HomeMy WebLinkAboutApplication APPLICANT 2/5/2010
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:City of Springfield
Development Services Department
225 Fifth Street
Springfield, OR 97477
Drinking Water Protection Overlay District Development
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Applicant Name: .::r:;.c.-k..~D^ '-" '"Po,..,)
Icompany:
IAddress: .3fSb f:Drllrne..rc:.eJ.,.:. c..+ Ner; J.ie>..n
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IAPPlicant's Rep.:Uc::'Jl.A.M- K~
Icompany: \>Db
IAddress: 13'35 5W U, loW Av-t., ,sh ;:;l.ol
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I Property Owner: . ....~A1ne M 4,..a;'...-L
Icompany:
IAddress:
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IASSESSOR'S MAP NO: n O:s:z~~O
I Property Address: 337 z; G:feo.L.li
ISize of Property:
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IZOninq: Com"'p-,""~',....J
I Existinq Use: C. A <: ,S-i~,'+"D" - (J"",u;:> " ;,.,,,,, e.. ~
I Description of If you are filling in this form by hand, please attach your proposal description to this application.
Proposal: A'Di> Ale,,) D I''''S~ I \,,-";1<. n"o';"~ ... k" "is roL/1<:'",,...
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Si natures: Please si nand rint our name and date in the a ro riate box on the next
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Phone
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. Fax: 503-3;7..7-~"'S'"
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Fax:
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Acres 0
Square Feet 0
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Associated Cases: Cov.-, 2010" tJZroSI (6 P)
Icase No.: \)\\2 c.. 2-0/0 .- bb{)CI Lv I Date: 2./>1/0 I Reviewed bv: -h---z-
IAPPlication Fee: $ I01..D.U\J I Technical Fee: $ 7/.~ I Postaqe Fee: $0
!TOTAL FEES: $ }) 0:I--/.!;'\"\ I PROJECT NUMBER: -
J
Date Received:
FEB - 5 2010
Original Submittal
Revised 1/15/09 ddk
1 of 5
Signatures
The undersigned acknowledges that the information in this application is correct and accurate.
Applicant:
Date:
Signature
Print
Owner:
If the applicant is not the owner, the owner hereby grants permIssion for the applicant to act In his/her behalf.
~ ~ Date: 19!/;f)
ignature /v ,
.~ Jtlt/23 r-.c ,7 ~<O/lC; ;;;;; 6Y<tt6,Lt.
Print -
Date Received:
FEB - 5 2010
Original Submittal
Revised 1/15/09 ddk
20fS
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
DRC20 I 0-00006
DRC20 1 0.00006
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
CTY Drinking Water Protection
+ 5% Technology Fee
Paid By
AJK, INC DBA PDG
PLANNING DESIGN GROUP
~.~,.""'(l~I~.....',_
l' #,.._ " " .
_Ii ,.
( , of Springfield Official Receipt
lJevelopment Services Department
Public Works Department
3201000000000000042
Date: 02/05/2010
8:51 :25AM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
1,020.00
51.00
$1,071.00
Amount Paid
tj
$1,071.00
2013
In Person'
Payment Total:
$1,071.00
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Date Received:
. FEB -5 2010
Original Submittal
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Page I of I
2/5/20 i 0
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CITY OF ~. '.UNGFIELD
VICINITY MAP
DRC2010-00006
3375 Gateway
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Map 17-03-22-20
Tax Lot 901
North
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Date Received:
FEB - 5 2010
Original Submittal
,
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541)726-3689
www.ci.springfield.or.us
January 20, 2010
Jacksons Food Stores, Inc.
3450 Commercial Court
Meridian, Idaho 83642
Raven & Associates, Inc.
P.O. Box 278
Gladstone, Oregon 97027
Dave Kimmel
PDG
1335 SW 66th Avenue, #201
Portland, Oregon 97225
Re: Building Permit COM201D-00051
3375 Gateway Street, Springfield, OR
The City of Springfield Planning Division has been routed building permit COM201D-00051 for
review. This building permit submittal proposes installing a new 10,000 gallon underground
diesel gas tank. This site is located in the 5 year Time of Travel Zones for the Sports Way
Wellhead in the Drinking Water Protection overlay District. The City of Springfield derives all
of its drinking water from various wellheads located throughout the City.
In December a representative from Raven & Associates called and spoke with the Urban.
Planning Division and was told that the site was located in a Drinking Water Protection Overlay
District and that a review would be required. He was also given the name and number of the
Water Quality Protection Coordinator for Springfield Utility Board for specific information on
requirements for underground tanks and drinking water protection requirements. The Water
Quality Protection Coordinator for Springfield Utility Board works with the City of Springfield to
review Drinking Water Protection OVerlay District applications.
A Drinking Water Protection (DWP) application and review is required before the building
permit can be issued. I have enclosed a copy of the application and fee schedule. The
Springfield Development Code, applications and fee schedule are located on our website at
www.ci.sorinrneld.or.us.
Date Received:
FEB - 5 2010
Original Submittal
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,
Please contact Amy Chinitz, Water Quality Protection Coordinator, at Springfield Utility Board
for questions on specific application submittal requirements as it relates to hazardous materials
storage, use, handling and Hazardous Materials Management Plans. The phone number for
Amy Chinitz is (541) 744-3745.
Please give me a call if you have any questions regarding this letter or other application
submittal requirements at (541) 726-2301.
SJerelY,
111}1-Jl'[ ilL
Liz Miler
Planner I
cc: Chris Carpenter, Building
Amy Chinitz, SUB Water
Date Received:
FEB - 5 2010
Original Submittal
DWP Overlay District Development Submittal Requirements Checklist
NOTE: If you feel an item does not apply, please state the reason why and attach the
explanation to this form.
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Submitted Concurrently with Site Plan Review or Minimum Development Standards
applications, where applicable.
Application Fee - refer to the Development Code Fee Schedule for the appropriate fee
calculation formula, A copy of the fee schedule is available at the Development Services
Department. The applicable application, technology, and postage fees are collected at the
time of complete application submittal.
DWP Overlay District Development Application Form
Copy of the Deed
Copy of a Preliminary Title Report issued within the past 30 days documenting
ownership and listing all encumbrances.
Narrative explaining the proposal and any additional information that may have a bearing
in determining the action to be taken, including findings demonstrating compliance with
the Standards for Hazardous Materials within Time of Travel Zones (TOTZ) listed in SDC
3.3-235.
NOTE: Before the Director can approve a DWP Overlay District Development request,
information submitted by the applicant must adequately support the request. All of the
Standards for Hazardous Materials within TOTZ must be addressed. Incomplete
applications, as well as insufficient or unclear data, will delay the application review
process and may result in denial. In certain circumstances, it is advisable to hire a
professional planner or land use attorney to prepare the required findings.
Three (3) Copies of a Plot Plan reduced to 8 '12" by 11" outlining the applicable TOTZ
boundaries in relationship to the property boundaries
Three (3) Copies of the Following:
o Use of hazardous materials that pose a risk to groundwater that existed on the
property prior to May 15, 2000, if applicable
E'J Hazardous Material Inventory Statement and Material Safety Data Sheet for all
materials entered on the Statement. Hazardous material weights shall be converted to
volume measurement for purposes of determining amounts (i.e. 10 pounds shall be
considered equal to one gallon)
o List of chemicals to be monitored through the analysis of groundwater samples and a
monitoring schedule if groundwater monitoring is anticipated to be required Nil
)2J Detailed description of the activities conducted at the facility that involve the storage,
handling, treatment, use, or production of hazardous materials in aggregate quantities
greater than 500 gallons
rL!'Description of the primary and any secondary containment devices proposed, and, if
applicable, clearly identified as to whether the devices will drain to the sanitary sewer
or stormwater system Date Received:
FEB - 5 2010
Revised 1/15/09 ddk
Original Submittal
4 of 5
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~roposed Hazardous Material Management Plan for the facility that indicates -.--
procedures to be followed to prevent, control, collect, and dispose of any unauthorized
release of a hazardous material .
nDescriPtion of the procedures for inspection and maintenance of containment devices
and emergency equipment _
6 Description of the plan for disposition of unused hazardous materials or hazardous
material waste products over the maximum allowable amounts, including the type of
transportation and proposed routes
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Date Received:
FEB - 5 2010
Original Submittal
Revised 1/15/09 ddk
5 of 5
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PDG Planning Design Group
1335 SW 66'. Ave. #201
Portland, Oregon 97225
PH: 503-329-5399
Fax: 503-327-8456
Emall: pdgplanning@Comcast.net
February 4,2010
City of Springfield
225 Fifth St.
Springfield, OR 97477
RE: Building Permit COM2010-00051
3375 Gateway St.
Springfield, OR
This site is located in the 5 year Time of Travel Zones for the Sports Way Wellhead in
the Drinking Water Protection Overlay District. The following is the narrative
response to the Springfield Development Code, section 3.2-235.
B, One to Five Year TOTZ Standards.
1. The storage, handling, treatment, use, application, or production or
otherwise keeping on premises of more than 20 gallons of hazardous
materials that pose a risk to groundwater in aggregate quantities not
containing DNAPLs are allowed only upon compliance with containment
and safety standards specified by the most recent Fire Code adopted by the
City.
The applicant is proposing to add a 20,000 gallon Diesel tank to an existing gas
station. The tank is a double wall fiberglass tank with interstitial monitoring.
2. Unless exempted, all hazardous or other materials that pose a risk to
groundwater shall be stored in areas with approved secondary containment
in place (Springfield Fire Code 2702.1 and 2704.2.2).
The applicant is not proposing for this site to be exempted.
3. All new use of DNAPLs are prohibited.
The applicant is proposing to add a diesel underground storage tank. Diesel is not a
DNAPL. . d'
Date Receive .
FEB - 5 2010
Original submittal
4. Any change in the type of use or an increase in maximum daily inventory
quantity of any DNAPL is considered a new use and is prohibited.
Does not apply.
