HomeMy WebLinkAboutCOM2001-00084 Gas Tanks - COM Permit / Conditions - 9/11/2001 0
O
K cn Cl) o. D X
No a ri X � co � � ,� cn O
ojCD
vN - M nr
oo mk
.. C (n v r D
cnm o 90 n form- mZ
m °
CA
CD m rt r, 0 K � � 9 ;u0 cn
C/, D a ° O � vm � z v
� _ — �
cn l< Cl) a , , O
m ° m c o � N � yy o Z
CD co �• O N N -n -n
(n
3 •� 3 = v � r rt � zmm D �
O — O% 7 Oor -< -C U1 CO C
CD (D O �" Z
v ?! m N --I --I -i `�
� c m � (A ZOO w
m ' � > rmm N
m z (n Cl) CY)
v —
mZ m
o m „ m o - n p
S y CD
C
n i
0
0 o w m
m n O O
m 0 �
a Co ic
z v D 0
O � r X
z
ai y W o 0 0
CD S. Zo = --I r Z
O m m C co Q p z O p N
o m �, Dn y Co �' o � o m Z O 0
CD 5. -• � o �
(� -, N Z
a mom :yam CD c° ooC D O CU
H o tiX 3 n m 00 m
Cl) Oo O
m O A
ic
Qo m CC) m.� ° 90 Z
n 0 �
n
=r O m O m _
o �' 00 o V
� m c 0 0
�
m O
T 00 v c � �,
m N Aa p CD .. .. .. O 0
co lG O CD 3 CD CD
0 n_
rCD
vi a cn X (no o �
�'a -0 � m N yr
N O N5'
J J J b o a O J^
fD
WW c) a p �4 t
C �
J
N N N
v
O O O
N N j
lI
O00 .� °'
N
O CD
O
' n -U'D 'a (n 0 X O
O C O 'd 'o X X E � a O M = M. - 0 -` �
_ 0
pOp CD C7 O (D 0 C N 0 ^O. .Z1 �d N < -� a N
< ' N cn ,f 0 N N CCD N CD O 3 o
(D 7 CD (D O N .n► CD C p .o+ CD 7 rr
O CD p 0 o y d �, •�• 0 N c a N 3
O C_0p o CD ^' = N X < o (D -O 11 < -0 CD a --h o ppj
0; CD 0 a rn N N CCDD ��, p C C% 0 =n. W j rt
vi �cvCD Ch 'o moO � o c
' m cr o D
XrnCl CD - � o w cn
(a m (A Zo _ ° ,
t0 r " moO
h a O CC CD
= cn or CDc � m
D CL m CD ;w n� o � oowMma o � CD
< a co W CD
cc CD- 0 M o. CD CD
CDa�
Z oCn m a � 0 � o or= CAC) C CD0 - o W
p o a Q CD v � O n 0 = <'l< CD CD 0 C
CD o 0 a to ? * 0 m o m 3 a �n = m
p '0 N p m CD CD 0
"0. O N O = N � = -1 = a v 7 sy CD 7
F.
o 0 CD N O n N N 0 CD 0 . cc CD -cn 0w r O (D
fCD 30 0 a = p 0 x. 7' m CD 3 CL. 3= CD N Cp O N 3 O = CD CD CD a
3 0 O N 0 .3. a; O CD
CD �' 3 3 CD °: v, an m o cn Ct m o
cn 0 N 3 CD 0 .O+ p 7 0 Su S
C �` N CD '� ^'� a 7• 0
X cn CD -. �; CD 0 a = a
X� o cn y � � �.� @C _ � o cc
.. (;D O 00 O O p n = 0 N 0 O CA) p1
3 0 c0i y (D 3 7 N
o _ 3 o � ooaM. 3C � iu � 3 n n c
_o `< 3 CD00cn m � a — m CD n0 nD
CD X p � Q �► n. c'n o Cl) CO r° CD `° n� O Z O N y
v' CD � m oho m -, ; 3 0 �' � p icm
a � o =r0 mo c m - - o y N � N Z 0
o m _- • oo C:CD Cl `< 3 y OD O0
m vi o 0m g C3 m � � � cn �
m CD � rn� m ' `�° m � (no OZ bm
.. Cl) CD vi O N O Co
o su ccnn r: � 3 mrn o � m �: = CD � � � �1
ti p Za �, � m O
a
cnQ y L" .« m
0 �' CD cn o � � v � y no 0
-� c 0 CD o
� 77tin o a5a U) o. c CD D
su = = C00OQ � 0 � � a
cn a CD -+ o r► 0 -, 0 c > > a
0 O cn su cn
CD < o � � � � o � s � N
0a<< c a� a� fl: 3 0 0 T
o �' x 00 � � v, CD 0 ga' n T
CD
m 0 (n 0C�D0 a � o
`O N .=-. O 0 C) d.� < to 7 T
m
s
cnCD 3
.� _
o 3 n D 3 W
i
T {
m ((
m
c ti r
0 0
V N N pN
d O O O
bB 69 (!!
