 VIA OVERNIGHT MAIL State of Connecticut Department of Environmental Protection Underground Storage Facilities Program Bureau of Waste Management 79 Elm Street Hartford, CT 06106-5127 Re: Alliance Energy Corp Updated Tank Registrations dated September 2005 To Whom It May Concern: We are in the process of updating all our tank registrations with correct addresses. Please find the enclosed tank registrations for the following sites: SITE NARIE ADDRESS SITE ID # 1. Avon Buck Stop 80 East Main Street 4-101 2. Branford Global 202 East Main Street 14-1478 3. Bridgeport (Lou's) Exxon 565 Lindley Street 15-3410 4. Bridgeport Noble Ave 1360 Noble Ave 15-3401 5. Bristol Shell Service Station 57 Middle Street 025 6. Brooklyn(D &Z) Route 6 19-224 7. Canton Exxon Rt 44 Albany Tpk 23-294 8. Cheshire Sunoco 1123 Meriden/Waterby Rd 25-4531 9. Danbury Mill Plain Exxon 111 Mill Plain Rd 34-6764 10. Darien Exxon 1044 Boston Post Rd 35-4938 11. Durham Sunoco 9 Main Street 38-378 12. Enfield Exxon 241Hazard Ave 49-610 13. Farmington Exxon Colt Highway 52-7030 14. Glastonbury Global 2997 Main Street 54-3229 15. Greenwich Exxon 780 W Putnam Ave 57-5032 16. Hamden Sunoco 2263 Whitney t y Ave 62-5751 17. Hamden Carmel Exxon 3070 Whitney Ave 62-5581 18. Hartford Exxon 125 Weston Street 64-4891 i 19. Hartford Citgo 351 Woodland Street 64-5310 20. Manchester Exxon 330 Tolland Turnpike 77-1179 I ,&\ffiance Alliance Energy Corp. Page 2 Alliance Energy Corp Updated Tank Registrations (Continued) SITE NAME ADDRESS SITEID # 21. Meriden Scott West Main 583 West Main Street 80-3298 22. Milford Sunoco 298 Boston Post Road 84-6236 23. Milford Devon Gas 25 Bridgeport Ave 84-6389 24. Monroe Buck Stop 456 Main Street 85-4770 25. New Haven Quinnipiac Exxon 1260 Quinnipiac Ave 93-6630 26. New Haven Exxon 775 Whalley Ave 93-6634 27. New London Citgo 445 Williams Street 95-1848 28. Newtown Exxon 75 South Main Street 97-6276 29. Norwalk Cross Roads 93 Main Street 103-8019 30. Norwalk Exxon 347 Main Street 103-7675 31. Plantsville Exxon 828 Meriden Ave 131-7459 32. Rocky Hill Exxon 479 Cromwell Ave 119-7724 33. So Windsor Sunoco 5 John Fitch 132-2271 34. Queen Street Exxon 682 Queen Street 131-7454 35. Southington Buck Stop 662 West Street 131-7838 36. Stamford High Ridge Exxon 1199 High Ridge Road 135-8656 37. Stratford Exxon 2816 Main Street 138-8379 38. Wallingford Scott 70 Center Street 148-2732 39. Waterbury Exxon 474 Bank Street 151-2773 40. Waterbury Exxon 10 Scott Road 151-2771 41. Waterbury Exxon 1003 Wolcott 151-2774 42. West Hartford Exxon 55 Kane Street 155-8335 43. Westbrook Exxon 198 Essex Road 154-3719 44. Westport Exxon 485 Post Road East 158-6886 45. Willimantic Exxon 104 Main Street 163-3813 Copies of additional tank registrations will be sent to you upon completion. Please feel free to call me with any questions. Sincerely, Victoria Caroline Environmental/Construction/Project Director /mz Enclosure Cc: J. Gargano, A. Peters, Esq.,Local Fire Marshal —�-A 'JflERGROUNDSTORAGE PO of STATE OFCONNECTICUT e��Lr}T�� '� EPHM6 Rev5/ae A DATE ENTERED 2, Department of Environmental Protection ,,,"�l 3 FOR STATE FACILITY NOTIFICATION UNDERGROUND STORAGE FACILITIES PROGRAM �1 A��avvvq��$$$ AGENCY USE ONLY Z Bureau of Waste Management It' 9 FEE BILLED C.FEE RECEIVED O FIRST 79 ELM STREET,Hartford,CT 06106-5127 `�• F 1 a. NOTIFICATION TEL,(860)424.3374 V SITE I.D. D GRID COORDINATES E.DOES FACILITY MEET NEW REOUIREMENTS? w OR PLEASE TYPE OR PRINT.ALL THREE COPIES MUST BE LEGIBLE U) y v J. ��i SUBSEQUENT (If checked, Refer to INSTRUCTIONS FOR FILING NOTIFICATION before completing form. ^ i ❑YES ❑NO I{�,J NOTIFICATION enter no.) LOCATION SITE NAa�MI�E�� NO.AND STREET NEAREST INTERSECTING STREET CITY OR TOWN STATE S.LATITUDE LONGITUDE 4,OF FACILITY WtALU nuumctL �UTH1� Ij` ,7 � _�� um_c�+ �yp� Z, _ BUSINESS NAME AND NAME NO.AND STREET OVP}!"' E CODE TELEPH 6,MAILING ADDRESS Alliance l ( I _COr�. _____ __ _ m NAME NO.AND STREET E TE NE4W-EQ6B Z 7.FACILITY OWNER O - C0=- Sial-Road W 8.TYPE OF OWNER ®PRIVATE ❑STATE ❑ MUNICIPAL ❑ FEDERAL(G.S.A.NO. N OPERATORfcONTACT NAME NO.AND STREET CITY OR TOWN STATE ZIP CODE TELEPHONE 9.PERSON Victoria. Caroline 36 Ent INdastri.al Road -AnfiA Ila, 11b. 12a. 12b.STATUS 13 TYPE OF 14.CONTENTS 15.CONSTRUCTION 16.PROTECTION 17.INTEGRAL 18. 19.FAILURE CONTENTS MATERIALS a.INTERNAL b.EXTERNS PIPING SYSTEM DETERMINATION E CONDUCTED? TANK I.D. DATE OF TOTAL w I EST.QUANTITY o DATE CHEMICAL NAME OF PRINCIPAL N O E O z0 _O O Oz 3 DATE OF MONITORING INSTALLATION CAPACITY w Z tw.? I LEFT STORED TANK 5�5�2 <o SUBSTANCE O O o:e o w o f O w o r tim INSTALLATION SYSTEM (If'YES',enter*DATE' (MaIYr.J (Gals.) g I (If any) O LAST n g (nol bade name) w o y= a Z z O w a w =2•m w�° OR and attach results) " z z t (Gals.) w USED a _ (Enter C.A.S.No.,d known) in w i a p � -+ z < O¢ < o - REPLACEMENT (Bpecay type (II'NO',enter T107 y c z t ¢ (Mo lYr.) o m¢ N o a `�3 O a w J g— (Mont) from list B) Example 5/75 30 5000 X X Heating fuel K2 X X H 3 H 5/75 U NO Example 7/60 - 8000 X 8/78 X 1,1,1,-Tricloroethane X X E 7 W 7/60 U - _ CAS k79016 Yea 3/06 a�2 1 30 8000 1 X X iGasoline X I I I X A I nan wyfln I ye�/06 - U Z �IiI10 O � 6 V esel W _ L -- N KPYOSE'I10 -__-_ 20.HAVE YOU ATTACHED SKETCH OF TANKS AND LOCATION? ®YES s 22.CERTIFICATION:I certify nder Pahatty of law that I haw personally eaaminod 22a.SIGNATURE 221,.DATE SIGNED a._.,as and am hmillar with me mIwmallon aubmMW in Mr and all altaahed documentk and mat z 21.COMMENTS:Kero tank Environ Piping DIN unlined. Site h braced on mymowry of those Tdlv,duals immediately responsible for oblainng the mmnelion, i 5. 0 R ill corltaiTu,lEu) & 1 9 Efts n 1 baliere Ihel W submitted Inlormellon i9 ne,accursle end complote 22e.NAME(typo or Prinq� 22d.OFFICIAL TITLE(ol owner o/aUlhpnied O ypi l �I,� }j�J � l 1/I 6 rar tmt res&s t 3/05 19.T Line test 3 2 I/ P►naRIM:sny ow al who knOWIngly fails Io nuIlly Shall be sublw,l to a 60 penally not to represenlalls9). N aaceetl s1D 000 forsneRleok br wr,icn noeficeernunot phrenorlorwhlehfabe Mfomnatl i42Wria Caroline �1Vi rC1. �iQMCtO� Is eubmllled. COPY 3. RFTAIN FOR YOUR RFMRDS • TANK TIGHTNESS TEST CE�TIEICATE CLIENT ALLIANCE ENERGY CORP. VICTORIA CAROLINE ADDRESS 36 EAST INDUSTRIAL RD. BRANFORD,CT. TANK ADDRESS EXXON 5 JOHN FITCH BLVD. S.WINDSOR,CT TEST METHOD ESTABROOK'S LOCATOR PLUS TEST DATE MARCH 21,2006 TANK NO, PROpUCT TEST RESULT #1 REGULAR PASSES #2 SUPER PASSES #3 DIESEL PASSES #4 KERO PASSES REMARKS; THIS TANK SYSTEM PASSES THE CRITERIA SET FORTH BY THE STATE CT.AND EPA FOR ALLOWABLE TEST RESULTS. E OF APPROVAL:RICHARD BRADFORD ESTABROOK#0227 SIGNATURE: ' ADVAN CEIu TANK TEgMG SERVICPS,INC, PO BOX 385 &DECREELD,MA 01373 413-665-3300 �zv s LocAToll PLUS • PRESSURE MCULATION&WATER SENSOR =13RATTON MANUfAC'r1jRE0 By.-ESTABROOK'S.1NC, 1.877-368-7215 DATE DATA SHEET TOTAL TANK VOL. P89'q (NEYtil YORK) TANK Y PROOuOT VOL.� 7 �^ ,/ LOCATION ✓C�..F . LJ ULLAGE VOL. PRODUCT IY.PE—; PRESSURE SENSOR CALCULATION X Z4 INCHES OF PRODUCT WEIGHT c)F PR00LJ T zZ Psi ( 1 ) INCHES OF WATER 1N TANK •036 Line I + Line 2 ; PSI Total PasI11Ve Head Pressure In Tank = l, 7L X .036 — PSI (3) INCHES OF' WATER OUTSIDE TANK PSI (4) Total Head Pressure Minus Outside Water Pressure Always add .5 PSI — / t/- PSI(5) NOTE: If Line 6 is Less Than + .5 PSI Llne 7Shall be .5 PSI PS1 (oj TEST PRESSURE TIME PRESSURE PSl 17 Blower Started: f �e:' --42. Test Pressure Reached: 20--Z�j 1-xz Blower Turned Off: Depfh of Groundroler Determined: Test Began: By., -�-- 1- ' � Where/ Test Ended: Added: WATER SENSOR CALIBRATION t Cal#1— Ca#2 � I Average: C01 #3 Nefgnl Woter Intrusion Test Period: egan; 8oii0M Produce To CQICulation for Test P od: In c•rss��;� + 378p � Tank r + .OS h'Oier AVe. Col. A Factor -- ,. or Tlme of Test Wolelln Tank t+ II 3 LO GATO R PLUS I'REssuRE CALCUTAY10N & ' MANUMCWRFo By:ESTABROOK'S INC. 1-877.368-7215 WA7FA SENSOR C�4lJ8RATlON DATA SHEET DINE xfore PB9'a (NEW YORK) TOTAL TANK VOL. ��r��. TANK q PRODUCT VOL. ` u UIIAGE VOL. LOCATION .3 �,3�, n PRODUCT TYPE PRESSURE SENSOR CALCULATION ---to' �� _ INCHES OF PRODUCT WEIGHT OF`pRODU T # 7�a PSI ( 1 ) � x � INCHES OF WATER IN TANK .036 PSI (2) Line I + Line 2 = Total Positive Head Pressure In Tank PSI (3 �-Z-- X .036 = a INCHES OF WATER OUTSIDE TANK PSI (4) Total Head Pressure Minus Outside Water Pressure T/- PSI( ) Always add .S PSI + / NOTE: if Line 6 is Less Than .5 PSI Line 7 Shall be .5 PSI `�p PSI (6) TEST PRESSURET/- PSI 7, TIME PRESSURE � S� I i Blower Started: ,5--- e, Test Pressure Reached: r U Z. L L'�-.