5, The following certain types of facilities or changes in chemical use and/or
storage of hazardous or other materials that pose a risk to groundwater are
prohibited:
a. Hazardous material product pipelines used to transport the hazardous
material off of the tax lot where it is produced or used;
b. Injection wells;
EXCEPTION: Dry wells for roof drainage;
c. Solid waste landfills and transfer stations;
d. Fill materials containing hazardous materials;
e. land uses and new facilities that will use, store, treat handle, andlor produce
DNAPLs.
The applicant is not proposing this type of facility. This does not apply to this
application.
6. Requirements found in Springfield Fire Code 2704.2.2.5 for a monitoring
program and monitoring methods to detect hazardous or other materials in the
secondary containment system shall be met for all amounts of hazardous
materials that pose a risk to groundwater unless exempted.
The applicant will meet these requirements. See attached documentation describing
the secondary containment for the tanks and piping.
7. The following requirements for inspection and record keeping procedures
for monthly in-house inspection and maintenance of containment and
emergency equipment for all amounts of hazardous or other materials that
pose a risk to groundwater shall be met unless exempted: Schedules and
procedures for inspecting safety and monitoring and emergency equipment
The applicant shall develop and follow a written inspection procedure
acceptable to the Director for inspecting the facility for events or practices
which could lead to unauthorized discharges or hazardous materials. An
inspection check sheet shall be developed to be used in conjunction with
routine inspections. The check sheet shall provide for the date, time, and
location of inspection; note problems and dates and times of corrective actions
taken; and include the name of the inspector and the countersignature of the
designated safety manager for the facility.
See attached inspection sheets and record keeping procedures for monthly in-house
inspection and maintenance.
Date Received:
FEB - 5 2010
Original submittal
. .
We believe we meet the Springfield Development Code in its application of the 5 year
Time of Travel Zones for the Sports Way Wellhead in the Drinking Water Protection
Overlay District.
Sincerely, , 7
fj~). f K~
David P. Kimmel
:1
Date Received:
FEB - 5 2010
Original Submittal
Page I of3
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CHEVRON USA PRODUCTS CO - CPS272102 DIESEL FUEL NO 2 - 9140-00F027952
Product Identification ===-====~-=-g~====~-=
Product ID:CPS272102 DIESEL FUEL NO 2
MSDS Date:04/01/1993
FSe: 9140
tUIN: ODr027952
Statu.s Code:A
MSDS Number: BRBHK
--= Responsible party
Company Name:CHEVRON USA PRODUCTS CO
Address:575 MARKET ST RM 2900
City:SAN FRANCISCO
State:CA
ZIP:94105-2856
Country: US
Info Phone Num:510-242-5357/800-822-5823
Emergency Phone Num:800-231-0623
CAGE: 81230
=== Contractor Identification
Company Name:CHEVRON PRODUCTS COMPANY LUBRICANTS AND SPECIALTY PRODUCTS
Address:GOOl BOLLINGER CANYON RD
Box:C1ty:SAN RAMON
State:CA
ZIP:9450J
Country: US
Phone:800-414-6737 / 800-582-3835
CAGE: 81230
company Name:CHEVRON USA INe DBA CHEVRON PRODUCTS co
Address:575 LENNON LN
BOX:City:WALNUT CREEK
State:CA
ZIP:94598
country: US
Phone:510-977-7283
CAGE: 04BHO
==:========== Composition/Information on Ingredients
Inqred Hame:PETROLEm.,; HID-DISTILLATE, ALIPHATIC PETROLEUM NAPHTHA
"'93-1'"
CAS: 68476-34-6
Fraction by Wt: 100%
Ingred Name:GAS OIL, BLEND (MOUSE CARCINONGENIC BY RTECSI
CAS: 64741-44-2
RTECS #:LX3296000
ACGIH TLV:5 MG/CUM
Ingred Name:KEROSENE, KEROSINE
CAS:800B-20-6
RTEC~ #:OA5S00000
Other REC Limits: 100 MG/CUH NIOSH
Ingred Name:HYDROSULFURIZED KEROSlt~
CAS: 64742-81-0
RTECS #:OA5510000
Date Received:
Ingred Name:LIGHT CATALYTICALLY CRACKED DISTILLATE
CAS: 64741-59-9
RTce~ #:J1l9385000
FEB - 5 2010
H.!IIz.!IIrds Identi fica tion ==== ___.__ =-= ______2=
LOSO LeSO Mixture:ORAL LOSO (RAT): >5 ~~/KG
Routes of Entry: Inhalation:YES Skin:YES Ingestion:YES
Reports of Carcinogenicity:NTP:NO IARC:NO OSHA: NO
Health Hazards Acute and Chronic:3KIN: IRRITATION. PAIN OR
HEAT, DISCOLORATION, SWELLING' BLISTERING. INGESTION:
Original Submittal
FEELING OF
ASPIRATION
http://sz0031.ev.mail.comcast.netlzimbralh/search?si;Q&so=O&sc=85863&sfi=2&st=messa. .. 214/20 I 0
Page 2 of3
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HAZARD. INHALATION: CENTRAL NERVOUS SYSTEM EFFECTS.
Explanation of Carcinogenicity:NONE
_a~==~==:===______==== First Aid Measures =======================
First Aid:EYE3: FLUSH W/WATER FOR 15 MINS. SKIN: WASH W!SOAP & WATER.
INGESTION: GIVE WATER OR MILK TO DRINK. DON'T MAKE PERSON VOMIT
UNLESS DIRECTED TO DO SO BY MEDICAL PERSONNEL. INHALATION: REMOVE
TO fRE:JII A IR. ODTAIN MEDICAL ATTENTION IN' ALL ~Im. NOTE TO
PHYSICIAN: ASPIRATION OF MATERIAL INTO THE LUNGS CAN CAUSE
PNEUMONITIS.
=====-==== Fire Fighting Measures
Flash Point Method:PMCC
Flash Point:125F/52C
Lower Limits:O.6%
Upper Limits:4.7'
Extinguishing Media:C02, DRY CHEMICAL, FOAM, WATER FOG
Fire Fighting Procedures:DON'T ENTER ANY ENCLOSED OR CONFINED FIRE
SPACE WITHOUT PROPER PROTECTIVE EQUIPMENT. USE SCBA.
Unusual Fire/Explosion Hazard:LIQUID EVAPORATES' FORMS VAPOR WHICH CAN
CATCH FIRE & BURN W/EXPLOSIVE VIOLENCE. INVISIBLE VAPOR SPREADS
EASILY & CAN BE SET ON FIRE BY IGNITION SOURCE.
--------- --
------------------
Accidental Release Measures
Spill Release Procedures:ELIMINATE IGNITION SOURCES. CLEAN UP SMALL
SPILLS USING ABSORBENT MATERIALS OR PUMPING. WHERE
FEASIBLE/APPROPRIATE, REMOVE CONTAMINATED 30IL. PREVElrr FR~1
CONTAMINATING SOIL, WATER, DRAINAGE & SEWER SYSTEMS.
H~ndling ~nd stor~gc
Handling and Storage Precautions:OQN'T USE OR STORE NEAR FLAME, SPARKS,
OR HOT SURFACES. USE ONLY IN WELL VENTILATED AREA. KEEP CONTAINER
CL03ED. REPLACE CAP OR BUNG.
Other Precautions:OONtT WELD, H&AT OR DRILL CONTAINER. EMPTIED
CONTAINER MAY CONTAJN HAZARDOUS OR EXPLOSIVE VAPOR OR LIQUID. DONtT
U3E PRE33URE TO EMPTY DRm1 AS IT f~Y RUPTURE W/EXPL03IVE FORCE.
========g:=== Exposure Controls/Personal Protection
Respiratory Protection: NO SPECIAL RESPIRATORY PROTECTION IS NORMALY
REQUIRED. HOWEVER, IF OPERATING CONDITIONS CREATE HIGH AIRBORNE
CONCENTRATIONS, THE USE OF AN APPROVED RESPIRATOR IS RECOMMENDED.
Protective Gloves:RECOMMENDED
Other Protective Equipment:PROTECTIVE CLOTHING
Work Hygienic Practices:REMOVE/LAUNDER CONTAMINATED CLOTHING BEFORE
REUSE. DISCARD CONTAMINATED NON-WATERPROOF SHOES & BOOTS.
Supplemental Safety and Health
WAP.NING: NOT FOR USE AS PORTABLE HEATER OR APPLIANCE FUEL. TOXIC FUMES
HAY ACCUMULATE & CAUSE DEATH.
=====----.------. == Phy:.ic.:ll/Chcmic.:ll Propcrtic~
------------------
------------------
Boiling Pt:B.P. Text:176-370C
Vapor Pres:O.04 PSIA
3pec Gravity:O.04
Solubility in Water:INSOLUBLE
Appearance and Odor:PALE YELLOW LIQUID
Date Received:
Stability and Reactivity Data
=====:>: _ u_._ U~
3tability Indicator/Materials to Avoid:YE3
MAY REACT WITH STRONG OXIDIZING AGENTS SUCH AS CHLORATES, NITRATES,
PEROXIDES, ETC.
St~bility Condition to Avoid: FLAME, SPARKS, HOT SURFACES OR OTHER
SOURCES OF IGNITION.
Hazardous Decomposition Products:NORMAL COMBUSTION FORMS C02' WATER
VArOR; 1.............. ....ETE COMBUSTION CAN PRODUCE CO.
FEB - 5 2010
Original submittaL
http://sz0031.ev.mail.comcast.netlzimbra!hlsearch?si9)&so9)&sc=85863&sfi=2&st=messa... 2/4/20 I 0
Page 3 of3
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""""'''''= --- .-=...""::::::"""""",,,,:::: Disposal Considerations ==-====""...""==,*,,,,,======
Waste Disposal Methods:PLACE ALL CONTAMINATED I~TERIAL3 IN DISPOSABLE
CONTAINERS . DISPOSE OF IN A MANNER CONSISTENT W!APPLICABLE
REGULATIONS.