N .wi A 00 cn
0 0 0 0 0 0
h
W N W W fj
Off v N
'O
n
O O 3 0
O -a
C = '^ S A W N _. CD
Cv
N C cn N• �. .. `.
.. OD
o m CToo
CD CL CD
pp O ID 0) 3_ ZmD2 -Jor- CD _3 o D ncD n m0 DCOD v D
rn CT mD (nD � v � e e. o � m0 Tmn � a =
� D < CD mcno � m � cn O � ,� mco DCZn XOCc� co
O CD 0 �_ m 2 � am) D CD o - 0 � o Coi, OXDZ CD ..
Z CT C3D — Cl) 0u) Z o �CD m CO � o � C M0Zu) = a,
OR Cn Z � � W � m � O Da m M0 v00 � o e
o CD = cnm0Dm � -0O oac � °► � -0 z _� � C � C o �
CD sy = X 'nm (� > � � o � 0 e o e 0 DO � � cnn rtfD
CD sy � OVOm g ve, o CD Z -V � Zr � ccDD CD
CL a � Cl) -a CD a, n vX � (� � O o
O 0 o DmOmz 0CD F0 D � ZO OZ 0 -�
a 0 --1z v o r0 m Qa :7m 0 co = ` OC v0i
O 0 N'o
-00Z � � Cod pa 0) CO � cn ZOOS aC.
cr o m � OCK 0 CD � ,� � � a � � G) v -. K to
m 3 --ib — co ? o ffo 0 � a) 0 m 2rn a', �
0 CD � 00 °Xmyc aa� aa - Fm X mm � o 03
c 0 0 0 � � � vy X3 fD � 0m cm0 CD C
aaCD
y 0 0 Z fDa 02v � � rKm cD CD
m2 -n m =+ n �, o C) CCD nv FZjo 5 �
~O` 3 ; v0 CD I e e o m
CL 51 M
arn o � G) D D a03 D CL
v Ta
o xn �po � On py � ao -u -j ;0co0 coo D Xto
_ m �CD Z
-» a -� Z m -1 � �_ >Cao D Own e
o y DZ � OO5- m Cn �v Co CD X DOS
o 0 vvrnZZK CD (CCDi � 0 m � mv0 0,
0 o mmz � � uc) Q o c zom
3co 3 O Cy
3 0coMc � D �, � m ncnD a
.. CD to 2
° � zoo Fu < a `° m � _ � Zoo c
CD Cl) Z — Z rn 0 ' 0— 0 m
m a ZG) D � � � m - myoCo to
0 CD n ,.
0 3 -U � . mo � ID w Cn 0) = y � 0X CD
CQ :3 %nKDym < < o c nni 0 c7Om o
D y 0D � c_ _m � O0 = aCL CL Z m -ems
Cn — v = CD O n O
Il �' a � FZ � WZ m o to CD O Z :17 �.
