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Home My WebLink About0117628-Storage Tank e OSHKOSH ON THE WATER Job Address 3 BROAD ST CITY OF OSHKOSH No 117628 STORAGE TANK PERMIT -APPLICATION AND RECORD Contractor u.s. PETROLEUM & EQUIPMENT Tank Type . Metal 0 Fiberglass Service . Install 0 Remove Contents 0 Petroleum 0 Kerosene Owner RAILROAD Create Date 12/19/05 Category 280 -INSTALL STORAGE TANKS Tank Size 145 Tanks ---..1 0 Solvent 0 Liquid Petroleum . Above Ground 0 Underground 0 Natural Gas 0 Other Use/Nature Installation of 145 gal sub-base diesel tank for generator of Work $1,500.00 Permit Fee Paid $160.00 Valuation Issued By: Date 12/19/05 0 PermitVoided Parcel Id # In the performance of this work I agree to perform all work pursuant to rules goveming the described construction. Signature Date Address 558 CARTER COURT Agent/Owner KIMBERLY WI 54136 -0 Telephone Number 920-730-4240 Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a pariy, if you perform the work described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement holder(s) and to secure any necessary approvals before starting such activity. .~ OSHKOSH ON THE WATER Job Address 4 BROAD ST CITY OF OSHKOSH STORAGE TANK PERMIT -APPLICATION AND RECORD No 117628 Contractor U.S. PETROLEUM & EQUIPMENT Tank Type . Metal 0 Fiberglass Service . Install 0 Remove Contents 0 Petroleum 0 Kerosene Owner RAILROAD Category 280 -INSTALL STORAGE TANKS Create Date 12/19/05 Tank Size 145 Tanks 1 0 Solvent . Above Ground 0 Underground 0 Natural Gas 0 Other 0 Liquid Petroleum Use/Nature Installation of 145 gal sub-base diesel tank for generator of Work Valuation $1,500.00 Permit Fee Paid $160.00 Issued By: Date 12/19/05 0 Permit Voided Parcelld # In the performance of this work I agree to perform all work pursuant to rules governing the described construction. Signature Date Address 558 CARTER COURT Agent/Owner KIMBERLY WI 54136-0 Telephone Number 920-730-4240 Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a pariy, if you perform the work described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement holder(s) and to secure any necessary approvals before starting such activity. L~) JobSiteAddress:t><Dèd.S+ ~~~S\;w(";b ('. Contractor:/ ÀS-~-P'Á(T)\'€LAI/'V\ E:.c !A':)P . - l Address: .5 5 "D' C ';) ..r-\e r C::t-- ~ ,- \IÝ\ be, \'-\ l W\ 54;\3 Lo UST/AST PERMIT CHECKLIST Phone Number: (qW \ 'lb5 - 'i'2.'6! Fax Number: C. q-z..c, ) ..'"3"'\ -0 ì '-\ \ AST /' Instal! Tanks / Upgrade Tanks UST Remove Tanks Upgrading Piping Tank Information Ð #2 #3 #4 #5 C,mpo"Ü," ~ ðke.- \ (5v\ '0 '~~þ \.'" {,.", L J;;, ß~c,~ t 4:~ ~ \ S . . Contents ------r> ,e ~-e... l Piping f:-Jo¡'o"le.fj[!'HA(\ à -~\eil.D \ -f.- "5 ~ l<- Approximate Cost of Job: Approximate Start Date: Tank Size Permit Issuance Approv~ Yes V ~ Conditions of Approval: {'.:e l L('\-~ í'ð No ~\~S Permit Approved ~ ~ Date: \ LJ 01 \ () 5 . DO Tank System Fee l DO Plans Review Fee ! Q () PERMIT FEE: ~\ leD - Note: This is not a permit. To obtain the required permit. present THIS CHECKLIST. along with a SITE PLAN an, a CHECK made payable to the "CITY OF OSHKOSH" for the amount listed in PERMIT FEE, to the Building Inspectors Office, Room 205 at City Hall, between the hours of 7:30-8:30 a.m. and 12:30-1 :30 p.m. or by appointment (920) 236-5045. This City Permit shall be obtained and on site prior to commencement of work. '\'\0. FLAMMABLE I COMBUSTIBLE Environmental & Regulatory Services Division \Yisconsin LIQUID TANKS ~~~~o~fia~~oieum Products and Tanks D,p"""" ,'Common, INSTALLATION APPLICATION Madison, WI 53707-7837 INSTRUCTIONS: Fill in ALL applicable data. Failure to complete the form entirely may cause add"ional (608) 267-9795 (608) 266-8981 delay. Submit this form with fiva sets of plans which include details and data as required by Comm 10.10, along with the required fees made payable to: Department of Commerce at the address in the upper right comer of this