Disclaimer (provided with this information by the compiling agencies) :
This information is formulated for use by elements of the Department
of Defense. The United States of America in no manner whatsoever,
expressly or implied, warrants this information to be accurate and
disclaims all liability for its use. Any person utilizing this
document should seek competent professional advice to verify and
assume responsibility for the suitability of this information to their
particular situation.
Date Received:
FEB - 5 2010
Original Submittal
http://sz0031.ev.mail.comcast.netlzimbralhlsearch?si=O&so=O&sc=85863&sfi=2&st=messa.. . 2/4/20 I 0
HAZARDOUS MATERIALS PROCEDURES
SITE #112
Storal!e of Hazardous Materials
. Gasoline & Diesel Fuel are to be stored only in the existing onsite Underground Storage Tanks.
. The Underground Storage Tanks are currently permitted through Oregon Department of
Environmental Quality.
. All fuel stored onsite is clean, fresh fuel for resale purposes.
. In the event the site discontinues the function of petroleum sales and distribution, the
Underground Storage Tanks will be taken out of service per the procedural requirements of the
Oregon Department of Environmental Quality.
Date Received:
FEB - 5 2010
Original Submittal
MONTHLY INSPECTION CHECKLIST
FUEL SYSTEM
Fuel Inventory Console
o All Functions Normal
o Alarm Mode I Action Taken:
Emergency Shut-off
o Status Normal
o Abnormal I Action Taken:
Dispenser Equipment
o All Functions Normal
o Abnormal I Action Taken:
UST Fill Connections
o Equipment Status Normal
o Abnormal I Action Taken:
Date Received:
FEB - 5 2010
Original Submittal
Dispenser Containment Sumps
o Status Normal I Liquid Free
o Abnormal I Action Taken:
Turbine Containment Sumps
o Status Normal I Liquid Free
o Abnormal I Action Taken:
InSDected by:
Date:
Actions ReDDrted to:
Date Received:
FEB - 5 2010
Original Submittal
"
Material SafetY Data Sheet
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CHEVRON and TEXACO MID-GRADE UNLEADED GASOUNES
Product Use: Fuel .
Product Number(s): CPS201001 [See SeclIon 16 tot Addilional Product Numbers]
Synonyms: CaloO Mld-Grade Unleaded Gasoline, Chevron MId-Grade Unleaded Gasoline, Chevron' Plus
Unleaded Gasoline, Texaco Power Plus Gasoline '., .'
. c.. ." ..'Idenliflca'tlon
Chevron ProductsC. ,""'.
Marketing, MSDS COOfdlnator
6001 Bollinger Canyon Road
San Ramon, CA 94583
United States,ot America ;',
Transportation Emergency Response
CHEt.ITREC: (800) 424-9300 or.(703) 527-3887 .
Healtll Emergency' :'. .' .
Chevron E..... b'('.,'I. :', , ,:;.,: Center: Located in the USA. InL.."",::."" I coIIecl caDs" ..,,;, J. (800) 231"()623
or (510) 231-0623 . .
Product Infll "",:.
Technical Information: (510) 242-5357 .,' .
SPECIAL NOTES: This M,S, OS 89Wato; ~~~~\ ' . ., ~ . .
~~..eM~HfA~!f~~~~~~
COPIIf'ONENTS
GasOIne
Benzene
Toluene (melhvlbenzene) , ' .
~~~ <>-, m-, & p- xylene ~mers'In'
varyillJ amountsl
I Butane, . ,
I Heptane
I Hexane
I te1~ne ' .'
I ol1e/ll'ne .
I ne, !~,4-lrmethy\- (Isooctanel
~trJy ,.
~te~~~JE1:t~~E)
E1hvftel~':~;; (ETE!~\
CAS NUMBER
86290-81-5 .
71-43-2
1Q8.8~3
100-41-t
1330-2G-'
I tQ6.97~
142-82-5
11(l,54-3 .
110-82-7
1lJ8087-2
54G-8'4-1
&1-20-3
8-1-17-5
1634-0+4
994..Q5-8
I 637-92-3
: '\.
ReYlslon Number. 30
Rov/olon Dale: ~ 31, 2008 .
lof11 ..'
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AMOUNT
100 %voIIIIol
0,1 - 4.9 %vollvol
. 1, - 25 %vol/Vol
0.1 - 3 %volIwl
1 - 15'%voUvol
1 . 12 %lIOI/VoI , .
1 - 4 %voIIvol
1 - 5 %voI/vol
1 - 3 %vqflYol
1-2 %voINol
1 - 13 %lIOI/VoI
0.1- 2 %voVvoI
O. 10 %voIIvoI
0- 15 %VQIIvol
0- 17 %voUvol
,O-18%voVvoI' ,
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CHEVRONondTEXACOIlIp.y~R ' d'
UNLEADED CASOUNE8' . ualt: ecelve.
!IS1l8, 3205
'FEB - ~ 2010
Original Submittal
and shoes or thoroughly clean before reuse.
Ingestion: If swallowed. get immediate medlcal.attenflon. Do not induce vom~lng. Never give anythfng by mouth
to an unconscloua person.
Inhalation: Move the exposed person to fresh air, If not breathJng, give artificial respirado'1- If breathing is
difficult. give oxygen. Get medical attention If breathing difl1cullles continue.
Note to Physicians: Ingestion of this product or subsequent vornldrig may result in aspiration of light ~,,;, . ~,,>...
Uquid. which may cause.pneumonltie.
~1!m~iilI1-l8.'~~'. ~~"-~~~
See Section 7 for proper handling and Storage. '
FIRE C'LASSIFlCATlON:
OSHA Classlllcation (29 CFR 1910,1200): Aammable liquid.
NFPA RATINGS:
. Hea~h: 1
Flammability. 3
, ReactIVity: 0
FLAMMABLE PROPERTIES: .
Flashpoi~ (Tagllabue Closed Cup ASTM 056) <:..\5 'C (<-49 'F)
-1WtoIgnitlon: > 280 'C (> 536 'F)
Flammability (Explosive) Umlts (% by volume In air): lower: 1.4 Upper: 7.6 (T~IcaQ
EXTINGUISHING ""EDIA: Dry Chemical. C02, AFFF Foam or alcohol resistant foam if >15% volume polar
solvents (oxygenates). .
PROTECTION OF FIRE FIGHTERS:
Fire Fighting Instructions: Use water spray to cOol flnHlxposed ....:..:....~ and to protect .__~.....J. Forfirea
Involving this material, do not enter any enclosed or .. ,:"" , ; fire space without proper proteclive equipment, .
including self-contained breathIng apparatus. . " . . .
Combustion Products: Highly dependent on combustion conditions. 'A complex mixture of airborne sonds. .
liquids. and gases Including carbon monoxide, carbon dioxide. and unidentified organic oompounds win be evolved
when this "",:, \.1 undergoes rombustlon. .
""""",...-"",,,-,,,,,,,,_.r'''~. ~~~I
~\:I.":oF.>'_v.~"M~""""'~ _' .G":~ ' '.. -... - , . ,-~ - ...J
Pr0tsctJv8 M~ure8: 8imlnste.aa .89.iJrces of Ignitlon in thl! v1clnltyofthe spm or released vapor" /fthls material
is released into the well< area, evacuate the area immediately. Monftor area with combustible gas Inclcator.' .
Spill Management: Stop .the source of the ~ase !f you can do ft without risk. Contain release to prevent
further contamination or so1~ surface water or groundwater, Clean up spIP as soori as possible. Observing
precautions in Exposure ControlsIPersonal Protection. Use app....:"~, techniques such as applying .
non-<:ombustible absorbent materials or pumping. All equipment used Votlen handling the product must be
'grounded. A vapor suppressing foam may be used to reduce vapors. Use clean non-&parking Iools to ooAact
absorbed material. Where feasible and. appropriate, remove contaminated soD. Place.. 1",'-.." d materials In
. disposable '. ,~: d and dispose of in a manner consisient with applicable regulalions. .
Reporting: Report spiJlsto local authorities and/or !he U.S. Coast Guard's NatIonal Response Center at (800)
424-8802 as appropriate or required. This material is covered by EPA's Compre~ve Envf ".. ,,~JI
Response. Compensation end Uablllly Act (CERCLA) Petroleum Exclusion. Therefore. releases to the
environment may noi be reportable under CERClA.. '. .
c--...""'.......-... ''il.J.' , ".~-,,~<<'''~--'''!~-''''~''''.''''''~~....,.,.,,'.l'.;ll\:~
Lij~eVi.J:I...I'1-~;t:t.I.n.fW.~~a \"iJ~~ ;.I.~C)l!.~'"' _. - . ..t..~;:,-'!:'..~~"i""': ~'"I:,IiIll2{ ;.~ . .:!~m.~~..;~~1}j,.
Precautionary Measures: READ AND OBSERVE All PRECAUTIONS ON PRODUCT LABEL This p~uct .
presents an extreme fire hazard. liquid very quickly 8\~~y,":~., lIVen at low temperatures. and forms vapor
(fumes) which ban catch fire and bum wi!h .....:..:..'e violence. invisible vapor spreads easily and can be set on
. . . . ...
RevIsion Number: 30
Ravlslan Dale: March 31. 2008 :
lofll
:L~'::'~=MID~' Received:
MS~: 3205' ,
FEB - 5 2010
Original Submittpl
approved rasplmtorthat provides adequate protection from this ...d~:.J, such as: Air-Purifying Respirator for
Organic Vapors.
When used as e fue~ this material can produce carbon monoxide in the exhaust. Delllmllne If airborne
concen:<:- ."." are below the occupational8l<posure lima for carbon monoxide. If not, wear an approved
. .<:J '. ,~..Jre air-suppiying resplmtor.
Use a positive pressure elr-supplying respirator In circumstances wherl\ elr-purifylng respirators may not provide
edequate P"_:'_~.'1.. .