-< m
y O v (lmmc �.tfl �
v0) Qc C
K: -q t�om � Z
CD = Z
Z 3
° K ; CD c Cl 0 m W m �
O ri) -0 CD
co o mZQO mF Z o m
e � e m Ov en Z * mmm
'
f
o
OFin cn n CD
CD r- f
r
OD O
00
a
� o
CD _
O N
b N
C
to
-n O
W 7
— a
0
W y
V O
CD
0 N
0 -0
e CD
0
i
0?/25/2001 14:02 FAX 960 427 770` MASON CO PERMIT CTR 0 004
PERMIT NO.: BLO
FORM MUST E COMPLETED IN INK
PLEASE PRES HARD MASON COUNTY
BUILDING PERMIT APPLICATION �� �
r
426 W.CedarIP.O,Box 186,Shelton.WA 98584
Shelton(360)427.906 Belfair 360 275.4467 Elma 360 82.5269 Seattle _ 464�96
APPLICANT M
I FORAT!ION CONTRACTOR INFORMATION
Owner S&C l rf C- Contractor Name Sao 14-* L-
Mailin Addr sS ll�.� �4 ACE P?E Mailing Address 17 ' * tie er
City LLOt State*A, Zip Code 9totC-�CD/ City Fl F� State W A Zip Code dflL 54z
Phone�.,�, �-� - seo
they Ph_( Ph.( o ) 7.7-44/f Other Ph.(_,
Lien/TitleHo er Contractor Reg.#
Expiratio
Addressn / /
[SEPTICfWA7(ERjySTJEMINFORMA1! '-Connect to New Septic Existing Septic Connect to Sewer
em ame of Sewer SystemWell Water System„__Nameof
er Sys e ��-
-- re
PARCEL INF RMATION-12 digit Ta:� P,•. I No.l':3 7„��! ?Z / Fi DistrictN
Legal Descrip ion SFrc- G 3- (_ G
Site Address(Please inglude street n4,: yet number nd city) 5 710-M
Directions to ite_.- 00-4— g 3
Will timber bl cut and sold in parcel pr, tion? (Yes/No
Saltwater
Is your property within 200' of the follov. . Body of Water(Name)
I Lake F fiver/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs__, _
PERMANENT RESIDENCE SEASON,i JENCE O
TYPE OF JOg New Add _Repair Other Use of Building KkP10 K
Describe Wo �4-� s 7a1--Ta,e�-J !" �'
I No. of Bearoos Np. of Bathrocr —SQUARE FOOT E-1st Floor�32- 2nd Floor_
I 8as -�' Deck 0' Other -G- sq. ft.�_
3rd Floor_ _Loft
i Garage Attached_$bet� Carport Attached Detached �-
MOBILE N011�IE INFORMATION-M w � Model Model Year
1 Length I Width_Seri,
_ No. of Bedrooms No. of Bathrooms
Type of Heat I PurL, Rcpiacement Unit?(Yes/No)
Installer Nam' Certification No.
NOTICE: THIS P RMIT BECOMES NULL 'IRK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED Oj c;i FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY ..:LA• >F A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is aeeurwa and grants = of Mason County access to the above described property and structures for review and
inspection of this project. AeMnowledgmm. s;on3lure .,.uw:
OWNER AFFIDA IT-1 certify that I am exemP! h- CONTRACTOR'S A` VIT-I certify that 1 am currently registered as a
Contractor Regist tion Law RCVV 18.27 and arr: orci:; n contractor in the State..r :vashington and that I am aware of the ordinance
requirements for vlhich this permit is issued an" requirements regu,r.` ","work for which this permit is issued and all work
conformance Cher 'th. No changes shall be n, :'rst outi;ninX. shall be done in conormance therewith. No changes shall be made without
approval first obtaining approval.
X _ `. - L6 X Date
tA.!. ^EYOND THIS POINT,
Accepted by ` rnittal Amount Du, Receipt No.
Ae
Building Department
Occ Grouo i Tyee Constr._
Planning Department fqL Get -
Environmenta�Health Department
Public Works Department
Fire Marshal
07/25/2001 14:02 FAX 360 427 779:' MASON CO PERMIT CTR 0 004
PERMIT NO.: 8L0
FORM MUST e E COMPLETIED IN INK
PLEASE PRES 9 HARD MASON COUNTY
BUILDING PERMIT APPLICATION GoMz6Dt-�D$�
426 W,CedarrP.O.Box 186.Shelton.WA 98884
ahello (360)427S67u Belfair 360 275.4467 Elma 360 825269 Seattle 206 464 b968
APPLICANT 1 FORMATION CONTRACTOR INFORMATION
Owner S A (N C., Contractor Name Joe a41-
Mail' Addr sS� _J �4 lA�e E ' Mailing Address I 17
City I,Lfir r State �I1, Zip Code 9EofC-B�/ City Fr F& State W A Zip Code dSlt - u
l--�- Ph ( Sly ) Z77-69-IS Other Ph.(_,
Phone !!--L1C-VDtherPh.(_�„_
Lien/Title HolQer _ _ Contractor Reg.# .
