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State of Wisconsin STORAGE TANKS <br /> Department of Natural Resources AIR POLLUTION CONTROL PERMIT APPLICATION <br /> Section 144.391,Wisconsin Statutes <br /> Form 4500-1T Rev. 12.86 <br /> 1. Facility Name <br /> 2.This data is for Storage Tank I T <br /> 3. Which has its emissions reduced by control device 4.Storage Tank Capacity <br /> I C (gallons) <br /> (Use N from appropriate Form 4500-1C) <br /> 5. Type of Storage Facility(check ✓ one) 6.Tank Height <br /> ❑ Open Top Tank ❑ External Floating Roof, (feet) <br /> Single Seal <br /> ❑ Fixed Roof ❑ External Floating Rod, 7.Tank Diameter <br /> of <br /> Double Seal (feet) <br /> ❑ Fixed Roof ❑ Other(specify) <br /> W/Internal Floating Roof 8.Color of Tank(check • one) <br /> ❑White ❑Underground <br /> ❑ Pressurized Tank ❑ Other(specify) <br /> 9. Is this tank equipped with a submerged fill pipe? <br /> ❑ Yes ❑ No <br /> 10. Control Equipment(check ✓ appropriate items) <br /> ❑ Vapor Condensation ❑ Incineration 0 None <br /> ❑ Vapor Recovery (specify) ❑ Vapor Holding Tank <br /> 11. Is this tank equipped with a pressure vacuum conservation vent? <br /> ❑Yes ❑No If yes,at what pressure is it set? (PSIA) <br /> 12. Complete the following table for materials to be stored in this tank. <br /> Annual Amount Material Material Storage Average <br /> Throughput Stored Molecular Vapor Pressure Storage <br /> Material Stored Daily Avg. Weight Pressure Temperature <br /> (gal/yr) (gallons) (lb/lb-mole) (PSIA) (PSIA) (°F) <br /> • <br /> 13. Describe the operations this tank will serve. <br /> SEE INSTRUCTIONS ON REVERSE SIDE <br />