Occupational Exposure Umlls:
Induced in human lymphocytes. Gasoline was net mutagenic when tested In the mouse dominant lethal assay.
Administration of g3s0line to rats did not cause chromosomal abemltions in their-bone JTIliIT'OW celis. 1, ," , ,. ,
exposure of rats to the light ends of ~_y::,,~ caused I, ___j sister"; ".". I Jd exchange In Iliei' perlpheral while
blood cells but did not cause an increase in micronticlealed red blood cells In Ihelr bone marrow. '
ADOmONAL TOXICOLOGY INFORMATION:
Gasolines are highly wlatile and can produce 6lgnIflcant .. ., \L.:....w of vapor at amtllent temperallJres. '
Gasoline vapor Is heavier than air and at high ..",.,.,:., lons may accumula181n conIIned spaces to present both
safety and healh : ~~.\, When vapor exposures are klw, or short duration and .Infrequent such as during
refueling and tanker Ioading/l" :.., ~:, 'b' nei1her total hydrocarboo nor compOnents such as benzene are <ely to
resul in any adverse health effects. In sIlualionS such as accidents or SPIlls wher9 exposure to gasoline vapor Is
potentially high, attention should be paid to potential toxic effects of specific componen1s. Information about
specific components in gasoline can be found in SectIons 2,8 and 15 of this MSOS. More delailed infonnation on
the health hazard of specific'gasoline ..' ,.. ~ can be'obtained calling the Chevron Em"., '., Information
Center (see Sectlon 1 for phone numbers).
Pa1hological misuse of solvents and gasoline, Involving" ;".;" J and prolonged exposure 10 high concentrations
of vapor is a slgnillcant exposure on which ihere are many reports In the medicalliteralure. As wI1h other solvents,
perslstentabusa involving "r ,.,~, ~ and, " \ '" ,: exposures to high .. ., . ,; :'. " of vapor has been ""\'"
to result In central nervous system damage and eventually, death. In a study in which ten human wlunlaenl were
exposed lor 30 minutes to approximately 200, 500 or 1000 ppm ..' ., ,: ,;,,\., of gasoline vapor, Irritation of the
eyes was the only significant etlect observed, based on both subjective and objective assessments.
Ufetlma inhalation of whoIIy\~._.:""J unleaded gasoline at 2056 ppm has caused' '. ,.,.,.,d liver tumors in
female mice and kidney cancer in male rats. In their 1988 review of can;' .",,,:. risk from gasoline, The
I..:".. .w:"..!. Agency for R~search on Cal)C'lr (!ARC) nole!llhal, ~use published epidemiology stuelles did not
,Includa any exposura deta, only occupations where gasoline exposure'may have occurred ware reviewed, TheSe
included gasoline service ataUon attendants end automobne mechanics. !ARC also noted that there was no
opportunlly to seperate effecls of combustion products from lhasa of gasoline itself. Although' IAR~ allocated
gasoline a llnal overall cfassiflcaUon of Group 28, I.e. possibly c.. .:., "0' ,:0 to humans, this was based on lironed
evidence In experfmental animals plus supporting evidence including the presence in gasoline of L "'~,, ,. The
actual evidence for carclnogenlclty in humans was considered inadaquata. ,
To explore the health effects of workers potentJaliy ,,~.,' ~ to gasoUne vaporsln,the marketing end dlstr1bution
sectors of the petroleum Industry, the American Patroleum Inslltuta '.., ,...'ed a cohort mortality study (publication
4555), a nested case,oontrol study (Publication 4551), and an exposllnl a5lI ",."" ,,,,. study (I'ubllcatlon 4552).
Histories of exposure to gasoline were reconstnJcled for cohort of mora then 18.000 employees from four
__....~.:es lor the time period '.,~ " 1946 and 1985. 'TI1e results of the cohort mortarllystudy Indicated that
. .. . . ,.
there was no increased mortality from either kidney cancer ~ leukemia among marketing ~ mama cflSlribulion
emplOyees who were exposed to gasoline In the petroleum Induslry, when compared to the ~ population
More '. .. ., lllIy, based on Intemal cOmparisons, there was no association between mortality from kidney cancer
or leukemia and various i']dices of gasoline exposure. In par1lcuIar, neither dlnltlon of employment, duration' of
exposure, age at first axposure, year of first exposure, job catagory, cumulative exposure, frequency of peak
exposure, nor average Intensity of exposure had any effect on kidney cancer or leukemia rportaJity. The results of
the nested case,oontrol study confirmed the findings of the original COhort study. That Is, exposure to gasoline at
the levels ....,.\..__j by,this cohort of dlslribution wOlkers is not a significant risldaclDr for leukemIa (all !'SO
!)pes), acute myeloid leukemia" kidney cancer or multiple myelome. '
~llV....l',<oi.'i.Ji!)~~~NJWRID!..~~~I~F~~~
ECOTOXICITY
96 hoUr(S) LC50: 2.7 mgll (Oncorhynchus m~ss)
48 hour(s) LC50: 3.0 mgJl (Daphnia magna)
96 hour(s) LC50: 8.3'mgJI (~..:".~_.. verlegatus)
96 hour(s) LC50: 1.8 mg/l (MysIdopsls bahla)
Gasoline stucfJ9ll have been conducted in the laboratory under a variety of test conditions wI1h a /lInge of fISh and '
1m" :,~,.il species. An even more extensive database Is avaiable on the aquatic toxicity of individual,. .,..
conslltuenls. The majority of published studies do not Identify the type of gasoline evaluated, 0< even provide
RevIsion Number> 30
RovIsfon Date: Martl131,20OB
10111 ,
CHEVRON ..d TEXACO III1).GRADE,
UNLEADED GASOIJNES ' D .
MSOS: 320S ate Received:
FEB - 5 2010
Original Supmittal
..
01-2B=lARC Grix!p 2B
02=NT!' Carcinogen
05=MA RlJ(
Oll-NJ RlJ(
01=PA RTI<
The f~nowing oomponents of ,this material are found on the regulalol}/ Isls Indlca~.
B, ,..,... 01-1,02, 03, 04, 05, 06, 01
Butane 05,06,07 '
Cyc~exane 03,05,06,07
Ethanol 01-1,02, 04, 05, 06,07
Bhyl benzene 01-28, 03, 04, 05, 06, 07
Gasoline 01-28,07'
Heptane', , ' 05, 06, 07
Hexane 03, 05, 06, 01
Methyltert-bu\Y1 ether (MTBE) 03,05,06, 07
Methyfq .:., ".o-",e 05, 06, 07
Naphthalene " . 91-2B, 02, 03, 04, OS, 06, 07:
r, ,:.." ,,2,2,4-trimethyl- (Isooetane) OS, 06, 07 ,,',
Toluene (meth)'lbenzene) ,03,04,05,06,07
Xylene (contains, 0-, m-, & I>- xylene Isomers in, 03,05, 06, 0.7
~ng amounts)
'.
, ,
CERCLA REPORTABLE QUANTITIESrilJEPCRA30il n ~HOLO P~tI1NG Q,YAty.., I~I:, ' '
I 'omponem . . \lOnenl RQ , ponenfTfll:i 1Iroduct Irei
I llrzerJe 0 s . e .. 186 lbe
I :ulan..' ' , ' , I 100 Ibs _ None . 125 Ib9
I CyclDl1V}Clllle 1000 Ibs None 34188lbe
I Efhanol 100 Ibs None 19341bs '
Ethyl ~e 1000 1b8 I None 349641bs
Gasoline 100 lbe None 1071bs
Heptane 100lbe None I 34421bs
. > Q 5OO0lbs None 129149 Ibs
r' ""lert-butvl ether (MTBE) .. 1000 Ibs ' None 75131be
f ~ p(cIohexane , 100 lbe None ' ~278 lbe
la ''''a\~; " I 100lbs None ~ooo Ibs
~2, 'ethyl- Ooooctane\ 1000 Ibs None 6210 Ibs
To!IJene{m ,.,~,..,).. , '1000100, 'None 3678lbe
. Xylene ( s o-,-m-, & I>- xylene' _ 100 Ibs I None 649115 .
Isomanl in varvjno amounts\, '
I,
1
CHEMICAL INVENTORIES: '
AI components comply with the fonowlng chemicallnventcry requirements: DSL (Canada), ElNECS (European
Union), KEel (KOrBe), TSCA (United States). '
One or mora oomponents does not comply with the following chemica/inventory requirements: Ales (Australia),
ENCS (Jepan), IECSC (China), PlCCS (Philippines).
WHMIS CLASSIFICATION:
Class B, Division 2: FlammSble Liquids
Class D, Division 2, Subdlvisloo A; Very Toxic Material-
Carclnogenlcity ,
Class D, Division 2. Subdivision B: Toldc Matarial~'
Skin 0( Eye 1. :'",~' ., '
Rovl&lon Number: 30 '
Revlalon Date: March 31. 2008 ~:
1 of 11
CHEVRO~ .ndT~oM~.Received:
UNLEADED OASOLIN&S
'NSDS: 3205
FEB - 5 2010
0r'~:r;' c;lJhrr'i~a'-
I
"
r
RevIllIon Numl>>~ 30
Rovlslon Da1o:, Mard13i. 200ll
10111
CHEVRON and TEXACO MID-GRADE
UNLEADEDGABllIJNES Date Received'
MSDS: 3205 '
FEB - 5 2010
Origiri~I'Submittal
Form No. 1402.06
ALTA Owner's Poncy (6-17-06)
1100302P050600
Policy No,: 7091-1458524
OWNER'S POLICY OF TITLE INSURANCE
ISSUED BY
First American Title Insurance Company
Any notice of claim and any other notice or lta12ment In writing ," ". to bo given to ttie Company under thIs policy must be
given to tho CO.....ny at the address shown In _n 18 of the Conditions.