Expiration
Address I
LICfWA ER SYSTEM INFORMATI 1-Connect to New Septic Existing Septic Connect to Sewer
m ame of Sewer System_ Well Water SystemName of
r Systetk
+�- .
I ' ! Fire Districti+"I'to'o
PARCEL INF RMATIOPJ-12 digit Tax P I No.1 L 3:9 Si 2 ZJ
Legal Descri4ion S6c- G.3 - !_ G r .0�6
Site Address(Please in0lude street n�: et number nd city) S'�� R�-� Z
Directions to i
ite_y��t_ g6 [fie a3
Will timber bel Cut and sold in parcel F:r' tion? (Yes/No)� Saltwater
Is your propely within 200' of the folio•:. Body of Water(Name)
Lake f�Iver/Creek Pond Wetland Seasonal Runoff__ Stream Slopes or
Bluffs,__,
PERMANENT RESIDENCE SEASON, 1 "JENCE p
FFloor
New Add ilapair other Use of Building 920 K
{ �o.
sthrocr / SQUARE FOOTA E-1st Floor W2- 2nd Floor
._Loft 'D Bas:.. Deck ®' Other -C- sq. ft. _
Garage _Attach�ed_�Deto S- Carport -U- Attached gfletached �—
_.� -
EInstaller
OE INFORNATION-M:_ !v ivlodel Model Year
II Width Ser,. No. of Bedrooms No. of Bathrooms
I Pure, .� R�uiscement Unit?(Yes/No)
' Certification No.
NOTICE: THIS P RMIT BECOMES�NULL_ -' "'K OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION.WORK IS SUSPENDED O; ";I FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY ..LA. )F A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is acouratte and grants : of mason County access to the aboVc described property and structures for reviewand
inspection of lhislI project. Aeltnowledgmc. signmure .�.uw:
OWNER AFFIDAWIT-I certify that I am exemP! a_ �- CONTRACTOR'S A` "'VIT-I certify that 1 am currently registered as a
Conlroctor Reyist�ttt�lllly�ion Law RCVS t8.27 and au, orau;arc. contractor in the State..1:v'ashington and that I am aware of the ordinance
dor re uirements re t °work ror which this permit is issued and all work
requirements for vJhich this permit is issued any 9 g '
conformance ther 'th. No changes shall be rn, shalt be done in conormance therewith. No changes shall be made Without
approval. first obtaining approval.
X - ��, / X Date
F.: tA.+. __ 'DEYOND THIS FUINT-
j, Accepted by ':rnittal Amount Du, _. Receipt No.
u •:•.°��":A RI' .E ' � .Ell w� � .Lr..
Building Department
Occ Grouo Tyee Constr.
S Planning Department
Environmental Health Department -
Public Works Department
Fire Marshal
i
'I
r
O L Y M P I C
AIR POLLUTION CONTROL AUTHORITY
909 Slealer-Kinney R(i. S 1-,_ Stijl(,, I • Lace. . OVA 98503
June 20, 2001
Joe Hays
In Form, Inc.
12330 120th Ave NE
Kirkland, WA 98034
SUBJECT: FINAL DETERMINATION
Dear Mr. Hays:
Olympic Air Pollution Control Authority's (OAPCA's) final decision is to approve your NOC
application to install a gasoline dispensing facility at the Safeway Stores, Inc. - Belfair facility
at State Route 3 and Clifton Lane in Belfair, Washington.
Enclosed you will find a Final Determination report and an Approval Order issued by OAPCA.
Please read these documents and retain them for future reference as they describe the air
regulations that apply to your installation and special conditions of approval required by
OAPCA. Applicable regulations are listed in Table 1 of the Final Determination. Special
conditions of approval are listed in the Approval Order. Both applicable regulations and
special conditions of approval are enforceable by OAPCA and subject to penalties if not
complied with. Also, please remember to notify OAPCA in writing of completion of
construction or installation within 15 days of the completion date.