-�..�. Z y--- Depth of Groundwater Determined BlowerTurn�d Off: / S" ! Zq By: Test Began: r 3 Where: Test Ended: Added; WATER SENSOR CALIBRATION + I Cal #I C0� I— #2 Cal3 Heighl Average: ' Wafer Intrusion Test Pe n: // !! Bo►tom •Ended: To Ily Product Groae i Calculation for Test Period: In Grour.; Tank j —w._. + 3780 = + .05 = Ave. Col �� "A Factor Time of Test woterin �-- Tank M T T Rcrb;npp� a tC Y 3 LOCATOR PLUS RESSURE mcuun ' MANUfACTUROD 9Y:ESTAMOK'SINC, 1-877-$68.72t3 ON &WATER SENSOR G U8FAT1pN DATE DATA SHEET P89'1t TOTAL TANK VOL. (NEW YORK) PRODUCT TANK tt r VOI. ��7� 11,111,111,111, LOCATION ULLAGE VOL. 3C1 l7 PRODUCT TYPE PRESSURE SENSOR CALCULATION X INCHES OF PRODUCT n7� / WEIGHT OF PRODUCT P.SI ( ) ) INCHES OF WATER IN TANK x .036 PSI (2) Line 2 W Total Positive M ead Pressure In Yank Line I + X ,036 _ PSI (31 INCHES OF WATER OUTSIDE TANK PSI (4) Total Head Pressure Minus Outside Water Pressure = Always add .5 PSI PSI(5) NOTE: If Line 6 is Less Than .5 PSI Line 7 Shall be .5 PSI ' PSI (b) TEST PRESSURE 2, TIME PRESSURE TI- PSI It7' Blower Started: Test Pressure Reached: 5-- /(0 Depth of Groundwater Determined: Blower Turned Off: Began:Test 13 Where; Test Ended: � 57� — WATER SENSOR CALIBRATION Added: - _ } Cal #I C 2 Heil ht Ayeroge: Water Intrusion Test Period: Began:-------. Botlom Ended' Product To In Croce. Calculation for Test Period: Cce. Tonk .�• _ -4�z + 3780 Grovp.c + .d$ � w tiler ao Ave. Cal. . A Fac tor Time of Test Wate Tonk T Rev:W/?00� ' FZ'Y 3 LOCATOR PLUS PRESSURE CALCULATION&WATFJ' SENSOR CAU$RAnON MANUFACTURED BY.ESTABROOK'S INC.' 1-877-36ag215 DATA SHEET DATE L TA 7 � /_ PBS'# (NEW YORK) TOTANK VOL. �� G� TANK # PRODUCT VOL 7S LOCATION_ YYC� ULLAGEVOI. PRODUCT TYPE I VD iAll~ PRESSURE SENSOR CALCULATION x INCHES OF PRODUCT l PSI (1 ) WEIGHT OF PRODUCT X .036 — CJ INCHES OF WATER IN TANK PSI (2) Line i + Line 2 = Total Positive Head Pressure In Tank = X �' � �� PSI (3) INCHES OF WATER OUTSIDE TANK .036 = PSI (4) Total Head Pressure Minus Outside Water Pressure Always add .S PSI , +/- PSI(5) + NOTE: If Line 6 is Less Than .5 PSI Line 7 Shall be .5 PSI ' PSI (6) TEST PRESSURE TIME SURE �-/- PSI (7) PRESSURE Blower Started: o U Test Pressure Reached: [ d s Depth of Groundwater Determined: Blower Turned Off: .2,c r /�--� ay: Test Began: / v Z; a r——� Where: , Test Ended; ��• 5' FAve ATER SENSOR CALIBRATION ^.�� al #i Ca� I~ Ca #3 Height „ sion Test P ( d: Igan:�_ Bottom Ended: Product To n for Test Period: In Grade + 3780 = Tank I Ground WQfer Ave. Cal. D;a. CJ "A"Factor Time of Test Watertn Tank RM 04/2001 LINE & LEAK D=- ECTOR TEST CE'RTIF/CATE CLIENT ALLIANCE ENERGY CORP. VICTORIA CAROLINE ADDRESS 36 EAST INDUSTRIAL RD. BRANFORD, CT,06405 TANK ADDRESS EXXON 5 JOHN FITCH BLVD. S.WINDSOR,CT TEST METHOD ESTABROOK TEST DATE MARCH 21,2006 LINE LINE TIGHTNESS LEAK DETECTOR NO, TEST RESULT TEST RESULT #1 REGULAR PASSES ELECTRONIC #2 SUPER PASSES ELECTRONIC #3 DIESEL PASSES ELECTRONIC #4 KERO PASSES PASSES REMARKS; EACH LINE TIGHTNESS TEST AND MECHANICAL LEAK DETECTOR TEST COMPLIES WITH THE STATE OF CT,AND EPA GUIDELINES FOR ACCEPTABLE TEST RESULTS. TESTS CONDUCTED FROM DISPENSER TEST PORT(S). SWEAR VALVES WERE FUNCTIONAL, APPROVAL: RICHARD BRADFORD ESTABROOK#0227 SIGNATURE Cio'e� t RED JACKET#3629 ADVANCED TANK TESTMG SERVICES,MC. PO BOX385 SZEERFIELD,MA 01373 413.665-8300 LEAK DETECTOR TEST RESULTS ESTABROOK, INC. Location G7` d �. Address 3-an "7U C Date 3�ao echnician's name and number Type of leak detector tested _fake Model type Serial numte, 9:?G. �r.� •es: - _—. i i c,2rnant Reviency Leax Rage *�^^ P ^ c: - Psi C) 2 3 s i EZY CHEK SYSTEMS PRODUCT LINE TESTER DATA SHEET DATE 0 F TEST TECH NAME & LOCATION NAME Z 2 ADDRESS �� ' I� CO.ti'TACT PERSON I TELE S t APPLIED PRESSURE v 7-- NUT TIME DATA •�r (.0037) GPL RES —�. _GHP MIf TIME p T CPS R>r'$ G 0 Q a -�- 23 U - - o 41 Lo �' 1 tir• • r IJJfDEf'IGROUND STORAGE PG of - STATE OF CONNECTICUT y EPHM-6 Rev 5i94 \ FOR STATE A DATE ENTERED 2.� -- Department of Environmental Protection a �: t-,,� g_ Q FACILITY NOTIFICATION UNDERGROUND STORAGE FACILITIES PROGRAM _ AGENCY USE ONLY Z Bureau of Waste Management B FEE BILLED C FEE RECEIVED O FIRST ( )79 ELM STREET,Hartford,CT 06106-5127 - H 1 a. 1:1 NOTIFICATION TEL. 860 424-3374 U SITE LID. c� D.GRID COORDINATES E DOES FACILITY MEET NEW REQUIREMENTS? N OR ! ' d- PLEASE TYPE OR PRINT.ALL THREE COPIES MUST BE LEGIBLE Y j b aSUBSEQUENT I'd checked, 132-2271 �� Refer to INSTRUCTIONS FOR FILING NOTIFICATION before completing form. " y ` YES ❑ NO NOTIFICATION enter no.) P LOCATION SITE NAME NO.AND STREET I NEAREST INTERSECTING STREET CITY OR TOWN STATE 5 LATITUDE LONGITUDE 4, OF FACILITY Saith WindSW Exxon 5 John Fitch Blvd Bllrltgo St South WirklWr Cr o I o 11 BUSINESS NAME AND!NAME NO.AND STREET CITY OR TOWN STATE ZIP CODE TELEPHONE 6. MAILING ADDRESS AlliatCergy Corp 36 East Industrial Road r 171640 ( ) - m I NAME NO.AND STREET CITY OR TOWN STATE ZIP CODE PHONE O 7. FACILITY OWNER__i Alli��L �Y� Corp__ 36 East Industrial good ( ) _ Cr 0 -b�8 LJ 8. TYPE OF OWNER PRIVATE STATE MUNICIPAL U FEDERAL(G.S.A.NO. ). p`. -- --- -- ---- - ---- ----- OPERATOR/CONTACT NAME NO AND STREET CITY OR TOWN STATE ZIP CODE TELEPHONE 9. PERSON ( ) 10. 11a 11b. 12a. 12b.STATUS 13TYPE OF 14.CONTENTS 15.CONSTRUCTION 16.PROTECTION 17.INTEGRAL 18. 19.FAILURE CONTENTS MATERIALS a.INTERNAL b.EXTERNAL PIPING SYSTEM DETERMINATION b CONDUCTED? TANK-I.D. DATE OF i N TOTAL W EST.QUANTITY o DATE J CHEMICAL NAME OF PRINCIPAL W E v O o v O E o f z DATE OF MONITORING INSTALLATION _ CAPACITY w z I LEFT STORED w TANK 0 o o SUBSTANCE J J U U Q° o 0 o f o w o i,- cc. d o n INSTALLATION SYSTEM (If"YES",enter"DATE" U a m O a > F-o w ¢H a w o_ m (Mo./Yr.) w s (Gals.) D O J (It any) 0 LAST w o_ (not trade name) w 0 0 W ==- w Z O 0 F o_ 0 c) w r_ RN O f OR and attach results). Z Za I (Gals.) as O � Cr J � m Z J xw ¢Q xw x � m w USED �_ LL'- Enter C A.S No..if known to w Z a ~ 0.71 � z t-'' O¢ F i d mL iQ o m REPLACEMENT (Specifye , If"NO",enter"NO" QZ w xJ ( ) a0a <0 a0 On o ¢N AP ( ) a- I ¢ (Mo.Nr.) 0 J ED¢ rn � �cr v� �a cn �a a- (Mo.;1 r) from list B) -- I Example -5/75 ! 30 5000 X X Heating fuel#2 X X H 3 H 5/75 U NO Example 7/60 - 8000 X 8f78 X l,l,l CAS# 9016 methane X X E 7 W 7/60 U - B-3 10/88 30 8000 X X Gasoline X X ADM 3 10 88 M100— Z B-4 10/88 30 8000 X I X Gasoline X X 0 W B-5 10/88 30 8000 X X Diesel B2-R 9/97 30 6000 X X I Kerosene I ��� 22.CERTIFICATION:I certify under penalty of law that t have personally examined 22a.SIGNAT E 22b.DATE SIGNED 20.HAVE YOU ATTACHED SKETCH OF TANKS AND LOCATION. YY YES RerO tank -En r0n � and am familiar with the information submitted in this and all attached documents and that Z 21.COMMENTS: Piping DW unlined. Site has overfill Spill based on my inquiry of those individuals immediately responsible for obtaining the information, X Z i /�- rJ 7 Ocimitainminit & TLS I believe that the submitted information is true.accurate and complete. - - 0 Penatties:any owner who knowingly tails to nobly shall be subject to a civil penalty not to 2 (TYPe or Print) 22d.OFFICIAL TITLE(o!owner or authorized LU epresentafive). (D exceed 5t O M for each tank for which notification is not given or for which false information is submitted Jahn Gargano Executive Vice President COPY 2: SEND TO LOCAL FIRE MARSHAL -4 !IQ 03 0 0 G O-AV O O- 0 �ti0 XQ C4 r,011- 0 C) UNDERGROUND STORAGE I PG.I of STATE OF CONNECTICUT �10 Depertmenf of Environmenlel ProtectionEPHM-6 REV 390a FACILITY NOTIFICATION 2. UNDERGROUND STORAGE FACILITIES PROGRAM 3. FOR STATE A SITE I, Al HAZARDOUS MATERIALS MANAGEMENT UNIT AGENCY USE ONLY Z 163 Cop toI Avenue,Hertford,CT 06106 O RRST B.DATE RCVD BY D.E.P C.DATE ENTERED NOTIFICATION TEL 566-4630 , u+ ORPLEASE TYPE.ALL THREE COMES MUST BE LEGIBLEI y'r D.GRID COORDINATES iE DOES FACILITY MEET NEW REOUIREMENTS? SUBSEC LENT (If checked, b. ❑ NOTIFICATION enter No.) Refer to INSTRUCTIONS FOR RUNG NOTIFICATION before completing form. X Y ❑YES ❑NO LOCATION SITE NAME N0,AND STREET I NEAREST INTERSECTING STREET CITY OR TOWN ;STATE,SAATIO DE jr, LONGITUDEIt „ 4 of FACILITY c Burn South Windsor Sunoco 5 Jahn Fitch Sou _ ham St. South Windsor Ct 41- 9 25 172 37 18 BUSINESS NAME AND NAME NO,AND STREET CITY OR TOWNSTATE ZIP CODE TELEPHONE 6. MAILING ADDRESS Petrol Plus, Inc. 38 Ccmnerce St. , P.O. Box 477 Derby Ct 06418 1203 ) 776-71 19 as NAME NO.AND STREET CITY OR TOWN STATE ZIP CODE TELEPHONE O 7. FACILITY OWNER Petrol Plus, Inc. 38 Ccamerce Ste, P.O. Boat 477 Derby Ct 06418 203) 776-7119 F V w 8. TYPE OF OWNER ❑ PRIVATE ❑ STATE ❑ MUNICIPAL FEDERAL(G.S.A.No. N OPERATOR/CONTACT NAME NO.AND STREET CITY OR TOWN STATE ZIP CODE TELEPHONE 9. PERSON Victoria Caroline 38 Ca=erce St., P.O. Box 477 1 Derby _ C t06418 203 ) 776-7119 10 16.PROTECTION 17. INTEGRAL ilo. lib. 120. 