COVERED RISKS
SUBJECT TO THE EXO.USIONS fROM lDVERAGE. THE EXCfPTlONS
FROM COIIERAGE COtITAlNED IN SCHEDULE B AND THE
CON._._...., FIRST AMERICAN T1TlE INSUAANCE COMPANY, a
Cailfomla CllrjXlr.~on (the "Company"') insures, as of Dale of Policy
and, 10 the extent stated In eo.ered Risks 9 and 10, aftEr Date of
Policy, .galnst loss or damage, not exceeding the Amount of
Insurance, sustained or Incurrm by tile lnslRd by reasoo of:
1. TIlle being vested other than as staled in Schedule A.
2. My defect in or Den or enam1lrance on the Title. Th~ eo.ered
RIsk includes but Is I'<lt Um/led III insurance against loss from
(a) A defect in the TItle caused by
(I) forgery, fraud, undue Inftuence, duress, : .. ,.. _ =/,
. .."I _-;"" or r .. ~~. L:. ".:
(N) failure of any persorl or Entily to have authorized a
transfer Of conveyance;
(iii) a docu'nent affecting Tille not properly ae.ted,
executed, -. ~ c J, sealed, acknowledged, mtarized, or
delNered;
(Iv) failure to perform those acts , ..~ , to create .
document by .:, _. . '. means al ',' . ;,.'- by law;
(v) a document executed under a falsified, expired, or
I ,', -.. .Invalid power of attorney;
(vi) a doaJment not properly filed, recorded, or indexed In
the Pub/Je Realrds Indudlng f.U.... to perfonn those acts
by to, _ . ,. means aulhorUed by law; or
(VOl a def~ judldal or , .-' '-... . :Jve proceeding.
(b) The lien of real estate taxes or .~w ",..~ imposed on the
Tille by aL.,,, '''~ authOlity due or payable, but unpaid.
(c) My , I,C'-. ,~enaunbrance, YIoIalion, variation, or
adverse dra.mstance afIeclIng the Title that woUd be
dJsdosed by .n acante and COI11>Iete land survey of the
Und. The term 'encroadlment" includes '"'. ..:, "ts of
existJng Improvements located on the lJInd onto adjoining
land, and encroadunents onto the Land of existing
3. l' ~.Iocated on adjoining land,
4. No rlg,t of acxess to and from the Land.
S. The violation or e. ., , ,of any law, ordinance, permit, or
got . , -. ' regulation (Indudlng those relating to building and
zoning) ~_: _' ~ ~lallng, prohibiting, or relating to
(a) the ~ncy, use, or enjoyment of the Land;
(b) the character, :. ..-. ~ or location of any Improvement
erected on the Land;
By:
Attest:
(c) the SlbdMsion of land; or
(d) envI. _ "I'otediuo,
W a notice, desa1lllng any part of the Land, ~ recorded in the
Public Records setting _ the violation or Intention to enforce,
but only to the extent of the violation or en.'. . _ ,. referred to
In that notice,
6. AIL '.., !tlt action based on the exercise of a .., ,.1
police power I'<lt covered by Covered RIsI< 5 W a notice of the
enfon:ement action, describing any part of the Land, ~ recorded
In the Public Records, but only 10 the exll!nt of the , ... _, ".
referred to In that notice.
7. The exertlse of the rights of eminent _ W a notice of the
exercise, I '->'. -. - ,I any part rA the land, is recorded In the
Public Records,
B. hr( taking by a governmental body that has 0CX1JITed and Is
binding on the rights of a purchaser for value without Knowledge.
9. TlUe being vested other than as stated in Schedule A or being
defective
(a) as a resuk of the avoidance In whole or in part. or from a
court order " . .' I an aftematiYe remedy, of a transfer of
aU or any part of the title to or any Interest In the Land
OCOJn1ng prior to the ,. ~ .,. vestin9 Tille as _ in
5cheduIe A _ that prior transfer CXlIlSlit1ted a
fratWlent or preferential transfer under federal bankruptcy,
state insolvency, or similar , ,..... . rights laws; or
(b) because the Instrument of transfer vesting Title as shown In
Schedule A constlt1Jtes a preferential transfer under federal
~, state Insolvency, or similar aeditolS' rtghts laws
by reason of the faDore of its ,.. ,::, In the Pubic Records
(I) to be limeJy, or
(n) to Impart notice of Its existence to a purchaser for value
or to a Judgment or lien aeditor.
10. hr( defe<t in or Den or encumllrance on the TlUe or otI1er matter
Irduded In Covered Risks llhrough 9 that has been aeated or
attad1ed or has been filed or reccnled In the PubIlc _
subsequent to Dale of Policy and prior to the recording of the
deed or other instrument of transfer In the Public Rec:onls that
vests TlUe as shown In Schedule A.
The Corr1>any wll also pay the msts, attorneys' fees, and ..' . ~
Incurred in defense of any matter _ against by this poky, but
only to the extent provided In the Conditions.
PresIdent
Sec:ret4Iy
Date Received:
FEB - 5 2010
Original Submittal
Form NO. 1402.06
ALTA Owner's Policy (6-17-06)
EXQ. , ...; ~ ~. FROM COVERAGE
ll1e following matters are _ .'~, exdueled from the coverage oIlhis pohey, and
the... ..~ , will not pay loss or damage, costs, ~ _. ...,.... fees, or expenses that
arise by reason 01:
1. (a) Arrr law, orcinance, permit. or g<lYemmental regulation (lndlJding those
relating to building and zoning) restricting, regulatJng, prohibiting. or
relating to
(I) the oc:wpancy, use. or enjoyment of the lm1d;
(JI) the d1aracler, dimensions, or IocatJon of any 1m. . , ... ereded 011
the Land;
(III) the subdivision of land; or
Ov) environmental . ...... ;
or the effect 01 any _lion 01 these laws, ordinances, or govemment3
regulatlon~ This fxduslOlll(a) does not modify or Ilmilthe CCl'Mage provided
under CoYered Risk 5.
(b) My .., , "'~ police _. ThIs Exdu_ l(b) does not modify or
limit the .. ,. ,. provided under Covered RIsk 6.
2. Rights of eminent domain. This Exclusion does not mod1fy or nmJt the
.. . Co ~.' ~ under Covered Risk 7 or 8.
J. Detects, llens,enn" ~ ",. .w,adYefsedalms,orothermatters
(a) ""'led, suffered, assumed, or agreed to I>y the Insured Caimant;
(b) not Known to the COmpany, not tealI'ded In the PIlbllc _ at Date 01
Policy, but Known to the Insured Caimant and not d;sdosed In writng to
the.. .. , by the Insured Claimant prior to lhe cJate lhe ln5ured
Oaknant became an Insured under this policy;
(c) resulting in no loss or damage to the InSIJred Calmant;
(d) attaching or created subsequent to Date 01 Policy ('-,lh~ does not
modify or IIm~ the.. ".' JIov/ded under Covered RJsIcs 9 and 10); or
(e) resull*lg in loss or damage that _Id not have been sustained If tile
Insured Claimant had paid value fer the nJe.
4. Arrr daim, by rea"'" of the oper-. of federal banl<lupt<y, state InsoNency,
or SlmJlar , ,_".,. rights Jaws. that the lransadbl vesting the 11tIe as shown
In _Ie A, ~
(a) a frauWlent mnveyance or fraudJlent lransler; or
(b) a, ~', ' ,~, lransfer fer any rea"", not stated In Covered Risk 9 of this
policy.
S. My !en 011 the 'f1tJe for real _'" taxes or a"""""",1S Imposed I>y
governmental autl1aily and aeated or attaching between Date 01 PoJIcy and
the elate 01 ... :'~ j. of the deed a other lnsbument of transfer In the Pubic
_ that vests Title as shown In Sch....1e A.
....:. ..
1. DE.. .. ... ~OfnRM$
1I1e _g .....s when used In lh~ policy mean:
(a) 'Amount 01 Insurance": 1I1e amount stated In Schedule A, as may be
Increased or :.. ..., J by ..- lo th~ policy, Increase:! I>y
SectIon 8(b~ or ,',. ,,,_,' by SectIons 10 and 11 01 these .. J". ;.
(b) "Date of PolIcy": 1I1e date " ~;. _." as "Date 01 Policy" In SdleduIe A-
(c) "Entity": A """",atlon, ,_ . ,; '.. trust, limited nab;lity c:ompany, or
othe<slmJlarlegalentlty.
(d) 'Insured": The Insured named In _'e A.
(I) The term "Insured' also _
(A) suaessors to the T1tfe of the Insured I>y operalion of law as
dstlnguished from purchase, _g he.... devisees, SUlVivors,
perscnall.....~ltatives. a next of kin;
(8) SUcte5SOtS to an Insured by d;ssoMJon, meog..., mnsoIkIalion,
distribution, a reorganlzatlon;
(C) SU<X1!S5O/S to an Insured by Its """,""Ion to a_... kJnd 01
Entity;
(D) a ~tee of an Insured under a deed delivered wlthcxt
payment of ilClUaI valuable a>nsJderMQ, <XlIlVeI'lng the me
(I) lthe_1<. shares, mem_lps, orolhere<JJity_
of the grantee are wooily-<lwned by the named Insured,
(2) lthe grantoe wholly owns the named Insured,
(3) If the grantoe ~ woolly-owned I>y an affUlated Enlly of the
named 1n5ind, provided the affillated Entity and lhe
named Insured are both whol~ I>y lhe same person
or Entty, or
(1) l the grantee's a tnJ.... or bene!icialy oIa trust aeated
by a written Instrument eslablJshed by the Insured nan-ed
In ScheWIe A for estate planrWlg purJlOSeS.
Policy Page 2
Policy Number: 1458524
(n) W;th regard to (A), (8), (C), and (D) reserving, however, all rights
and defenses as lo any successor lhallhe Company _Id have had
against any ~ ..:.. ~........ Insured.
(e) '1nsured Calmant': An Insured daJmlng loss or damage.