You may petition OAPCA for reconsideration of the Approval Order by filing a petition in
writing within twenty (20) days to OAPCA's Executive Director. OAPCA must consider all
petitions and respond in writing within thirty (30) days. Within thirty (30) days from notice of
OAPCA's final decision on a petition, you may appeal the Approval Order to the Pollution
Control Hearings Board (PCHB) by filing the appeal in writing with the PCHB and serving a
copy upon OAPCA.
Please call me if you have any questions at (360) 438-8768 extension 107.
Sincerely.
Gordon Lance
OAPCA Engineer
Enclosures: Form 1, Approval Order, and Final Determination
r
(360) 438-43768 • I-800-422-5623 • I-:-.tail OAl'(,.\0 wln.coln • Ilome Page hllp:Hw\vw.wln.com/-oapca
I \X (360) 491-63043
i'f
OLYMPIC AIR POLLUTION CONTROL AUTHORITY
909 Sleater-Kinney Rd SE Suite#1 - Lacey, Washington 98503-360-438-8768- Fax 360-491-6308
FORM 16
GASOLINE DISPENSING FACILITIES
Fill out the information requested below and submit with Form 1 and the appropriate NOC fees.
Stage I Information
System Type O One-point Coaxial' Two-point
Brand
CARS Executive JT
Order No. - 70 - 4 - A
One-point coaxial systems will not be permitted in conjunction with vacuum systems.
Sta a II Information
System Type U Balance acuum assist
Brand
Nozzle
L s 6o a-s" 60 0 L o
PIV Valves' d e /Y�
CARB Executive /+ - 7d_ E
Order No. (.a
`Required on all vacuum assist systems.
Gasoline Sales
If this is a new facility, what is estimated annual gasoline sales ADD �` lAr �
in allons ?
If this is a modification, what were the annual gasoline sales (in
gallons) for the past calendar year?
Site Information
Distance from-the centroid of the pumps to the nearest point on K,.�,.. ,da
the property line of the nearest lot on which a permanent
residence is located in meters
Fees includes Filing fee and Plan and Examination fee)
E
tion of an existing facility $300.00
ction of a new facility $400.00
�I
i F:ICOMMONIENG\NSRINocformskForm16.doc Revised February 2000
...••vn 0002
OLYN• Z AIR POLLUTION CONTROL JTHORITY
909 Sleater-Kinney Rd SE Suite# 1 - Lacey. Washington 98503 - 360-438-8768 — Fax 360-491-6308
FORM 1
NOTICE OF CONSTRUCTION
TO CONSTRUCT- INSTALL - ESTABLISH OR MODIFY AN AIR CONTAMINANT SOURCE
Business Name: For OAPCA use only
S�c I`'.•�-G L � �E • File No: ; CI
County No: 4 r
Mailing Address ( ddress, city. state, zip):
Source No: .9'
�G- u u.c W A. 9$t 15 - g SU Application No:Q(ill04: !�(
Date Received:
Physical Address (address, city. state. zip):
S`rIFTE RIDI 'E 3 14 61"C4'.Q LRNE
u,z LO a RECEIVED
Are you currently registered with OAPCA? Yes No o JUN 13 2001
Previous business name (if any):
Process/ E uipment to be n talled:
icy D15i>c»
s� w - o co 0 .41 T s
Do you request confidentiality? Yes Q No
If yes, provide a separate copy of the application void of the materials nfident alconsidere o confidential.mar method. page
considered confidential must be individually identified by stamping co
Confidentiality reasons: Trade secrecy and similar concepts whereby limited disclosure is necessary to
retain business advantages.]
This project must meet the requirements of the State Environmental Policy Act (SEPA) before OAPCA
can issue final approval. Complete one of the fallowing�I options. (date).agency) on /LJ(date).SEPA was satisfied by
I copy of the final determination and the environmental checklist is enclosed. A copy of the
approval b (government agency).
El SEPA is pending app Y of the final determination will be forwarded to OAPCA
environmental checklist is enclosed and a copy
when issued.
El OAPCA is the only government agency requiring a permit. A completed environmental checklist is
enclosed.
