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~. OCT 31 '97 12~0?PM DEQ • WVR ' P.3i5
<br />if7i,N AlIIC~t'~
<br />Notificatiorr~ for~ L1~nd~: ~round Stora~e 7'an~Cs _-- 4u,.°.:~5°-~.y
<br />rrfOv~,l f~~:=e5 b~ s~.~u
<br />:~iU~n To: Ortgon O~partment of Environmentai Quality . V. STaTE 1;:~ oh~Y
<br />Underground Stora~e Tank~~P;ogram. .. . ~.mo" .
<br />F.O. $Cz 1760 ~„~,e.«,.~
<br />Port(and, Ore;on 9i20T ~ ~ ' . - - - - - - - -
<br />VOIi~~G~~+an IS -tquired Sy FeaCrsl I~w ler ~ll urtder~ro~nd I~nlq Ihal h.l~e bttn ]. Slat~e :1A43:
<br />uStd lo !la~e ltgl+llted 1~6Sl~nCt7 {inCS ~a~uary I. 197j. ~a~ i~f In {I1! afCYfld if ~. piFetine (at:liues !inclucing guharing linest regulated unde< <h4 N~tural Gas
<br />of l~1~y a, t9efi, er ~hae are :~aushi ?~ta use ~her ,u~y S, t986. Tha inlarma~ion p~FZ!ine S~inty .+c; o~ 19bb, er tha Mazard4us :iau~d ~pe~~ne S+~c:y J,ct oi
<br />dtQVel[!O 11 ftqulfrd yy $tC:70A a4~2 af IhG RtSOU~tO ~O~v[h7UOf1 3114 RKOrl~ jCjt p~ whiG1 i7 an intqfWl! ~t0llin! i]GIIQy qSL~~ICd UAE2f S!~!G 4]~wa,'
<br />~C., IR~YAJ, as ~mend~, 5. turt~<^ irt1pOV~dments, pi~s, pondS. Or Isgav~s:
<br />The pnmary2wpase af ih~s necife~con pragram ~t ro loa~e i~d e~~w~e v~dc-- i- unrrn w~~er o~ wasce w~re~,eo~~echo~ s~n~ear.
<br />raund i~nks ~hat tra~e er have slo~ed pt<ro~eum or ru:ardoVS suoxancet tl ~s 7. Aow•inrou~rt proee~t t~~k~;
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<br />expeetEd ltid~ [he irtFOrmaNOn yo~ plo~Ge w~il Ot b~t¢G on fUfan~6lv 7tidaol~ d. IiGuio -tf]pf o~ ~Ssoddlld aslheting Gnat dirrttly rsl~~ttJ to ad or g~i
<br />in ~~e•wsen<: o! wch rrcordt. yo~r knrn.kdge, htlieL or recoilecnon.
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<br />recores p~oducaan ane ;athenng opeeanons;
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<br />wko ~~~y~ No1i~ 1 Secuon 9C02 ar RGZe1, as~ ame:~ded, reqe,iret tAae, vnlns
<br />Y ~' uOn;_ einks S~~u~ied n~~ undergrounC xe~ (Sutn at a aasemen~. eallar.
<br />rts~newocScing d~~R. shah. oc cunneh if u+e S~Or~ge t~~k Is s~tuated upan Or ~bave
<br />excmoced. ownen of ~ndergrevnC ~inkt thu ue~t rcgv~ited subu~~ccs mu~~ non~y the ~vrlace of the rloer.
<br />o~si'naud Su[~ or lacsl ~grn~;~ o! che axntencror their mnks. G\.net means--
<br />la} in thr t~:0 0~ ~n u~de~ground s~a~ge c~nk in ute en Nov~mper ~. 198a, o~ .
<br />'Nhai Su~st~n<es ~~e Ca~eredT ;he naai~c~tma ~rqu~r~~nint= ~pp(y co v~drt•
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<br />brou~nt inla use aner tha~ tlate, ~ny persoA who ewn> >n unde~g~oUnd itOnge ~1nk h~s ~~cluacs a~y subst:nce
<br />;round StOr~gO Wnks that tont~in ~eg~la~ed 3ubS~Sntif. 1
<br />osed ~or che sco~aga, usa, ol diipeniin; ol retr.rlJled Suostances. 7nd
<br />under;round scan;c :snk !n ViC bCfer~ NOV~(nbCf 6. ~9a4.
<br />ast a( an
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<br />ti tlell~ed ~S hi Lafoo~S in SKLIOn 101 ll il ef [Ae Comprthensive En~~ra~m~~i~1
<br />R~svo~:~. eoma~n:~~~~ ~~o ~izar,~r ,~~ or iyaa cC:RC.~I. +~.4n ihe exceanon or'
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<br />bu~ na bns;r in 41G O~ Ih~l d~tt, iny rrtion who Ovvned WeS lutk immediur,ly 1hOSe yV'a!t]nCp rCV~itl~ ~3 h~=~rU0u3 wiSt~af~dtr SuCl~ll! ~ Cl RC.v\. U iliq
<br />e~ud~ Ou or ~ny f~acio~ ~f~ereof wh~CiS ~S liqu~ ~j 7wn[!rC
<br />intlud~t p(etfOltvm
<br />e,g.
<br />Leler~ ahr d~uo~~~uadon o( ils u52. ,
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<br />~oAUllion6 Oi lent~pzr~tur! ~nd pr~SS~~e 450 dcg~lt5 f]~~tnheit 7~J 1 a.i ~a~nds per
<br />wh~~ i,nks .+.e Inc;vdod2 undar¢ ound uoca~r iank a aafir.ed ~s any e~e or com• s ~are ~~ch a5soluiel.