(f) "Knowledge" or "Known': Actual knowledge, not a>nstructive "'-ledge
or notice that may be imputed to an Insured by reasoo of the Public
_ or any other reaJ<ds that Impart _ notJce 01 matters
affecting the11tle.
(g) "land': ll1e land desaibed in Schedule A, and affixed 1m" . " ~"..; that
by law CClllStltute real property. The term "Land" does not InckJde any
property beyond the lines of the area described In _Ie A, nor any
right, litle, Interest, -. or ,.. ,.0 . , in abutting streets, roads,
-, alleys, lanes, ways, or waterways, but lh~ does not modify or
IlmJl the extent that a r1ght of iICaSS to and from the land is InSlrlld by
th~poI'lC'f"
(h) "Mortgage': Mortgage, deed 01 tnJst, trust deed, or other se<urity
Instrument, Including one evidenced by _Ie means a_ by
law.
(I) "PIlblle Records": Realrds emblished under state statutes at Date 01
PolIcy for the purpose 01 imparting con_ notice 01 motlers reJatIng
to reaJ property to purchasers for vakJe and without k. ....1 " WIth
respect to Covered RIsk 5(d), 'PIlblic Records" shaH also IndJde
environmental . ."... liens filed In the realI'ds of the dert of the
lk1ited Slates D1str1ct Court for the lIstrid ..... the land ~ Iocall!d.
(j) "TItle": The estate or_ ,'~.: ..In ScheWIeA.
(k) 'lk1mar1<etable 11tIe': Title _ by an aJIeged or apparent mailer that
would permit a.. . ~ ~~:. . e lM'Chaser CI" tessee d the Ttl:Ie or lender on
the _ to be released from the obligation to purchase, lease, or lend l
~ is a <Xlf1lractual a>ndIlion requlrtng the dellllOl'f of m___ title.
;z. CON11HUATJON 0' INSUItAltCI!
The.. ".' oIlhls polley shaH continue In force as 01 Date of Policy "' favor
of an Insured, but ooly so long as lhe Insured retains an estate or _ In the
Land, or holds llIl obligation sealred by a purchase money Mortgage given by a
purchaser from the Insured, or 0II1y so long as the Insured shall have liability by
reason of warranties In any b'ansfer rx CXlflveyance of the TltJe. This IX>1k:y shall not
a>nUnue In force In favor of any purchaser from the ln5ured of _or (i) an _'"
Of Interest In the Land, or (II) on obligation secured by a purchase money Mortgage
given to the Insured.
3. NOTJCI! OF CWM TO IE GI\/EN BY INSURED CLAIMANT
The ln5ured shall notify the Company ~ In writing (I) "' case of any
k1gatiJn as set forth In SectkJn Sea) d these .... ,':'-_. .~ (II) In case _'. ~. I '
shall come to an JrlSU'ed hereunder of any claim of tIUe or Interest that Is adverse
to the rltle. as Insured, and that m~ cause bss or damage ror whk:h the
Company may be I~ble by virtue 01 this policy, Of (JIl) l the l1tIe, as Insured, ~
re)ectecl os L . , """. , TltIe. If the _. . " , ~ prejudiced by the fallure 01 the
Insured Clalmilf1t to provide prompt notice, lhe Con1>anY's lIabllly lo lI>e Insured
Calmant under the policy shall be rewced to the extent 01 the prejudice.
4. PROOF OF LOSS
In the event the Ccwnpany Is unable to dete.rnWle the amourt: of loss or
damage, the ".' ,.' ". may, at its~, recp.J1re as a condlbon of ", ~,that
the Insured Claimant furnish a signed proof 01 loss. The proof oIioss 11>J5t_
the defect, lien, enOJmbrance, or othe- ...- Insured ogaJnst by this policy lhat
(011_ the basis 01 loss or <Iamage and shaH state, to the extent possible, the
basis 01 caIculatino the amount r:I the loss a damage.
5. DI!FENSI!ANDPROSECunoNOJ~,.. ,I~, oJ
(a) Upon...-illen requestbythelnsored, Il1ld subject to the optIoos .. .;,.J
In SectIon 701 these ConcItJons, the Company, at its own cost and without
unreasalable delay, shaH provide for the defense of an Insured In
lilIgation In which any third party asserts a claim covered by lhls policy
adveose to the lnstnd. Th~ obIIgalkln ~ Jlmlted to 0II1y lhose stated
causes of action alleging matters ",sured ogalnst by th~ poley. The
.. , ' , shall have lhe right lo select counsel ollIS choice (subject to the
right 01 the Insured to object fer reasonable cause) lo _...., : lhe
Insured as to those staled causes of action. 11 shal not be l~bIe fer and
wm not pay the fees 01 llIlY other COUlSeI. The Company will not pay any
fees, Cll5ts, or '.' .~ inamId I>y the Insured In the defense oIlhose
causes of a~ that allege matters not Insured ogolnst by II>~ policy.
(b) The ~ shaJl have 11>. right, In addition to tile Opllons CDIllained",
Date Received:
FEB - 5 2010
first Amerlcan Title Insurance... " . of Oregoo
Original Submittal
Form No. 1402.06
ALTA Owners Polky (6-17-06)
SectIon 7 of these COOd_s, at Its own cost, to Institute and prosewte
any action or proceeding or to do any""" act that In its oplnlon may be
necessary or desirable to establish the TItle, as insured, or to ~ or
n!ClJce loss or damage to the lnsl.nld. The COmpany may take any
, .. ., ,2 action ..- the terms of this poIky, whether or not I shal
be liable to the /nsurod. The exercise of these rlg/1ls shall not be an
adrn_ of liaMIty or waivef of any proylsJon of this polity. If the
Company exercises its rights under this subsection, it must dO so
diligently.
(e) Whenever the... ,,' , b'lngs an action or asserts a defense as required
or permitted by this poIky, th. Company may pu"". the litJgatiOn to a
final :~,~ :,,:Ion by a court of .."""jurisdlcllon, andtexpressly
reser;es th. right, Ul its sole cisaetlcr1, ID appeal any -.. judgment
or order.
6. DlITYOf INSURED CWMANTlO COOPERATE
(a) In an cases where lt1is poIky permits or """res the Company ID
prose<ute or provide for 1t1. defense of any acllon or proceeding and any
_'s, the _ shal secure ID the Company the ~ ID SO
prosecute or proolde defense il th. action or proceeding, IncJudlng the
right ID ...., at Its oplJon, 1t1. n. me of the Insured for lt1is purpose.
Whenever reqLJ<Sled by the COmpany. th. Insured, at the Company's
expense, shan giw 1t1. eon.>any all reasonable aid (Q In securtng
evidence, obtaining witnesses, proseaJtIng or defendng the action or
proceeding, or effectlll\l sellIemen~ and (I) In any other lawful act IlIalIn
the opinion 01 the Company may be necessary or desi'able to establish
the TItle or any oIt1er matter as __ II the Company Is prejudiced by
1t1. failure 01 the In",red to _ the required """"'.u...., the
c. , . ," obllQaUcn$ ID 1t1. Insun!d under the poIky shan terminate,
indJdll\l any JIablIIty or obIlgatJon ID defend, prosean, or a>nlJnJ. any
IJtJgatJon, wilt1 regard to the matter or matten """ ifng such
(b) ih: c.,;;:p.~y may ~ """Ire 1t1.lnsured Oalmanlto submlto
exam/natloo L<1der oath by any auIt10rized represenlalIYe of 1t1. Company
.nd to pnxlJe. for examination. Inspectlon, and mpytng, at such
reasonable tlmes and ~aa::s as may be ..);..)0". ,,__'"' by the authorized
representative 01 1t1. Company, al _, In __ medium
maintained, inducIino books, ledgers, ched:s, _.... I,
.. __.... ".:tenee. reports, e-maits, clsks, ta~, and videos whether
bearing a dat. before or aft8- Date of Polky. that reasonably pertain to
the loss or damage. further, If ""JleSted by any authorized
representathle of the Company. the In...-..d Oalmant shall grant its
permission, in wrltilg, for.ny authorl2ed rep.....llati... of the eon.>any
to examine, nspect. and copy all of these records In the a.astody or
~ of a third party that reasonably pertain to the loss or damage. AI
information deslgnalzd as mnfidentlal by 1t1. Insured Oamont __
to the Company pursuant to It1ls SectIon shall not be ,-,,:.",: tx> others
unless, in the reasoo_ Jl!dgnenl 01 the Company, lis necess;oy in the
administration of the darm. FalUre 01 the Insurod Clainant to _ for
examinatiOn under oath, produce lInf" .0-10. 'h..y requested In". . .'. 1
or grant permlsslon to secure reasooatly necossary In :., ,.-. f",nlll'lrd
paoties as """,Ired In this' subsectlon. unless proh_ by law or
governmental regulaliln, shail " I,.. any llablllty 01 the ~ny
under lt1is po/q as to that <!aim.
7. OPlJOftS 10 PAY OR OTHERWISE Sfnlf O.AIMS; TERMIHADON
OF UAaJlIJY
In case d a claim under this ~Icy. the.... ". shall have the followi1g
~loptJons:
(a) To Pay or Tender Payment 01 the Amount oflmur.n""
To pay or lender payment of the Amount 01 Jnsuranre under thJs polity
togeltJer with any <Xl6tS, attomeys' fees, and _. ..~ _ by the
lmured Clarmantlllal were ._ by tile CDInpany up to the tJme of
payment or tender of ~ and that the COmpany is ollIigated to pay.
Upon the exerdse by the Company d this option, aft labJIlty and
obllgatJons 0I1t1. .'''.' , to the Insured under lt1is poIky, other than ID
malce the payment teq.JJred In Ihls subse<lim, shaD Il!mlInaIe, indJding
any liability or ollIlgatlon to defend, posecllte, or cooti1ue any lillgallon.
(b) To Pay or Otherwise Settle With Parties other Than th. Insured or With
the Insured Claimant.