I
hereby
certify that the information contained in this request is, to the best Agency Use Only
of my knowledge, complete and correct. Co'.DMONALLY APPEMT.!l
FOR CONSTRICTION ONLY
Name of Applicant or Owner of Business: IN ACCORDANCE \:Tr:i
Phone: Y RC\V 70.94.WAC ►71-000
T�tl : 1- 77 ` AND REGULATION I
-ry + a (SEE ATTACHED ADDENDUM FM
CONDITIONS OF APPROVAL
Contact Name (if different than above):
G � S Pnone: s
Title:
Date:
Signa e:
Revised July 2000
\COMMOMEN(31NSRWOCFORMS\Form l.doc
ADDENDUM TO
NOTICE OF CONSTRUCTION 01 NOC159
Safeway - Belfair
ORDER OF APPROVAL
This Order of Approval is issued in accordance with Olympic Air Pollution Control Authority's
(OAPCA) Regulation 1, and Chapter 173-400 of the Washington Administrative Code (WAC),
and Chapter 173-491 WAC. Approval is hereby granted, as provided in Article 7 of OAPCA
Regulation 1, and provided that the conditions stated below are met, to Safeway Stores Inc to
install a gasoline dispensing facility at its State Route 3 and Clifton Lane store in Belfair,
Washington. Compliance with this order and its conditions does not relieve the owner or
operator from compliance with OAPCA Regulation 1, RCW 70.94 or any other emissions
control requirements, nor from the resulting liabilities and/or legal remedies for failure to
comply. The owner or applicant may petition OAPCA for reconsideration of this Approval
Order by filing a petition in writing within twenty (20) days to OAPCA's Executive Director.
OAPCA must consider all petitions and respond in writing within thirty (30)days. Within thirty
(30) days from notice of OAPCA's final decision on a petition, you may appeal the Approval
Order to the Pollution Control Hearings Board (PCHB) by filing the appeal in writing with the
PCHB and serving a copy upon OAPCA.
THIS ORDER OF APPROVAL IS ISSUED SUBJECT TO THE FOLLOWING CONDITIONS:
Installation Requirements
1. A pressure/vacuum (PN) valve shall be installed on each tank vent. The inside diameter
of the tank vents shall not exceed two inches. Vent lines may be manifolded provided the
manifold is installed at a height not less than 12 feet above the driveway surface used for
Stage I tank truck filling operations. At least one PN valve shall be installed on manifolded
vents. If two PN valves are desired, they shall be installed in parallel, so that each can
serve as a backup for the other if one should fail to open properly. The PN valve shall be
California Air Resources Board certified or meet the following specifications:
(a) Pressure must be three inches water column plus or minus one-half; and
(b) Vacuum must be eight inches water column plus or minus two.
The outlet(s) shall vent upward and be located to eliminate the possibility of vapors
accumulating or traveling to a source of ignition or entering adjacent buildings.
2. Except for tank vents, all openings on all tanks shall be equipped with tight fitting covers or
seals equipped with rubber gaskets.
3. The dispenser shall be connected to the riser with either flexible or rigid material that is
listed for use with gasoline. The dispenser-to-riser connection shall be installed so that any
liquid in the lines will drain toward the storage tank. The internal diameter of the connector,
including all fittings, shall not be less than three-fourths inch (3/4").
4. The length of hose that may be in contact with the island and or ground when the nozzle is
properly mounted on the dispenser is limited to six inches. Within the constraints of the
system, the maximum allowable length of any hose shall be fifteen (15) feet.
Operational Requirements
5. All fill and vapor recovery wells or boxes shall be kept free of liquid gasoline.
6. The owner or operator shall develop and implement an Operations and Maintenance (O&M)
plan. The plan shall be kept in a manual on site and be made available to all operators. At
a minimum, the O&M Plan shall include:
(a) Procedures and a schedule for maintaining and inspecting the system.
(b) Copies of all test results required in this Approval Order.
(c) A section identifying all possible defects in the system, including, but not limited to:
(1) Absence or disconnection of any component required in the certification of
the system.
(2) A vapor hose which is crimped or flattened such that vapor flow may be
impaired.
(3) Nozzle shutoff mechanism which malfunctions in any manner.
(4) Vapor return lines, including such components as swivels, anti-recirculation
valves and underground piping, which malfunction, are blocked, or restricted
such that vapor flow through the lines may be restricted.
(5) Pressure/vacuum relief valves, vapor check valves, dry breaks, or fill caps
which are inoperative.
7. An inspection and maintenance log shall be maintained and kept on site. The log should
include the date and description of all inspection and maintenance actions. All records
shall be maintained for a minimum of two years and shall be made available for inspection
by OAPCA upon request.