12 b.STATUS 13. TYPE OF 14. CONTENTS- 15.CONSTRUCTION 18. 19.FAILURE Y DATE CONTENTS MATERIALS o.INTERNAL b.EXTERNAL PIPING SYSTEM TANK ID. TOTAL DATE OF O EST. QUANTITY ► CHEMICAL NAME OF PRINCIPAL Z o. .DATE OF MONITORING DETERMINATION INSTALLATION "Q CAPACITY Z v i LEFT STORED I W TANK O D < SUBSTANCE V5 W Y rx�t Q pv O_ CIE -0 a �_ INSTALLATION SYSTEM CONDUCTED? W- (Gols.) 8 S ) LAST 0 V (not trade name.) O N u+g.. W g V 0 v a, o � m OR (If'YES',.rile,DATE' (blo./Yr.) x e W d (il any). Woe O ee w =e� 0 Z =w < 2 W �¢zo oa W} Z I O USED o o. f— Enter C.A.S. No. If known w W z5 ~CIE W ~'' t t-� E CIF= w— 7 <2 i to: } a O e4 O,` REPLACEMENT (Seedy type and orioch nwlh). m— i (Gels.) w �f xO �"' OyQ Z Z VoOe V3 < e 0 Z < (Ma./Yr.} J V 7 w e: o. V g` (Mo./Yr.) from list B) (0*NO',enter'NO') p 5/75 30 5000 X X Heating fuel#2 X X H 3 H 5/75 U ! NO Example �/ Q p �/ C 7 W Example 7/60 8 000 /� 8�78 X 1.1,I CAST#79016 ne X X E -" 7/60 U B-2 8/84 30 8000 X X Kerosene X X X A,D 3 8/84 K,L,O,Q yes 2/89 V B-3 110/88 30 8000 X X Gasoline X X A,D 3 � 10/88 !K L O 2/89 . . .Q yes B-4 � 10/88 30 8000 X X Gasoline X X A,D 3 ; 10/88 'K,L,O,Q yes-2/89 ULI — — - - B-5 10/88 30 8000 X X Gasoline X X ,D 3i 10/88 K,L,O,Q yes 2/89 — - - i 20. HAVE YOU ATTACHED SKETCH OF TANKS AND LOCATION? 22a SIG RE 22b.DATE SIGNED � ® �'V1011Sly sent 22. CERTIFICATION: I certify under Penalty of law that 1 have personally examined miliar with the information submitted in this and all attached documents and that 3 3U 92 z 21. COMMENTS: #7 corrected - Cathodic P. Survey dtd 2/12/92 at X / / O n my inquiry of those individuals immediately responsible for obtaining the — H I information, I believe that the submitted information is true, accurate and complete- 2 c NAME(Type or Prinz} 22d OFFICIAL TITLE (of owner or authorized l.1 Penekies:any owner who knowingly fails to notify shall be subject to a civil penalty not to representative). Nexceed$10.000 for each tank for which notification is not given or for which false information is submitted. Pxthur Bogen Executive Vice President 1 e SEND TO LOCAL FIRE MARSHAL f! Service Technology Inc. 20 EAST NEWBERRY ROAD P.O. BOX 549 BLOOMFIELD,CT 06002 TELEPHONE (203) 242.9558 —CT WATTS 800 842-8250— FAX (203) 286-0708 REPORT OF CATHODIC PROTECTION SURVEY REPORTING DATEt February 12, 1992 The following is our report of the recent cathodic protection survey made on the subject tank system, including its connected piping, as appropriate. TANK OWNER: Petrol Plus ADDRESSt 38 Commerce St. , Derby, CT. SITE NAHE: Snaxx Plus ADDRESSo John Fitch Blvd, S. Windsor, CT. TANK-1 I TANK-2 I TANK-3 I TANK-4 I TANK-5 1 TANK IDENTIFICATION 1911219. 11 TEST DATE 112-20-911 I I PRODUCT 1 Kero CAPACITY 1 8,000 i I ■ INSTALLED DATE I 08/84 TANK READING 1 —826 1 VENT READING I —1079 I I I I I PROD. PIPE READING 1 —350 VENT DIELECTRIC BUSH i —825 PROD. DIELECTRIC BUSHI —801 see page 2 1 PAGE 2 PETROL PLUS-SNAG% PLUS JOHN FITCH, S. WINDSOR, CT. 1. Kero tank doesn't meet the criteria for adequate corrosion protection. 2. Vents have fiberglass piping and galvanized steel risers,that do meet the criteria for adequate corrosion protection. 3. Product piping is fiberglass. If you have any questions concerning the information conained in this report, please do not hesitate to call. Sincerely John H. Suchecki Operations Hanager Service Technology, Inc. M S PETROL PLUS 38 COMMERCE STREET P.O.BOX 477 DERBY,CT06418 Telephone 735-8602 New Haven 776-7119 1-800-922-2236 GASOL INES • DIESEL • 2,3&6 OIL • LUBRICANTS • ANTIFREEZE March 31 , 1992 Ms . Lynn Olson-Teodora State of Connecticut D .E .P . Underground Storage Facilities Program Hazardous Materials Management Unit 165 Capitol Ave . Hartford , Ct . 06106 Re: Cathodic Protection Surveys Updated Tank Registrations Dear Lynn Enclosed you will find various sites with Cathodic Protection Surveys attached for your files . Also you will find a few updated Tank Registration forms where the facility owner has been corrected to read Petrol Plus , Inc . Any questions or concerns you may have please do not hesitate to call me . Sincerely, Victoria Caroline Project Manager /mz cc: Fire Marshal A\ffiance Alliance Energy Corp. r 36 East Industrial Road,Branford,CT 06405 800-899-8602 203488-6068 Fax:203488-3065 ., Suult;'•'�!ndsor EUILDIi4G DEPARTMENT February 1,2007 VIA OVERNIGHT MAIL State of Connecticut Department of Environmental Protection Underground Storage Facilities Program Bureau of Waste Management 79 Elm Street Hartford, CT 06106-5127 Re: Alliance Energy Corp Updated Tank Registrations To Whom It May Concern: We have updating all our tank registrations because the person who had initially signed all the registrations is no longer with the company. Please find the enclosed tank registrations-signed by John Gargano, Executive Vice President for the following sites: SITE NAME ADDRESS SITE ID# Avon Buck Stop 80 East Main Street 4-101 Bloomfield Exxon 47 Jerome Ave 114487 Branford Global 202 East Main Street 14-1478 Bridgeport(Lou's)Exxon. 565 Lindley Street 15-3410 Bridgeport Noble Ave Exxon 1360 Noble Ave 15-3401 Bristol Sunoco 201 North Street 17-524 Bristol Shell Service Station 57 Middle Street 25 Brooklyn(D&Z) Route 6 19-224 Canton Exxon Rt 44 Albany Tpk 23-294 Cheshire Sunoco 1123 Meriden/Waterby Rd 254531 Cheshire South Main Street Citgo 986 South Main Street 254545 Danbury Mill Plain Exxon I I I Mill Plain Rd 34-6764 Danbury Global 110 Newtown Road 34-1230 Darien Exxon 1044 Boston Post Rd 354938 Derby Buck Stop 208 New Haven Ave 37-5058 Durham Sunoco 9 Main Street 38-378 Enfield Exxon 241Hazard Ave 49-610 it A\ffiance Alliance Energy Corp. Page 2 Alliance Energy Corp Updated Tank Registrations Essex Mart 90 Plains Road 50-701 Fairfield Shell 1139 Post Road 51-9704 Farmington Exxon Colt Highway 52-7030 Glastonbury Global 2997 Main Street 54-3299 Greenwich Exxon 780 W Putnam Ave 57-5032 Greenwich Exxon 111 West Putnam Ave 57-5018 Hamden Mount Carmel Exxon 3070 Whitney Ave 62-5581 Hamden Sunoco 2263 Whitney Ave 62-5751 Hartford Citgo 351 Woodland Street 64-5310 Hartford Exxon 125 Weston Street 644891 Huntington Citgo 429.Shelton Ave 126-7893 Manchester Sunoco 330 Tolland Turnpike 77-1179 Manchester Exxon 1527 Pleasant Valley Road 77-1222 Meriden Scott West Main 583 West Main Street 80-3298 Milford Buck Stop 1065 Bridgeport Ave 84-10656 Milford Devon Gas 25 Bridgeport Ave 84-6389 Milford Sunoco 298 Boston Post Road 84-6236 Milford Exxon Plains Rd 118 Plains Road 3-7612 Monroe Buck Stop 456 Main Street 854770 Naugatuck 704 Rubber Ave 88-5399 New Haven Exxon 775 Whalley Ave 93-6634 New Haven Exxon 284 Whalley Ave 93-6536 New Haven Quinnipiac Exxon 1260 Quinnipiac Ave 93-6630 New London Citgo 445 Williams Street 95-1848 Newtown Exxon 75 South Main Street 97-6276 North Haven Exxon 276 Washington Ave 101-6334 Norwalk Cross Roads 93 Main Street 103-8019 Norwalk Exxon 347 Main Street 103-7675 Norwich Exxon 406 West Main Street 104-1768 Orange Sunoco 404 Boston Post Road 107-5801 Oxford Global 357 Oxford Road 108-5529 A\Lffiance Alliance Energy Corp. Page 3 Alliance Energy Corp Updated Tank Registrations Plantsville Exxon 828 Meriden Ave 131-7459 Rocky Hill Exxon 479 Cromwell Ave 119-7724 South Windsor Sunoco 5 John Fitch 132-2271 Southington Buck Stop 662 West Street 131-7838 Southington Queen Street Exxon 682 Queen Street 131-7454 Stamford High Ridge Exxon 1199 High Ridge Road 135-8656 Stratford Exxon 2816 Main Street 138-8379 Sunnyside Farms Route 12 Plainfield 