(I) To payor.: _ , .-" _ seIlle with other parties for or in the name of an
Insured ClaJmant any <!aIm Insured against urder lt1is polky. In
addIIlon, the CDInpany will pay any oom,.... .," fees, and
expenses InClJlJl>:l by the Insured ClaImant IlIal were ._ by
the COmpany up to the time of payment and that the Company Is
obligated to pay; or
(ii) To pay or .:, ~ _ settle wUi the Insured aafmant the loss or
damage provided for under this polity, together w11t1 any <Xl6tS,
Policy Page 3
Polky Number: 1458524
atlDmeyS' fees, and expenses ilClJlJl>:l by 1t1.1~ Claimant IlIal were
aultJortzed by th. COmpany up to the time of payment and IlIal the
Company Is.. '."'" to pay.
Upon 1t1. exerase by the Company of eitI1er 01 the options provlded for In
....",.;'. J (b)(I) or (II), 1t1. Company's oblgatrons to 1t1.lnsured urder Ihls
poIky for the daimed loss or damage, other than 1t1. payments requH-ed to be
made. "'.. .....Inate, Indudill\l any liablUty or obrogation to defend, prosean,
or mntinue any Imgation,
.. DETERMJNAT10N AND EXTENT OF LIAIlJUTY
This poIky I. a mntraCl 01 inderMlly against .auaf monetary loss or damage
sustained or _ by 1t1. Insunlll Oalmant who has suffered loss or damage by
reason of matten Insured agafnst by this policy.
(a) The I!lrtenl oIllablllty of th. Company for loss or damage under lt1is poicy
shall not exceed 1t1. lesser of
(I) the Amou1t of In...."",,,; or
(i) the difference between 1t1. value of lt1.lllIe as Insured and 1t1. value
of lt1.lllIe subject to 1t1. risk UlS<.<ed against by this poIky.
(b) II th. Con\>any pursues Its ~ under SectIon 5 of these ConditJons and
is unsuccesslulln estab!ishilg the T1tle, as insured,
(I) the _ oIlnsur.nce "'an be Increased by 10%, and
(I) the Insured aalmant shall have the right to havelt1e loss or damage
determined .1IIler as 01 the dale the claJrn was made by lhe Insured
Oalmant or as of the dale t I. _ and paid.
(e) In adcItJon to lhe _ of Iiablllty under (a) and (b), 1t1. COmpany wil
also pay those costs, l ::. _,..fees, and ~... ".-10:...1 inaured In aca:wdance
w~ _ 5 and 7 of these COOdillons.
t. UMlTAlJON OF walUTY
(a) lithe.. '.". , establishes It1.TolIe, or removes the alleged defect, lien.
or enaMIIbrana!, or CUfOS lhe lack 0/ a right 01 .ccess ID or !\om the
land, or wres lhe dalm of Unmarketable TrtIe, aD as Insured, In a
reasonably diligent manner by .ny me<llod, including ItlgatIon and 1t1.
.. ":,,.-. of any aweals, It shan have fully pefolll.ed tts obligations
wM1 respect to that matter and shall not be Rabie for any loss or damage
caused to the Insured.
(b) In the event d any litigation, Indudill\l Jitlgatlon by the Company or w~
the ~ mnsent, the Company shaI have no IIdbIIJty for loss or
damage lJ1lj1 there has been a nnaf determination by a aJUrt 01
mmpetent jurisdiction, and dlSp05itkll of all appeals, adverse to the 11tIe,
as Insured.
(e) The Company shaH not be liable for loss or damage to lhe Insured lor
liability voOOtarJIy .ssumed by the Insured In sellIIng any darm or su~
without 1t1. prior wrJtten mnsent of 1t1. Company.
ID, REOUcnOIl OP IIISURANCI!, REDUcnON OR nRHINAnON Of
LJABIUTY
All payn15lts lhder lt1is poIky, except payments .- for <Xl6tS, ,.,. " ~,"
fees, and _. _ H", shaI reduce the Amount of Insutance by 1t1. amount 01 the
payment.
11. WaJUTY 1I0NCUMUtA11VI
The Amou1l 01 In_ shall be """cod by '1 ilITOUOlthe Company pays
under any po/q inSUring . Mortgage to which '. ".." is taker11n 5chedu1e 8 or
to which the Insured has agreed. assumed, or taken subject, or which" executed
by an Insuted after Date of Policy and which is a charge or hen on the lltIe, and
the amount so paid shan be deemed a payment to the Insured under this po/IC'(.
1Z. PAYMINTOF lD5S
When liability and the extent of loss or damage have been defn~eIy lIxeel In
,...:. ., _these COOditJoo.. lhe payment shall be .- _In 30 days.
13. RIGHTS Of RlCOYERY UPON PAYMENT OR SET1UMENT
(a) Wh........II1. Company shall have ....Ied and paid a e;a;m under lt1is
poIky. I shall be subrogated .nd enUlIed to th. rights of 1t1. Insured
Calmant in the _ and .11 other rig'" and rornedJes In respect to the
dalm that the Inst.nd Oaimart has against any person Of property, to the
- 01 the amount 01 any loss, oosts, attorneys' fees, and expenses
paid by the Company. If re<Jlesled by 1t1. COmpany, lhe Insurod Calmant
shan execute <bcumenls to evider1<e the transfer ID the COn1>any of these
riglts and remedies. The Insured Calmant shall permlllt1. Company to
sue,.. ". ':-Io~. or settle In the name r:A the Insured Cairnant: and to
use the name 01 the Insured Calmant In any transaction or IJtJgatlon
Invofvln~ these rlg/1ls and ~', ;' _"
If a pay...... on aclXlUIlt of a daJm does not fully ctNer lhe loss 01 the
Insured Caimant, the COmpany shaI defer the exesclse of its right to
reawer oolla/bo' the Insured aalmant shan have c.. , ~: Its loss.
Date Received:
FEB - 5 2010
First AmerIcan 11tJe Insurance Company of Oregon
Original Submittal
~-
Form No. 1402.06
ALTA Owner's Policy (6'17-06)
(b) The COmpany's right of subrogat;o" ;"e1udes the rights 0( the _ to
hdemnitJes, guaranties, other policies of inSUIillce, or bonds,
nctwthstandng any terms or conditions Caltalned in those instruments
that adct'ess St.._ ....' ,". lights.
14. ARBITRATION
Either the Company or the Insured may demand that the dam or C'Of1troversy
shaD be submitted to _aUoo pursuant to the Title Insurance Arl>itration Rules of
the American Land Tole Association rRu1es1. Except as provided In the Rules,
thin shaI be no joinder or c:a1solld.1tia'1 with datms or .. "... ....a:es of other
persons. ArbIb'abSe matters may lndude, but are net limited to, any controversy or
daJm between the _. ,'. and the Insured arising out 0( or relating to this
policy, any service in connection with Its Issuen", or the breadl of a odley
pnvIsb1, or to CKlV other cootfO.rer$y or dalm arising out of the transactlon giving
rise 10 this polley. All arbitrable matters when the Amount of In...ranee Is
$2,000,000 or less shall be arbitrated at the option 01 either the Company or the
Insured. An arbib'able matters when the Amount of Insurance is In excess of
$2,000,000 shall be arbltrated ooly when agreed 10 by both the Company and the
Insured. ~ ,',.,. I"lrwant 10 this odley and under the Rules shaft be blnclng
upon the parties, Judgment upon the award, ",;~ ,; by the ArbItrator(s) may be
"'tered In any court of mmpetent lurlsdlctlon.
15, LJAIIILITY UMmD 10 THIS POUCY'; POUCY EN11RE COIITRACT
fa) ThIs polley together with all endorsements, " any, _ 10 ~ by the
~ Is the en~re odley and lXlllb'act between the Insured and the
Conl>anY. In Interpreting any prtlYl_ of this odicy, this polley shaJI be
construed as a YlhoIe.
(b) MY claim 0100 '" damage that arises out of the status of the TItle or by
.ny action assertlng s.,,1I claim sha" be restr1cted 10 this odley.
(el MY' . ". : 0( or endoosement to thIS odley 0'AJSl be In wrfbng .nd
aL ;. ,; ~ ;.1 by an autI10rized person, or expressly 1ncorpora1l!d by
Sche<1J1e A of this odley.
Polley Page 4
Polley Number: 1458524
(d) Each endorsement to this pelky issued at any time is made a part of this
policy and is subject to an of ts terms ancI .. . ".;. "". Except as the
,;,., ,ll_~,~, stalEs, lOOes not (1) rnodJfy any of the terms and
proYlsJons of the polley, (I) modify any ~.~ .. ..." .; (II) extend the
Date 0( Polley, or (Iv) Increase the Amount of In...rance.
lli. SEVERAllUTY
In the event any povision of this policy, In whole Of in part, is hekJ invalid or
· ,.'.... ~;, under applicable law, the odicy shall be deemed not 10 Indude that
P'OVision or such part held to be Invalid, but all other provisions shall remain i1 fuB
Iorce and efIect.
17. CHOI(;E DfLAW; FORUM
(a) Choice of Law: The Insured act. :,;,~ the Company has u_
the risks awered by this polley and detennined the p-emium charged
therefore In reliance upon the law affecting Interests i1 real pr'q)erty and
applcable 10 the interpretation, rights, remedies, or ..,'.._~ ,,: of
od'cIes 0( title insurance of the juris<f1Ctlon where the Land Is located.
Therefore. the court or an __ shan 'RliY the law of the ,...... '
wtlere the Land is bcated to determine the valklity of dams ~ajllSt the
Tille that are -.. 10 the Insured and 10 Inlerpret and ..,force the
terms of IhIs odley. In neither case shall the court or arbltr_ apPy Its
_ of law IJindpIes 10 det<!tmlne the '"... _'- law.
(b) Choice 0( faum: AIry fitigalloo or oth... p-tXeedJng Uought by the
Insured against: the Company must be filed only in a state or federal court
within the Unlred States r:J America or Its '. ~'.. I"" having ~.... '.. ,C"~
jurlsdlctloo.