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<br />~n~aon a~ :~nks :hat (:) :t used co GCnf~lq ~n u~.:muf:don ol "regulated
<br />SVOSZinC~S.~ ~AC (:1 wrese vdume Gnc!uci~s wn~e~ed u~e~grou~d ao%ng it `yhere To voti 1 Com le~d not~fitat~enlnrmj thovk' be sant to lht addreSS S+vcn
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<br />:0: ar mcra benaa~h :h+ ;roun~, $om~ e-aTnle; ~re undt~$rovnd Isnks s~aring: at lhe top af ih~s p~ge.
<br />t. ~acolina. used o~i, oc die~.-t ~uel, :na 1_ incu:cri~i soh~~ms, p~sticides, herh~eide: ar wF.en 7o Nocilyt t. Ownas of u~de:grou~d stonee :snks in uu or th:[ Savc bean
<br />IumiqintS. ~ t~ken ou1 0( operacipn att~r Ji~Vary ~. :°.7~, b~t StTI In.thu ;;raund, muyt r.o(~y hY
<br />Wh.71 T~nk! Art Psduded? Ta~kf remove0 rrOm Ih~ g~0und ~re nat Subjctt la ~Y e, 1?A6. 2, G~nrn who b~~s undergrau~d non6e canks inro use aieqr ~n~y 8,
<br />no~~~~c~~:o~. Oiher canks es<'uded lrom n0~~~~<a~~On ~re; 19ab, r,~u:e r,o~ily wiihin 30 Cays d b~~g~ng ~hc can~s inco ~sa.
<br />t. la~m o~ rrsid~n~ial innks o( I.IOG $aUert. Gr I~s ~.iPS<+ry VSO~ (O~Sto~g mOtC~ 7C~lliiqt~ Any OW~Cf who k~Owin=IY fdI1S IO ~O~ify 0~ fubMilS :~ISE iniortrt~lion
<br />I~cl [O~ M1O~fOTTlfG4]I aurpOSlS; 1fISII Ee labjeGS t0 a t'~'il pCaal{y nOt :v excecd St0,0o0 fa~ ~~ch iank for .~hieh
<br />2. ~~nks ~:ed for ycoring heiun~ ad foe ean~umoiiva use on :ha ereTrserwherr ~p~~fiC~tion is net Siven or far wnie5 false inierm.f~ion is fubrnifttd-
<br />tror~:
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<br />PleaSe type o~ A~i~t i~ ~~k al[ items exc.'pc ';S~gr+ltu~e" in SeCtio~ ~/. 7his (o~m muit bt tonpklCd Indit~:e numhec af
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<br />fo~ ~:ch Iot~~iqn Co~lsinin6 undcrr,: aund Slaragr t~nka. If ma~e ~han 5 wnks ~re owntd ~t th~f Ixatian, continuation sheece ~
<br />pnwocepy che re~ene side, and uaple continuu[ian ~heets w chiy lorm. _ - . ~twched- _
<br />p~~n~r IV~me ICaKro~aeion, tnCividua). Publie.~~eney, arGher En~Uy)
<br />Marion_County __
<br />Slree~'•ddre~s
<br />100 Hiah Street NE Salem, Ore4on
<br />CGun1y •
<br />Marion
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<br />c~y s~~« x~Q cad~
<br />Salem, Oregon 97301 ,
<br />.~rca Code Phonr tv~imi,sr
<br />~~~-373-4424
<br />Type o~Own~r (hlark afl cb~t appfy ~`Gi1
<br />~ Priv:te or
<br />~ Current ~ Sute Or LOC~I Gov't. COtpor~te
<br />Fed4'ai G0~ ~• ~ Ownefshia
<br />[,1 Foimer (C,SA fsciliry I.Q. r.o.) unctrtatn
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<br />ilf iame as Section 1, maric box here^
<br />fatility ~vame or Company Ske (dentifler. :s ~ppllcable
<br />Former Chevron Station
<br />Stree~ .~edress ar St:te Road. as appF~ab[e '
<br />595 Eourt Street NE
<br />~Ounly
<br />Marion
<br />Cicy(ne~rtsu - 5r,ce DpCode
<br />Salem, Oreqon
<br />Indicata
<br />numbe! of
<br />tanks at this 1
<br />laeauon
<br />,vamq (if sam~ as Stction 1, mark ba: here~) ~ 106 7itlp
<br />r___ „___...~ Senior Env~ronmental Engineer
<br />rKa~k har here ?f canklsl
<br />are lacated an land withtn
<br />,;n lndian reservation ^
<br />on Ocher Indi~n tru~I I~nds
<br />,~roa~od~31-6POh7~ Number
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<br />C,] t.ta~ic bax here ooly if this is an amended or~subseqvent no~ircac~on for th+s loadoa.
<br />r r~. .. „d. ~1 • ' x . -- - .~ - ~•~. •i u
<br />1 C2rti'ry vnder penalcy of la~v that ~ I~ave personally e:csmined and ~m lami(iar w~th the in~ormatton subrniued in th~s ~nd a!1 attathed
<br />dacume~ts, and thac based on my inquiry ol those ~nd~~~dvals immediately respansible for obcaining che informa~ian. I believe ~hat the
<br />submitted inForma~ian is true, accucace, ~nd compleie.
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<br />~~~s~ol¢ci~l i'e oio~~nera;ow~~er's a~tharixcd representarive +4~+~ Oa~eS~gned
<br />--~-.._°~ n-~r . ~~~...4~n.~.~.F~e~"4'{ _'~~' J- 7
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