109-1940 Wallingford Scott 70 Center Street 148-2732 Waterbury Exxon 474 Bank Street 151-2773 Waterbury Exxon 10 Scott Road 151-2771 Waterbury Exxon 1003 Wolcott 151-2774 West Hartford Exxon 55 Kane Street 155-8335 West Hartford Exxon 905 Farmington Ave 155-8187 Westbrook Exxon 198 Essex Road 154-3719 Westport Exxon 485 Post Road East 158-6886 Wethersfield Sunoco 1780 Berlin Turnpike 159-8090 Willimantic Exxon 104 Main Street 163-3813 Windsor Locks Ella Grasso Exxon 1-7 Ella Grasso Tpk. 1654116 Please do not hesitate to call with any questions or concerns. Sincerely, Fritz p onmental Consultant Representing Alliance Energy Corp /mz Enclosure Cc: J. Gargano Local Fire Marshal Part II: Owner/Operator Information (continued) 8. Financial Mechanism(s):Complete the table below identifying the financial assurance mechanism(s)used to demonstrate financial responsibility as specified in the Federal Register. Use the list of surety types below. If an 'other method'is chosen,please specify the method in the table. A. Self Insurance E. Guarantee I. Trust Fund B. Commercial Insurance F. Surety Bond J. *State Fund C. Risk Retention Group G. Letter of Credit K. Other Method(specify in D. Local Government H. Bond Rating Test table below) Financial Test *Pursuant to section 262 of Public Act 12-1 of the June 12`special Session,the state fund(UST Petroleum Clean-Up Program)will cease to serve as a financial responsibility mechanism on: October 1,2012,for those who own or operate USTs on more than five separate sites;and October 1,2013 for municipalities and for those who own or operate USTs on five or less separate sites. Surety Type IAmount Coverage Coverage Name Of Insurer Policy (insert letter Of Start End Number from list above I Coverage Date Date or specify) Tokio Marine Specialty Insurance Company PPK1426716 $2;000,000 B.Commercial Insurance 1 Dec 2015 1 Dec 2016 - ---- - Owners/Operators shall complete the attached'Certification of Financial Responsibility Form"and maintain such completed form at the facility where the storage tank system(s)are located.THIS FORM DOES NOT NEED TO BE SUBMITTED but must be updated to reflect any changes. Part III: Record Information Off-Site Storage of Records at a Centralized Location Does the owner/operator of more than 10 facilities with UST systems request to store certain records at a centralized location? Yes (Leave unchecked if'No') If yes,provide the central location address below. Address: City/Town: State: Zip Code: - Such records must be immediately available for inspection by the commissioner or the commissioner' s designee at any such central location. Please refer to section 22a-449 q CGS;for storage of underground storage tank system records that may be kept at a centralized location or that must be kept on site. DEEP-UST-NOT-001 5 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information Complete for all tanks and piping at the subject location. Begin by labeling tanks (including compartments, if applicable). Label tanks as required by the instructions. If you have more than 5 tanks in one location, reproduce this section and complete for additional tanks.You must read the instructions (DEEP-UST-INST-001) in order to properly complete this Part. Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number(see instructions) B-3R1 B-4R1 B-SR1 82-R1 Part of a compartmentalized tank Part of a manifolded or interconnected tank Complete items 1 through 5 for the entire tank-you do not have to complete the columns labeled for compartments. 1. Status of Tank Currently in Use ✓ ✓ ✓ ✓ Temporarily Closed Date Temporarily Closed Permanently Closed(check here and skip to Part L9 2. Date of Installation of Tank(month/year) 10/01/1988 10/01/1988 10/01/1988 09/O1/1997 3. Life Expectancy of Tank(years) 30 30 30 30 4. Material of Construction - Tank- check one per tank Asphalt Coated or Bare Steel Coated and Cathodically Protected Steel (STI-P3) Composite (Steel clad with Fiberglass) Composite (Steel with Plastic Jacket) Composite (Steel with Urethane) Fiberglass Reinforced Plastic ✓ ✓ ✓ ✓ Other (e.g., concrete, etc.) (please specify) 5. Construction Type-Tank- check all that apply Lined Interior with Epoxy Coating Excavation Liner Double Walled ✓ Single Walled ✓ ✓ ✓ Tank Manufacturer Check box if tank has ever been repaired Complete the following for each compartment or tank. 6. Emergency Generator Use Only 7. Estimated Total Capacity(gallons) 8000 8000 8000 6000 Farm Use DEEP-UST-NOT-001 6 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information (continued) Tank Identification Number (see instructions) Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: B-3R1 B-4R1 B-5R1 B2-R1 Part of a compartmentalized tank Part of a manifolded or interconnected tank 8. Substance Currently Stored (or last stored in the case of closed compartmentsftanks) check one per compartmentltank Gasoline ✓ ✓ Diesel ✓ Kerosene (for resale) ✓ Kerosene (on-site consumption) Heating Oil (on-site consumption) Heating Oil (for resale) Used Oil Biodiesel E-85 E-15 If Other, please specify here Hazardous Substance CERCLA name CAS Number 9. Primary Release Detection-check one per compartment/tank Annual Precision Tightness Testing Tank Tightness Test with Inventory Control Continuous(Electronic) Interstitial Monitoring ✓ ATG - CSLD-Continuous with Inventory Reconciliation/Control ATG - Static with Inventory Reconciliation/Control ✓ ✓ ✓ Monthly Groundwater/Vapor Monitoring Manual Tank Gauging Monthly Visual Interstitial Monitoring No release detection required (see instructions) If Other Method, please specify here DEEP-UST-NOT-001 7 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information (continued) Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number B-3R1 B-4R1 13-51R1 132-R1 Part of a compartmentalized tank Part of a manifolded or interconnected tank Piping Construction 10. Piping Installation Date 10/01/1988 10/01/1988 10/01/1988 09/01/1997 11. Piping Material - check one per compartmenUtank Bare Steel Galvanized Steel Epoxy Coated Steel Flexible Plastic No Piping associated with Tank or Above Ground Only Fiberglas,Reinforced Plastic ✓ ✓ ✓ ✓ Semi-Rigid Plastic Copper Other 1.2.Piping-Secondary Containment- check all that apply Containment Sumps at Dispensers ✓ Containment Sumps at Tanks ✓ ✓ �. r� 13. Pipe Fitting- check one per compartmenUtank x � "i, ; Metallic Fitting Isolated from Soil and Water Metallic Fitting Cathodically Protected 14.Construction Type-Piping- check all that apply $ Cathodically Protected Double Walled ✓ Metallic Piping Isolated form Soil and Water Single Walled ✓ ✓ ✓ Unknown 15.Piping Type- check one per compartmenUtank Pressure ✓ ✓ ✓ ✓ tt. 'U.S."Suction(valve at tank) Gravity Feed Only "Safe"Suction(no valve at tank) If Other, please specify here Check box if piping has ever been repaired DEEP-UST-NOT-001 8 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information continued 9 9 (continued) Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number B-3R1 B-4R1 B-5R1 B2-R1 Part of a compartmentalized tank Part of a manifolded or interconnected tank 16.Primary Release Detection-Piping- check one per compartment/tank Annual Precision Line Tightness Testing J J ✓ ✓ Precision Line Tightness Testing Every 3 years Continuous(Electronic)Interstitial Monitoring Monthly Visual Interstitial Monitoring GroundwaterNapor Monitoring PLLD—Annual.lgph Leak Test PLLD—Monthly Elec.0.2gph Leak Testing No release detection required(see instructions) If Other Method. please specify here 17.If piping type is pressure- check one per compartmentFtank Electronic Auto Line Leak Detectors J J J Mechanical Auto Line Leak Detectors J 18.Spill and Overfill Protection— check all that apply Audible Alarm Ball Float Device Flapper Device ✓ ✓ ✓ ✓ None Spill Prevention Device Installed ✓ ✓ ✓ ✓ Part V: Permanent Tank Closure Tank Identification Number Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Part of a compartmentalized tank Part of a manifolded or interconnected tank 1. General Information of Closed Tank Date of Installation(monthlyear) Estimated Total Capacity(gallons) Estimated date tank closed(month/day/year) (check one per tank): Tank was removed from ground Tank was closed in ground Tank filled with inert material Describe the inert fill material here DEEP-UST-NOT-001 9 of 12 Rev-12/18/12 Part V: Permanent Tank Closure (continued) s f Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identiftic tton Number gv,. Part of a compartmentalized tank Part of a manifolded or interconnected tank 2. Estimated date the UST was last used for storing regulated substances(month/dayiyear) 3. Site Assessment Required Site Assessment Completed (If Yes,provide consultant/contractor information below) Consultant/Contractor Name(s) Consul tant/Contractor Addresses(s) Consul tant/Contractor Phone(s) Soil Samples Collected and Analyzed for one or more of the following: VOCs,SVOCs,Metals,ETPH Groundwater Encountered During Assessment Groundwater Samples Collected and Analyzed for one or more of the following: VOCS,SVOCS,Metals.ETPH 'Soil Samples had Constituents of Concern above the following RSR Criteria: - check all that apply GA PMC GB PMC Res DEC 1/C DEC 'If any boxes were checked above,include a table summarizing Me data and highlighting the exceedances (See R.C.S.A.Sections 22a- 1331k-1 through 3 for definitions). 