page. Personal information you provide may be used for secendary purposes [Privacy Law, s. 15.04(1)(m)]. OWNER INFORMATION PROJECT INFORMATION CONTRACTOR INFORMATION Customer ID#: 920899 Site ID#: Facility ID#: Customer.ID#: 240928 Name Facility Name Contractor Name CNRRSWING BRIDGE US PETROLEUM EQUIPMENT Company Name Sita Address Number and Street CANADIAN NATIONAL RAILROAD BROAD ST & BAY SHORE DRIVE 558 CARTER CT Number and Straet ~City 0 Village 0 Town of: City, State, Zip Code 6250 N RIVER RD OSHKOSH KIMBERLY WI 54136 City, State, Zip Code C~I~EBAGO Contact Person Customar 10#: ROSEMONT IL 60017 TODD BROECKEL Telephone Number Fax Number Fire Dept. Providing Fire Coverage FDIO# Telephone Number Fax Number (920 ) 579-6754 ( ) ~- OSHKOSH 7003 (920 ) 735-8287 (920 ) 739-0741 iii Install tank(s) 0 Install automated fueling device: 0 System upgrade: 0 Install piping 0 Key centrol system 0 Spill protection 0 New install seW service 0 Card control system 0 Overfill protection 0 Revise a plan 0 Code centrol system 0 Leak detection TANK SYSTEM OCCUPANCY: oI ~ 0 líVEihlcleF~.Ii"g:ß AIt".dOiI ß'Ú"àti".dad. .., '.'.' . 0 Retail Fuel Sales 0 Bulk Plant Storage 0 Residential 0 Utility 0 Terminal Storage 0 School iii Backup Generator 0 Mercantile/Commercial 0 Industrial 0 Agricultural 0 Govemment 0 Other (specify): TANK CONSTRUCTION: oj. + Tank Type: 0 Single wall æ Double,wall 1!1 Bare Steel 0 Cathodically Protected & Coated Steel (Check one: A. 0 Galvanic or B. 0 Impressed Current) 0 Coated Steel 0 Fiberglass 0 Steel - Fiberglass Reinforced Plastic Composite 0 Lined - Date: 0 Other (specify): TANK SPECIFICATIONS: (each tank) iii Aboveground 0 Underground Burial depth: Manufacturer: Tank Listing: Dimensions: Capacity: Contents: ONAN UL142 7'X3.34' 145 GAL DIESEL 0 Corrosion system upgrade: 0 Line tanks 0 Impressed current 0 Galvanic 0 Tribal Nation WI Regulated Object No. (W applicable): Overfill Protection: . iii Yes 0 No Make/Model: VISUAL GAUGE Spill Containment: Ii! Yes 0 No Make/Model: GAUGE Tank leak detection method: 0 Automatic tank gauging 0 Vapor monitoring 0 Groundwater monitoring (Primary method) 0 Inventory control and tightness testing æ Interstitial monitoring 0 Aboveground / visual monitoring 0 Manual tank gauging (only for tanks of 1,000 gallons or less) 0 Statistical Inventory Reconciliation (SIR) PIPING CONSTRUCTION: oj. + 0 Underground ItI Aboveground Pipe Type: æ Single wall 0 Double wall 0 Bare Steel 0 Cathodically Protected & Coated 'l>el Check òne: A. 0 Galvanic or B. 0 Impressed Current 0 Coated Steel 0 Fiber lass iii Fiexibl e- 0 Other S e . Piping System Type: 0 Pressurized piping with. A. auto shutoff: B. 0 alarm or C. 0 flow restrictor iii Suction pipingv.ill>'" , r e<.tank 0 Suction piping with check valve at pump and inspectable Make/Model: Pipin9 leak detection method: used IT pressurized or check valve at tank: 0 Vapor monitoring 0 Interstitial monitoring 0 Groundwater mon"oring 0 Tightness testing 0 Electronic line monitor III Not required Vapor Recovery: DStage I CARB#: 0 Stage II CAR8#: 0 Fiberglass 0 Flexible 0 Other (spec/fy): Aggregate Tank Capacity: 145 gallons Numberoftanks:..1...-- Fee: (Fee table on reverse side) Plan Examination Install inspection a) Tank/Pipe System Installation $~(7636) $---1QQ,QL(8253) b) Addition OR Upgrade for cerrosion protection $_(7636) $_(8263) C) ConversiontoKey-Card-Code-POS $_(7636) $_(8253) d) AdditionORUpgradeforleakdetection $_(7636) $_(8253) e) Interior Lining o!Tanks $_(7636) $_(8253) f) Addition OR Upgrade of Stage II Vapor Recovery $_(7636) $_(8253) g) REVISION Previous Approved Plan # $_(7636) h) GROUNDWATER SURCHARGE $100 (WI Stat. 101.14(5)] (Required for items: a, b, d, eand D Stage II Operational: 0 Yes 0 No I certify by signature that provisions of the current Flammable and Combustible Liquids Code, 40 ~~acks (DNR), listed or not listed ~ ;;;;;:: be Subtotal $~ $- $- $- $- $- $- $ (7637) COpy ERS-9 (R. 10/05)