V. GOO
WASy,�Qi.►
IT o v
y
i�
� 6 0
Mcirk V Goodin, Reviewing Engineer
O L Y M P I C
AIR POLLUTION CONTROL AUTHORITY
NOTICE OF CONSTRUCTION
FINAL DETERMINATION
Issued by
Olympic Air Pollution Control Authority
Issued to
Safeway Inc - Belfair
Project
To construct a gasoline dispensing facility
NOC 01 NOC159
File: 197 Srce: 2148
Cnty: 45 RC: RC13
> m
0
F m O N W N - O.
m
�ff1 1 $C Z;_ ;lip
III = yNO ` �pi•1CD
. 9.' bhp O� • 1
PA
o d e/ ai � df7�s eT11R o _a z >�� ITln�emi
CPU P -
yp1= g ' r2- gym 1� Ana
� 1 a ���js_eg9 -4
pQN < p > IlloO��y
ExITU9 1n
0 IN-
_ _ O
D
C' III,N91" isl_9y �y
Vff
N 2y��
G
m$
VI YI II�^1
Z m W 1 •IV pp N
WL K i � W 1 1 1 NIA
it
wy � P NQ
<�� nm Ny 1
Q D y 1
'Il
m_
so o
Lil
1 ,
1 1 1
1 1 1 D
N Q D i
> S
N A aZ{Z -
g it o <
g r
•I�LI«I Y�9b a�N
> C
Safeway/Packages Page 1 of 1
FIVE DISPENSER PACKAGE
Quantity Quantity
Manufacturer Part No. 5 Manufacturer Part No. 5
Ameron FRP 3" Pie Estimate OPW 60VSP-100L 5
Ameron FRP 3" BxB coupling 2 OPW 1 OBHMP-5830 15
Ameron FRP 3" BxMNPT adapt 1 Prop 65 Cancer warning 10
Ameron FRP 3" BxFNPT adapt 1 Titeflex 111430-24-0240 5
Ameron FRP 3"45 degree 2 Titeflex 111430-24-0180 15
Ameron FRP 3"90 de ree 5 Titeflex 111430-32-0240 3
Ameron FRP 3"Tee 8 Typar 3401 -filter fabric 2
Ameron FRP 2" Pie Estimate Veeder-Root 329358-001 2
Ameron FRP 2" BxMNPT adapt 7 Veeder-Root 329359-001 1
Ameron FRP 2"45 degree 5 Veeder-Root 330374-001 1
Ameron FRP 2"90 degree 4 Veeder-Root 848480-001 3
Ameron FRP 3"x2" red bushing 5 Veeder-Root 849600-000 3
Ameron FRP Glue 1 Veeder-Root 849600-010
Amfab Island Form 5 Veeder-Root 794380-322 5
Da co 7574BTF-90 11 Veeder-Root 330020-012 11
Da co 7574BTN-12 11 Weaver 8DR-2.6 7
Da co 7174-stage II hose 10 Weaver 4DR-1.2 13
Da co 1" MNPT adapter 10 Weaver 4DR-1.4 14
DCI WWSQCZGR 3 Weaver WST-10.3-12 sealant 2
Dixon HSS16 clamp 10 Western TAP42-1685-B 3
Emco Wheaton A4005-002 12 Western TAP48-1793-B
FE Petro IST-2 w/24" riser 3 Western DMDS1142-D4 5
FE Petro IST-3 w/40" riser Western 9901 5
FE Petro VFC 3 Western DM850838 5
Husky 3360-VR 11 Western 9010 5
Jomar T-100-708 3 Western PI-4500- pipe Estimate 500ft
Korea 6" bumper post 20 Western PI-4531 -conduit Estimate 500ft
LSI SC-S-320SMV- 12 Western PI-4580C Male end 3
Nozzle-operation Decal 10 Western PI-4644-Tee 12
Octane Rating "87" 10 Western PI-4645-90 degree 3
Octane Rating "89" 10 Western PI-4633-crossover 12
Octane Rating "92" 10 Western PI-4636-test end 6
Western AC-8439 -entry 30
.,I
http://www.shieldsharper.com/Safeway%20Data/5Dispenser.html 7/27/01