'Groundwater Samples had Constituents of Concern above the following RSR Criteria: - check all that apply GWPC SWPC Res GWVC VC GWVC •If any boxes were checked above,include a table summarizing the data and highlighting the exceedances (See R.C.S.A.Sections 22a- 133k-1 through 3 for definitions). Remedial Actions Recommended by Environmental Consultant/Contractor If box is checked.a closure report must be submitted to the LUST Coordination Program for evaluation. Remedial Actions Completed If box is checked,a closure report must be submitted to the LUST Coordination Program for evaluation. DEEP-UST-NOT-001 10 of 12 Rev.12/18/12 Part Vl: Certification of Installation Complete within 30 days of installing an UST or adding an UST system to an existing notification. If you have more than 5 tanks in one location, reproduce this part and complete for additional tanks. Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number Part of a Compartmentalized Tank ❑ ❑ ❑ ❑ ❑ Installer of tank and piping must check all that apply Installer certified by tank and piping manufacturers ❑ ❑ ❑ ❑ Installation inspected by a registered engineer ❑ ❑ ❑ ❑ Installation inspected and approved by implementing n ❑ L� ❑ agency Manufacturer's installation checklists have been completed LJ J If Other Method,please specify here Provide signature of UST Installer to certify proper installation of subject UST System. Company Name: License Type: Company Address: City/Town: State: Zip Code: Business Phone: ext.. Name of UST Installer(print or type): Title: E-mail: Phone: ext.. Signature and Date of UST Installer: DEEP-UST-NOT-001 11 of 12 Rev.12/18/12 Part VII: Owner/Operator Certification The owner/operatorand the individual(s) responsible for actually preparing the notification must sign this part. A notification will be considered incomplete unless all required signatures are provided. "I have personally examined and am familiar with the information submitted in this document and all attachments thereto, and I certify that based on reasonable investigation, including my inquiry of the individuals responsible for obtaining the information,the submitted information is true, accurate and complete to the best of my knowledge and belief. I understand that a false statement in the submitted information may be punishable as a criminal offense, in accordance with section 22a-6 of the General Statutes, pursuant to section 53a-157b of the General Statutes, and in accordance with any other applicable statute. I certify that I have completed a Certification of Financial Responsibility Form and such completed form is maintained on-site. I also certify that this underground storage tank notification is on complete and accurate forms as prescribed by the commissioner without alteration of the text." Signed on: 1/20/2016 10:50:27 AM Signature of Owner/Operator Date Name of Owner/Operator(print or type) Title(if applicable) Signature of Preparer(if different than above) Date Name of Preparer(print or type) Title(if applicable) Check here if additional signatures are required. If so, please reproduce this sheet and attach signed copies to this sheet. Note: Please submit a completed Underground Storage Tank Notification and all Supporting Documents to: CENTRAL PERMIT PROCESSING UNIT DEPARTMENT OF ENERGY AND ENVIRONMENTAL PROTECTION 79 ELM STREET HARTFORD, CT 06106-5127 A copy of all completed Notification Forms must be maintained on site and the most recent completed form must also be forwarded to the local fire marshal. If you have any questions, please contact the UST Program at 860-424-3374 or by e-mail (D P. 1STF Pect_aov) DEEP-UST-NOT-001 12 of 12 Rev.12/18/12 Part II: Owner/Operator Information (continued) 5. Property Owner, if different than UST owner Name: ALLIANCE ENERGY LLC Mailing Address: Boo South St Suite 500 City/Town:Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext.. Contact Person: DAVID J.WENT Phone: (781)402-8893 ext. E-mail: dwent@allianceenergy.com 6. Class A Operator: must be the individual who was trained. Name: ERIC HARVEY Mailing Address: 15 NE Industrial Rd City/Town: Branford State: CT Zip Code: 06405 Business Phone: (845)238-7354 ext.. E-mail: eharvey@globalp.com Company Name,if applicable: alliance energy Approved Training Course: ECS/Eclipse Connecticut Class A/B Operator Trainin Training Date: 20 May 2014 ✓ initial or biennial training OR retraining ordered for non-compliance Certification Expiration Date: 20 May 2016 Class A Operator's Signature: eharvey Signed on:1/19/2016 9:59:21 7. Class B Operator: must be the individual who was trained. Name: ERIC HARVEY Mailing Address: 15 NE Industrial Rd City/Town: Branford State: cT Zip Code: 06405 Business Phone: (945)238-7354 ext.. E-mail: eharvey@globalp.com Company Name,if applicable: alliance energy Approved Training Course:ECS/Eclipse Connecticut Class A/B Operator Trainin Training Date: 20 May 2014 ✓✓, initial or biennial training OR l_I retraining ordered for non-compliance Certification Expiration Date: 20 May 2016 Class B Operator's Signature: eharvey Signed on:1/19/2016 9:59:21 DEEP-UST-NOT-001 4 of 12 Rev.12/18/12 Part II: Owner/Operator Information i) provide Secretary of the State business ID#: 0841321 This information can be accessed at the Secretary of State's database(CONCORD).(www.concord-sots.ct.gov/CONCORDAndex.jsp) ii) E, Check here if your business is NOT registered with the Secretary of State's office. "Notification or fee is NOT required for UST systems located on tribal lands. 2. UST Operator Name: GLOBAL MONTELLO GROUP CORP. This affiliate is the registrant(check if true): Mailing Address: 800 South St-Sufte 500 City/Town: Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7760 ext.: Contact Person: DAVID WENT Phone: ext, *E-mail: Invent@allianceenergy.com a) Business Type(check one): Cl individual L federal agency C state agency El municipality i **tribal *business entity(*If a business entity complete i through ii): i) provide Secretary of the State business ID#: 0841321 This information can be accessed at the Secretary of State's database(CONCORD).(www.concord-sots.ct.gov/CONCORD/index.jsp) ii) ❑ Check here if your business is NOTregistered with the Secretary of State's office. **Notification or fee is NOT required for UST systems located on tribal lands. ❑Check if any co-owners/operators.If so,attach additional sheet(s)with the required information as requested above. 3. Billing contact Name: GLOBAL MONTELLO GROUP CORP. Mailing Address: 705-A Lakeview Plaza Blvd City/Town: Worthington State: ON Zip Code: 43085 Business Phone: (614)433-0170 ext.. Contact Person: MEGAN KAZMIERCZAK Phone: (614)433-0170 ext. E-mail: MKAZMIERCZAK@ECSECLIPSE.COM 4. Primary contact,if different than UST owner Name: GLOBAL MONTELLO GROUP CORP. Mailing Address: 800 South St-Suite 500 City/Town: Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext.: Contact Person: DAVID WENT Phone: ext. *E-mail: Dwent@allianceenergy.com *By providing this e-mail address you are agreeing to receive official correspondence from the department,at this electronic address,concerning the subject application.Please remember to check your security settings to be sure you can receive a-mails from"ct.gov"addresses.Also,please notify the department if your e-mail address changes. DEEP-UST-NOT-001 3 of 12 Rev.12/18/12 Connecticut Department of Energy & Environmental Protection Bureau of Materials Management & Compliance Assurance Emergency Response & Spill Prevention Division Notification for Underground CPPU USE ONLY Storage Tanks App#: Please complete this form,in accordance with the instructions Doc#: (DEEP-UST-INST-001)to ensure the proper handling of your notification.Print or type unless otherwise noted. Check#: Submit one notification form per site. Part I: Notification and Fee Type Program: UST Check the appropriate box(es)identifying the notification type. 1. LOCATION of UST(s) Name of site: SOUTH WINDSOR SUNOCO Street Address or Location Description: 5 JOHN FITCH BLVD City/Town: SOUTH WINDSOR State: CT Zip Code: 06074-4006 2. UST Site ID Number: 132-2271 No.of Fee *No.of 3. This notification is for: exempt Tanks Total choose i,ii,[iior iv Fee excluding(b) Fee= (a) (b) (c) (a x c) ❑ i) first time site notification[new] $100.001 (Complete entire application) tank [#1032] ❑ ii)annual notification[renewal]with NO $100.00/ modifications tank (Complete Parts I and VII only) I#10321 ✓❑ iii)annual notification[renewal] with modifications,(specify modifications under $100.00/ iv below) tank (Complete Parts I and VII and [#1032] modifications only) 0 4 $400 ❑✓ iv) a modification to an existing notification;check any of the following to specify. (Complete Parts 1 and VII and modifications only) ❑ adding new UST system(Part IV) $100.00/ tank 1#10321 0 0 $0 DEEP-UST-NOT-001 1 of 12 Rev.12/18112 Part I: Notification and Fee Type (continued) No.of Fee *No.of exempt Tanks Total 3. (modifications continued) Fee tanks($0) excluding(b) Fee= (a) (b) (c) (a x c) ❑ adding an orphan UST system(newly $100.00/ discovered)(Part IV) tank 1#1032] 0 0 $0 ❑ update/correction to Part 11: $0 owner/operator info/financial responsibility ❑ transfer of ownership(Part II) $0 ❑ update/correction to Part III:record info $0 ❑ update/correction to Part IV:UST system $0 info ❑ Permanent Closure of an UST system $0 (Part V) o $0 *Compartmentalized tanks are counted as one tank. *Manifolded or interconnected tanks count as separate tanks *Total Fee: $400 *For municipalities,the 50%discount applies.The notification will not be processed without the fee.The fee shall be non-refundable and shall be paid by check or money order to the Department of Energy and Environmental Protection. Part 11: Owner/Operator Information *If an Owner/Operator is a corporation,limited liability company,limited partnership,limited liability partnership,or a statutory trust it must be registered with the Secretary of State.If applicable,the applicants name shall be stated exactly as it is registered with the Secretary of State.Please note,for those entities registered with the Secretary of State,the registered name will be the name used by DEEP. This information can be accessed at the Secretary of State's database (CONCORD). (www.concord-sots.ct.gov/CONCORD/index.jsp) If an Owner/Operator is an individual,provide the legal name(include suffix)in the following format First Name;Middle Initial;Last Name;Suffix(Jr,Sr.,It,III,etc.). 1. UST Owner Name: GLOBAL MONTELLO GROUP CORP. This affiliate is the registrant(check if true): ❑✓ Mailing Address: 800 South St-Suite 500 City/Town: Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext.: Contact Person: DAVID WENT Phone: ext. *E-mail: Dwent@allianceenergy.com *By providing this e-mail address you are agreeing to receive official correspondence from the department,at this electronic address,concerning the subject application.Please remember to check your security settings to be sure you can receive a-mails from"ct.gov"addresses.Also,please notify the department if your e-mail address changes a) Business Type(check one): ❑ individual ❑ federal agency ❑ state agency ❑ municipality ❑ **tribal ❑✓ *business entity(*If a business entity complete i through ii): DEEP-UST-NOT-001 2 of 12 Rev.12/18/12 i Part II: Owner/Operator Information i) provide Secretary of the State business ID#: 0841321 This information can be accessed at the Secretary of State's database(CONCORD).(www.concord-sots.ct.gov/CONCORDrindex.jsp) ii) ❑ Check here if your business is NOT registered with the Secretary of State's office. **Notification or fee is NOT required for UST systems located on tribal lands. 2. UST Operator Name: GLOBAL MONTELLO GROUP CORP. This affiliate is the registrant(check if true): ❑ Mailing Address: Boo south St-Suite soo City/Town: Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext.. Contact Person: DAVID WENT Phone: ext, *E-mail: Dwent@allianceenergy.com a) Business Type(check one): ❑ individual ❑ federal agency ❑ state agency ❑ municipality ❑ **tribal ❑✓ *business entity(*If a business entity complete i through ii): i) provide Secretary of the State business ID#: 0841321 This information can be accessed at the Secretary of State's database(CONCORD).(www.concord-sots.ct.gov/CONCORD/index.jsp) ii) ❑ Check here if your business is NOTregistered with the Secretary of State's office. **Notification or fee is NOT required for UST systems located on tribal lands. ❑Check if any co-owners/operators.If so,attach additional sheet(s)with the required information as requested above. 3. Billing contact Name: GLOBAL MONTELLO GROUP CORP. Mailing Address: 705 Lakeview Plaza Blvd City/Town: Worthington State: off Zip Code: 43085 Business Phone: (614)433-0170 ext.: Contact Person: Megan Kazmierczak Phone: (614)433-0170 ext, E-mail: megan.kazmierczak®atcassociates.com 4. Primary contact,if different than UST owner Name: GLOBAL MONTELLO GROUP CORP. Mailing Address: soo south St-Suite soo City/Town: Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext,: Contact Person: DAVID WENT Phone: ext. *E-mail: Dwent®allianceenergy.com *By providing this e-mail address you are agreeing to receive official correspondence from the department,at this electronic address,concerning the subject application.Please remember to check your security settings to be sure you can receive a-mails from"ct.gov"addresses.Also,please notify the department if your e-mail address changes. DEEP-UST-NOT-001 3 of 12 Rev.12/18/12 r Part II: Owner/Operator Information (continued) S. Property Owner, if different than UST owner Name: ALLIANCE ENERGY LLC Mailing Address: 800 South St-Suite 500 City/Town:Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext.: Contact Person: DAVID J.WENT Phone: (781)402-8893 ext. E-mail: dwent®allianceenergy.com 6. Class A Operator: must be the individual who was trained. Name: ERIC HARVEY Mailing Address: 15 NE Industrial Rd City/Town: Branford State: CT Zip Code: 06405 Business Phone: (845)238-7354 ext.: E-mail: eharvey®globalp.com Company Name,if applicable: alliance energy Approved Training Course: ECS/Eclipse Connecticut Class A/B Operator Trainin Training Date: 2 Dec 2016 ❑ initial or biennial training OR ❑ retraining ordered for non-compliance Certification Expiration Date: 2 Dec 2018 Class A Operator's Signature: 7. Class B Operator: must be the individual who was trained. Name: ERIC HARVEY Mailing Address: 15 NE Industrial Rd City/Town: Branford State: cT Zip Code: 06405 Business Phone: (845)238-7354 ext.: E-mail: eharvey@globalp.com Company Name,if applicable: alliance energy Approved Training Course:ECS/Eclipse Connecticut Class A/B Operator Trainin Training Date: 2 Dec 2016 ❑ initial or biennial training OR ❑ retraining ordered for non-compliance Certification Expiration Date: 2 Dec 2018 Class B Operator's Signature: DEEP-UST-NOT-001 4 of 12 Rev.12/18/12 Part II: Owner/Operator Information (continued) 8. Financial Mechanism(s):Complete the table below identifying the financial assurance mechanism(s)used to demonstrate financial responsibility as specified in the Federal Register. Use the list of surety types below. If an 'other method'is chosen,please specify the method in the table. A. Self Insurance E. Guarantee I. Trust Fund B. Commercial Insurance F. Surety Bond J. *State Fund C. Risk Retention Group G. Letter of Credit K. Other Method(specify in D. Local Government H. Bond Rating Test table below) Financial Test *Pursuant to section 262 of Public Act 12-1 of the June 12`h5pecial Session,the state fund(UST Petroleum Clean-Up Program)will cease to serve as a financial responsibility mechanism on: October 1,2012,for those who own or operate USTs on more than five separate sites;and October 1,2013 for municipalities and for those who own or operate USTs on five or less separate sites. Surety Type Policy (insert letter Amount Coverage Coverage j Name Of Insurer Of Start End Number from list above Coverage Date Date or specify) Tokio Marine Specialty fasurance Company PPK1744928 B.Commercial Insurance 1 Dec 2017 1 Dec 2018 52,000,000 Owners/Operators shall complete the attached"Certification of Financial Responsibility Form"and maintain such completed form at the facility where the storage tank system(s)are Iocated.THIS FORM DOES NOT NEED TO BE SUBMITTED but must be updated to reflect any changes. Part III: Record Information Off-Site Storage of Records at a Centralized Location Does the owner/operator of more than 10 facilities with UST systems request to store certain records at a centralized location? ❑ Yes (Leave unchecked if'No') If yes, provide the central location address below. Address: City/Town: State: Zip Code: Such records must be immediately available for inspection by the commissioner or the commissioner' s designee at any such central location. Please refer to section 22a-449 q CGS;for storage of underground storage tank system records that may be kept at a centralized location or that must be kept on site. DEEP-UST-NOT-001 5 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information Complete for all tanks and piping at the subject location. Begin by labeling tanks(including compartments,if applicable). Label tanks as required by the instructions. If you have more than 5 tanks in one location,reproduce this section and complete for additional tanks.You must read the instructions(DEEP-UST INST-001)in order to properly complete this Part. Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number(see instructions) B-3R1 B-4R1 B-5R1 B2-R1 Part of a compartmentalized tank ❑ ❑ ❑ ❑ ❑ Part of a manifolded or interconnected tank ❑ ❑ ❑ ❑ ❑ Complete items 1 through 5 for the entire tank-you do not have to complete the columns labeled for compartments. 1. Status of Tank Currently in Use ❑✓ O ✓❑ ❑✓ ❑ Temporarily Closed ❑ ❑ ❑ ❑ ❑ Date Temporarily Closed Permanently Closed(check here and skin to Part V9 ❑ ❑ ❑ ❑ ❑ 2. Date of Installation of Tank(month/year) 10/01/1988 10/01/1988 10/01/1988 09/0111997 3. Life Expectancy of Tank(years) 30 30 30 30 4. Material of Construction-Tank-check one per tank Asphalt Coated or Bare Steel ❑ ❑ ❑ ❑ ❑ Coated and Cathodically Protected Steel(STI-P3) ❑ ❑ ❑ ❑ ❑ Composite(Steel clad with Fiberglass) ❑ ❑ ❑ ❑ ❑ Composite(Steel with Plastic Jacket) ❑ ❑ ❑ ❑ ❑ Composite(Steel with Urethane) ❑ ❑ ❑ ❑ ❑ Fiberglass Reinforced Plastic ❑� 0 ✓❑ ❑p ❑ Other(e.g.,concrete, etc.)(please specify) 5. Construction Type—Tank—check all that apply Lined Interior with Epoxy Coating ❑ ❑ ❑ ❑ ❑ Excavation Liner ❑ ❑ ❑ ❑ ❑ Double Walled ❑ ❑ ❑ Z ❑ Single Walled ❑ ❑ ❑ Tank Manufacturer Check box if tank has ever been repaired F ❑ ❑ ❑ ❑ ❑ Complete the following for each compartment or tank. 6. Emergency Generator Use Only ❑ ❑ ❑ ❑ ❑ 7. Estimated Total Capacity(gallons) 8" 8000 8000 6000 Farm Use ❑ ❑ ❑ ❑ ❑ DEEP-UST-NOT-001 6 of 12 Rev.12/18/12 i Part IV: Underground Storage Tank Information (continued) Tank Identification Number (see instructions) Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: B-3R1 13-4111 B-5R1 B2-R1 Part of a compartmentalized tank ❑ ❑ ❑ ❑ ❑ Part of a manifolded or interconnected tank ❑ ❑ ❑ ❑ ❑ 8. Substance Currently Stored(or last stored in the case of closed compartmentsitanks) check one per compartment/tank Gasoline ✓❑ ❑ ❑ ❑ Diesel ❑ ❑ ❑p ❑ ❑ Kerosene(for resale) ❑ ❑ ❑ ❑,r ❑ Kerosene(on-site consumption) ❑ ❑ ❑ ❑ ❑ Heating Oil(on-site consumption) ❑ ❑ ❑ ❑ ❑ _ Heating Oil(for resale) ❑ ❑ ❑ ❑ ❑ Used Oil ❑ ❑ ❑ ❑ ❑ Biodiesel ❑ ❑ ❑ ❑ ❑ E-85 ❑ ❑ ❑ ❑ ❑ E-15 ❑ ❑ ❑ ❑ ❑ If Other, please specify here Hazardous Substance ❑ ❑ ❑ ❑ ❑ CERCLAname CAS Number 9. Primary Release Detection-check one per compartment/tank Annual Precision Tightness Testing ❑ ❑ ❑ ❑ ❑ Tank Tightness Test with Inventory Control ❑ ❑ ❑ ❑ ❑ Continuous(Electronic)Interstitial Monitoring ❑ ❑ ❑ ❑✓ ❑ ATG-CSLD—Continuous with Inventory ❑ ❑ ❑ ❑ ❑ Reconciliation/Control ATG-Static with Inventory Reconciliation/Control ❑✓ ❑ ❑ Monthly GroundwaterNapor Monitoring ❑ ❑ ❑ ❑ ❑ Manual Tank Gauging ❑ ❑ ❑ ❑ ❑ Monthly Visual Interstitial Monitoring ❑ ❑ ❑ ❑ ❑ No release detection required(see instructions) ❑ ❑ ❑ ❑ ❑ If Other Method,please specify here DEEP-UST-NOT-001 7 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information (continued) Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number B-3R1 B-4R1 B-5R1 B2-R1 Part of a compartmentalized tank ❑ ❑ ❑ ❑ ❑ Part of a manifolded or interconnected tank ❑ ❑ ❑ ❑ ❑ Piping Construction 10.Piping Installation Date 10/01/1988 10/01/1988 1 10/01/1988 09/01/1997 1L Piping Material - check one per compartment tank Bare Steel ❑ ❑ ❑ ❑ ❑ Galvanized Steel ❑ ❑ ❑ ❑ ❑ Epoxy Coated Steel ❑ ❑ ❑ ❑ ❑ Flexible Plastic ❑ ❑ ❑ ❑ ❑ No Piping associated with Tank or Above Ground Only ❑ ❑ ❑ ❑ ❑ Fiberglass Reinforced Plastic ❑p ❑✓ ❑p Z ❑ Semi-Rigid Plastic ❑ ❑ ❑ ❑ ❑ Copper ❑ ❑ ❑ ❑ ❑ Other ❑ ❑ ❑ ❑ ❑ 12.Piping—Secondary Containment— check all d at apply Containment Sumps at Dispensers ❑r Z ❑ Containment Sumps at Tanks ❑r ❑✓ ❑✓ ❑✓ ❑ 13. Pipe Fitting- check one per compartment/tank Metallic Fitting Isolated from Soil and Water ❑ ❑ ❑ ❑ ❑ Metallic Fitting Cathodically Protected ❑ El El El ❑ 14.Construction Type-Piping— check all that appl Cathodically Protected ❑ ❑ ❑ ❑ ❑ Double Walled ❑ ❑ ❑ 0 ❑ Metallic Piping Isolated form Soil and Water ❑ ❑ ❑ ❑ ❑ Single Walled Z ❑✓ ❑ ❑ Unknown ❑ ❑ ❑ ❑ ❑ 15.Piping Type-check one per compartmeni/tank Pressure 0 ❑� ❑ "U.S.*Suction(valve at tank) ❑ ❑ ❑ ❑ ❑ Gravity Feed Only ❑ ❑ ❑ ❑ ❑ "Safe"Suction(no valve at tank) ❑ ❑ p ❑ ❑ If Other,please specify here Check box if piping has ever been repaired ❑ ❑ ❑ ❑ ❑ DEEP-UST-NOT-001 8 of 12 Rev.12/18/12 Part IV: Underground Storage Tank Information (continued) Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number B-3R1 B-4R1 B-SRi B2-R1 Part of a compartmentalized tank ❑ ❑ ❑ ❑ ❑ Part of a manifolded or interconnected tank ❑ ❑ ❑ ❑ ❑ 16.Primary Release Detection-Piping- check one per compartment/tank Annual Precision Line Tightness Testing Z 0 0 Z ❑ Precision Line Tightness Testing Every 3 years ❑ ❑ ❑ ❑ ❑ Continuous(Electronic)Interstitial Monitoring ❑ ❑ ❑ ❑ ❑ Monthly Visual Interstitial Monitoring ❑ ❑ ❑ ❑ ❑ GroundwaterNapor Monitoring ❑ ❑ ❑ ❑ ❑ PLLD—Annual.1gph Leak Test ❑ ❑ ❑ ❑ ❑ PLLD—Monthly Elec.0.2gph Leak Testing ❑ ❑ ❑ ❑ ❑ No release detection required(see instructions) ❑ ❑ ❑ ❑ ❑ If Other Method,please specify here 17.If piping type is pressure-check one per compartment/tank Electronic Auto Line Leak Detectors 0 ❑ ❑ Mechanical Auto Line Leak Detectors ❑ ElEl0 ❑ 18.Spill and Overfill Protection—check all that apply Audible Alarm ❑ ❑ ❑ ❑ ❑ Ball Float Device ❑ ❑ ❑ ❑ ❑ Flapper Device O ❑✓ Z ❑ None ❑ ❑ ❑ ❑ ❑ Spill Prevention Device Installed ❑� p ❑ Part V: Permanent Tank Closure Tank Identification Number Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Part of a compartmentalized tank ❑ ❑ ❑ ❑ ❑ Pant of a manifolded or interconnected tank ❑ ❑ ❑ ❑ ❑ 1. General Information of Closed Tank Date of Installation(monthtyear) Estimated Total Capacity(gallons) Estimated date tank closed(month/day/year) (check one per tank): Tank was removed from ground ❑ ❑ ❑ ❑ ❑ Tank was closed in ground ❑ ❑ ❑ ❑ ❑ Tank filled with inert material ❑ ❑ ❑ ❑ ❑ Describe the inert fill material here DEEP-UST-NOT-001 9 of 12 Rev.12118/12 Part V: Permanent Tank Closure (continued) Tank Identification Number Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Part of a compartmentalized tank ❑ ❑ ❑ ❑ ❑ Part of a manifolded or interconnected tank ❑ ❑ ❑ ❑ ❑ 2. Estimated date the UST was last used for storing regulated substances(month/day/year) 3. Site Assessment Required Site Assessment Completed ❑ ❑ ❑ ❑ ❑ (If Yes,provide consultanticontractor information below) Consultant/Contractor Name(s) Consultant/Contractor Addresses(s) Consultant/Contracior Phone(s) Soil Samples Collected and Analyzed for one or more of El ❑ ❑ ❑ El following:VOCs,SVOCs,Metals,ETPH Groundwater Encountered During Assessment ❑ ❑ ❑ ❑ ❑ Groundwater Samples Collected and Analyzed for one or ❑ ❑ ❑ ❑ ❑ more of the following: VOCs,SVOCs,Metals.ETPH -Soil Samples had Constituents of Concem above the following RSR Criteria: — check all that apply GA PMC ❑ ❑ ❑ ❑ ❑ GB PMC ❑ ❑ ❑ ❑ ❑ Res DEC ❑ ❑ ❑ ❑ ❑ I/C DEC ❑ ❑ ❑ ❑ ❑ •If any boxes were checked above,include a table summarizing the data and highlighting the exceedances (See R.C.S.A.Sections 22a- 133k-1 through 3 for definitions). *Groundwater Samples had Constituents of Concern above the following RSR Criteria: — check all Mat apply GWPC ❑ ❑ ❑ ❑ ❑ SWPC ❑ ❑ ❑ ❑ ❑ Res GWVC ❑ ❑ ❑ ❑ ❑ IIC GWVC ❑ ❑ ❑ ❑ ❑ •If any boxes were checked above,include a table summarizing the data and highlighting the exceedances (See R.C.S.A.Sections 22a- 133k-1 through 3 for definitions). Remedial Actions Recommended by Environmental ConsultantlContractor ❑ ❑ ❑ ❑ ❑ If box is checked,a closure report must be submitted to the LUST Coordination Program for evaluation. Remedial Actions Completed If box is checked,a closure report must be submitted to the ❑ ❑ ❑ ❑ ❑ LUST Coordination Program for evaluation. DEEP-UST-NOT-001 10 of 12 Rev.IV18/12 Part VI: Certification of Installation Complete within 30 days of installing an UST or adding an UST system to an existing notification. If you have more than 5 tanks in one location, reproduce this part and complete for additional tanks. Tank No.: Tank No.: Tank No.: Tank No.: Tank No.: Tank Identification Number Part of a Compartmentalized Tank ❑ ❑ ❑ ❑ ❑ Installer of tank and piping must check all that apply Installer certified by tank and piping manufacturers ❑ ❑ ❑ ❑ ❑ Installation inspected by a registered engineer ❑ ❑ ❑ ❑ ❑ Installation inspected and approved by implementing ❑ ❑ ❑ ❑ ❑ agency Manufacturer's installation checklists have been ❑ ❑ ❑ ❑ ❑ completed If Other Method,please specify here Provide signature of UST Installer to certify proper installation of subject UST System. Company Name: License Type: Company Address: City/Town: State: Zip Code: Business Phone: ext.. Name of UST Installer(print or type): Title: E-mail: Phone: ext.: Signature and Date of UST Installer: DEEP-UST-NOT-001 11 of 12 Rev.12/18/12 Part VII: Owner/Operator Certification The owner/operatorand the individual(s) responsible for actually preparing the notification must sign this part. A notification will be considered incomplete unless all required signatures are provided. "I have personally examined and am familiar with the information submitted in this document and all attachments thereto, and I certify that based on reasonable investigation, including my inquiry of the individuals responsible for obtaining the information,the submitted information is true, accurate and complete to the best of my knowledge and belief. I understand that a false statement in the submitted information may be punishable as a criminal offense, in accordance with section 22a-6 of the General Statutes, pursuant to section 53a-157b of the General Statutes, and in accordance with any other applicable statute. certify that I have completed a Certification of Financial Responsibility Form and such completed form is maintained on-site. I also certify that this underground storage tank notification is on complete and accurate forms as prescribed by the commissioner without alteration of the text." Signed on: 9/25/2018 2:35:32 PM Signature of Owner/Operator Date Name of Owner/Operator(print or type) Title(if applicable) Signature of Preparer(if different than above) Date Name of Preparer(print or type) Title(if applicable) ❑ Check here if additional signatures are required. If so, please reproduce this sheet and attach signed copies to this sheet. Note: Please submit a completed Underground Storage Tank Notification and all Supporting Documents to: CENTRAL PERMIT PROCESSING UNIT DEPARTMENT OF ENERGY AND ENVIRONMENTAL PROTECTION 79 ELM STREET HARTFORD, CT 06106-5127 A copy of all completed Notification Forms must be maintained on site and the most recent completed form must also be forwarded to the local fire marshal. If you have any questions, please contact the UST Program at 860-424-3374 or by e-mail (DFFP1JSTFeeQct.Uov) DEEP-UST-NOT-001 12 of 12 Rev.12118/12 AOE% Connecticut Department of iwEnergy & Environmental Protection Bureau of Materials Management & Compliance Assurance Emergency Response & Spill Prevention Division Notification for Underground —CPPUUSEONIY— Storage Tanks App#: Please complete this form,in accordance with the instructions I Doc#: (DEEP-UST-INST-001)to ensure the proper handling of your notification.Print or type unless otherwise noted. 11 Check#: I Submit one notification form per site. Part I: Notification and Fee Type �_ Program: UST Check the appropriate box(es)identifying the notification type. 1. LOCATION of UST(s) Name of site: SOUTH WINDSOR SUNOCO Street Address or Location Description: s JOHN FITCH eu/D City/Town: SOUTH WINDSOR State: CT Zip Code: 06074-4006 2. UST Site ID Number: 132-2271 No.of Fee *No.of 3. This notification is for: exempt Tanks Total choose i,ii.Nor iv Fee excluding(b) Fee= (a) (b) (c) (a x c) i) first time site notification[new] $100.00/ (Complete entire application) tank [#1032] ii)annual notification[renewal]with NO $100.00/ modifications tank (Complete Parts I and VII only) [#1032] iii)annual notification[renewal] with modifications,(specify modifications under $100.00/ iv wlow) tank (Complete Parts I and VII and [#1032] modifications only) 0 0 $0 r✓ iv) a modification to an existing notification;check any of the following to specify. (Complete Parts 1 and VII and modifications only) C adding new UST system(Part IV) $100.00/ tank [#1032] 0 0 $0 DEEP-UST-NOT-001 1 of 12 Rev.12/16/12 Part I: Notification and Fee Type (continued) No.of Fee *No.of exempt Tanks Total 3. (modifications continued) Fee tanks(So) excluding(b) Fee= (a) (b) (c) (a x c) adding an orphan UST system(newly $100.00/ discovered)(Part IV) tank [#1032] 0 0 $0 update/correction to Part II: $0 owner/operator info/financial responsibility transfer of ownership(Part II) $0 update/correction to Part III: record info $0 update/correction to Part IV:UST system $0 info Permanent Closure of an UST system $0 (Part V) 0 $0 *Compartmentahzed tanks are counted as one tank 'Manifoided or interconnected tanks count as separate tanks *Total Fee: $0 *For municipalities,the 50%discount applies.The notification will not be processed without the fee.The fee shall be non-refundable and shall be paid by check or money order to the Department of Energy and Environmental Protection. Part II: Owner/Operator Information *If an OwnedOperator is a corporation,limited liability company,limited partnership,limited liability partnership,or a statutory trust,it must be registered with the Secretary of State.If applicable,the applicant's name shall be stated exactly as it is registered with the Secretary of State.Please note,for those entities registered with the Secretary of State,the registered name will be the name used by DEEP. This information can be accessed at the Secretary of State's database (CONCORD). (www.concord-sots.ct.gov/CONCORD/index.jsp) If an Owner/Operator is an individual,provide the legal name(include suffix)in the following format:First Name;Middle Initial;Last Name;Suffix(Jr,Sr.,11,III,etc.). 1. UST Owner Name: GLOBAL MONTELLO GROUP CORP. This affiliate is the registrant(check if true): Mailing Address: 800 South St-suite Soo City/Town: Waltham State: MA Zip Code: 02453 Business Phone: (781)674-7780 ext.: Contact Person: DAVID WENT Phone: ext. *E-mail: Dwent®allianceenergy.com *By providing this e-mail address you are agreeing to receive official correspondence from the department,at this electronic address,concerning the subject application.Please remember to check your security settings to be sure you can receive a-mails from"ct.gov"addresses.Also,please notify the department if your e-mail address changes a) Business Type(check one): individual federal agency state agency municipality **tribal *business entity(*If a business entity complete i through ii): DEEP-UST-NOT-001 2 of 12 Rev.12/18/12