1& I.'.' "~;",,WHE.ISEHT
AIry notJce 0( claim and any oth... notice or statement il writing required lD be
given 10 the Coolpany under this odlcy must be given 10 the CorrIlany at 1 Iht
American Way, Santa Ana, CA 92707, Attn: Claims I....~. . .t.
POLICY OF TITLE INSURANCE
AM E 11
'e
"/
1<
Date Received:
FES - 5 2010
Original Submittal
First AmerIcan TltIe Insurance Company olOn!gCltl
Form No. 1402.06
AlTA (NIner's Policy (6-17-06)
Policy Page S
Policy Number: 14S8524
SCHEDULE A
First American Title Insurance Company of Oregon
Name and Address of TItle Insurance Company:
FI/'St American TItle Insurance Company of Oregon
600 Country Club Road,
Eugene, OR 97401
File No.: 7091-1458524 Policy No.: 1458524
Address Reference: 3375 Gateway Street, Springfield, OR 97477
Amount of Insurance: $3,642,522.08 Premium: $6,065.00
Date of Policy: October 30, 2009 at 1 :09 p.m.
1. Name of Insured:
Jacksons Food Stores, Inc., a Nevada corporation
2. The estate or interest In the Land that is insured by this policy Is:
Fee Simple
3. TItle Is vested in:
Jacksons Food Stores, Inc., a Nevada corporation
4. The Land referred to In this policy Is described as follows:
See Exhibit "A" attached hereto and made a part hereof
Date Received:
FEB - 5 2010
Original SUbmittal
Fir>t Amerkan 'ntle Insurance COmpany of Oregoo
Form No. 1402.06
ALIA Owner's Polity (6-l7-o6)
Policy Page 6
Policy Number: 1458524
SCHEDULE B
file No.: 7091-1458524
Policy No.: 1458524
EXCEPTIONS FROM COVERAGE
This Policy does not Insure against loss or damage, and the Company will not pay costs, attorneys' fees,
or expenses that arise by reason of:
1. Taxes or assessments which are not shown as existing liens by the records of any taxing
authority that levies taxes or assessments on real property or by the publiC records; ~. _-<-~Jlngs
by a public agency which may result In taxes or assessments, or notices of such
proceedings, whether or not shown by the records of such agency or by the public records,
2. Facts, rights, Interests or claims which are not shown by the publIc records but which could be
ascertained by an inspection of the land or by making Inquiry of persons In possession thereof.
3, Easements, or claims or easement, not shown by the public records; reservations or exceptions
In parents or In Acts authorizing the Issuance thereof; water rights, claims or title to water.
4. Arrt encroachment (of existing Improvements located on the subject land onto adjoinIng land or
of existing Improvements located on adjoining land onto the subject land), encumbrance,
violation, variation, or adverse drcumstance affecting the title that would be disclosed by an
accurate and complete land survey of the subject land.
5, Any lien, or right to a i1en, for services, labor, material, equipment rental or workers
compensation heretofore or hereafter furnished, imposed by law and not shown by the public
records.
This exception (#5) Is hereby waived without additional cost In accordance with the provisions of
the Oregon Title Insurance Rating Manual provtsion 5.001 A 5 PROVIDED a Lender has been
issued a simultaneous title Insurance policy on the subject property and to the extent this
exception has been eliminated or modified on said Lender's policy,
6.
Taxes for the year 2009-2010
Tax Amount
Unpaid Balance:
Code No.:
Map & Tax lot No.:
Property 10 No,:
$
$
01900
1703222000901
1412269
13,103.75
13,103.75, plus interest and penalties, If any
7. Easement on the recorded plat/partition as follows: public utilities
8, Easement, Including terms and provisions contained therein:
Recording Information: June 02, 1967, Reception No, 86879, Official R..w,';~ of Lane
County, Oregon
In Favor of: PacIfic Northwest Bell Telephone Company Date Received:
For: ulllltles
FEB - 5 2010
First American T1t:Ie Insurance .,I.,'.. ~ "of Oregon
""'~;".,I c;lIhmittaJ
I .
F<<m No, 1~02.06
At TA OWner's Policy (6-17-06)
Policy Page 7
Policy Number: 1~58S24
9. Restrictive Covenant, indudlng terms and provisions thereof,
Recorded: August 19, 1987, Reception No. 87-36547, Official Records of
Lane County, Oregon
10. Easement, Indudlng terms and provisions contained therein:
Recording Information: October 08, 1987, Reception No. 87-44694, Offidal Records of
Lane County, Oregon
In Favor of: Durward L. Boyles
For: none-exduslve utility easement
Affects: Easterly 7 feet
11. Cross Easement Agreement and the terms and conditions thereof:
Between: Sycan 8 Corp.
And: Chevron U.S,A. Inc.
Recording Information: December 11, 1987, Reception No. 87-53789, Official Records of
Lane County, Oregon
12. Option to Purchase and Right of First Refusal, Induellng terms and provisions thereof, as
reserved in the Deed
From: Chevron U.S.A. Inc., a Pennsylvania corporation
To: M & M rentals, LLC and R2M Properties, LLC
Recorded: October 09, 2003, Reception No. 2003-099139, Offldal R<.~.";"
of Lane County, Oregon
13. Easement and maintenance Agreement and the tenns and conditions thereof:
Between: M & M Rentals Inc., an Oregon Umited Uabllity Company, as to
an undivided seventy-six percent (76%) Interest, as tenant In
common and R2M Properties LLC., an Oregon limited Uablllty
Company, as to an undivided twenty-four (24%) Interest, as
tenant in common
And: Chevron U.S.A. Inc., a Pennsylvania corporation
Recording Information: October 09, 2003, Reception No. 2003-099140, OffiCial Records
of Lane County, Oregon
14. Purchase Option and Right of First Refusal and the terms and conditions thereof:
Between: Jacksons Food Stores, Inc., a Nevada ~ t'u. ..ilon
And: Chevron U.S.A. Inc., a Pennsylvania corporation
Recording Information: November 06, 2006, Reception No. 2006-079922, OffIdal
Records of Lane County, Oregon
15. Unrecorded leases or periodic tenancies, If any.
Date Received:
FEB - 5 2010
Original submittal
First AmerIcan T41e Insurance COmpany of Oregon
f<>nn NO, 1402,06
AlTA Owner's Polley (6-17-06)
Poaey Page 8
PolJey Number: 1458524
EXHIBn "A"
Ale No.: 7091-1458524
Policy No.: 1458524
Real property in the City of Springfield, County of Lane, State of Oregon, desafbed as follows:
LOT 5, SYCAN COMMEROAL PARK, AS PLATTED AND RECORDED IN FILE 73, SUDE 614, LANE COUNTY
OREGON PLAT RECORDS, IN LANE COUNTY, OREGON, AND RJRT1-fER DESCRIBED AS FOLLOWS:
BEGINNING AT A POINT ON T1-fE EASTERLY RIGHT OF WAY OF GA'ffWAY STREET, SAID POINT BEING
SOUTH 000 04' 07" EAST 894.44 FEET AND NORTli 890 55' 53" EAST 495.70 FEET FROM T1-fE
NORlliWEST CORNER OF T1-fE WIlliAM STEVENS DONATION LAND O..AIM NO. 46 IN TOWNSHIP 17
SOUTH, RANGE 3 WEST OF THE WILlAMETTE MERIDIANi T1-fENCE SOUTH 000 04' 07" EAST 260.00
FEET TO THE TRUE POINT OF BEGINNINGi T1-fENCE SOUTH 000 04' 07" EAST 160.00 FEETi T1-fENCE
NORlli 890 55' 53" EAST 242.00 FEETi T1-fENCE NORT1-f 000 04' 07' WEST 180.00 FEETi T1-fENCE
SOUTH 890 55' 53" WEST 222.00 FEETi THENCE SOlJTH 440 55' 53" WEST 28.28 FEET TO THE TRUE
POINT OF BEGINNING, ALL IN lANE COUNTY, OREGON.
APN: 1412269
Date Received:
FEB - 5 2010
Original Submittal
First American TItle lnsuran<:e Company 01 Oregon
=It II 1-
lJ-7.. -
7()'1/-jl/5{;:> zy
AftcrRecordillil Return To
FintAlllerlcan Tille
POBox 10146
Ilugeno, OR 97440
Dlvl.lon 0' Chle' Depuly Clerk ~~-~ll~l
Lane Counly Deed. and Record. 'UU..~g ,
! IfIJlIII rUI I 111'1'11111 [/1111111111 $62,00
il.l11.r.11;j:0b_~';b11.;w 10!rl0."
10/30/2009 01:09:29 PM
RPR-DEED Cnl.1 Sln=l CASHIER O!
$2!.00 $11.00 $18.00 $10,00
STAmORY WARRANTY DEED
Grantor's Name and Address:
Grantee's Name and
Address:
Jacksons Food Stores,
Inc.,
a Nevada corporation
3450 Commercial Court
Meridian, ID 83642
M & M Rentals LLC,
an Oregon limited liability company, as to an
undivided seventy-sil percent (76%) Interest,
and R2M Properties LLC, an Oregon limited
liability company, as to an undivided twenty-four
percent (24%) interest, all as tenants-In-common
3015 Salem Avenue SE
Albany, OR 97321
After recording return to:
Hawley Troxell Ennis & Hawley LLP
Timothy W. Tyree, Esq,
877 Main Street, Suite 1000
P.O. Box 1617
Boise, ID 83701-1617
The true and actual
consideration for this
conveyance is
$ 1.642, ~22. 08
Until a change Is requested, all tax statements
shall be sent to:
Tax Account
Information:
Map No, 1703222000901
Jacksons Food Stores, Inc.,
a Nevada corporation
3450 Commercial Court
Meridian, lD 83642
CONVEYANCE
M & M Rentals LLC, an Oregon limited liability company, as to an undivided seventy-six percent
(76%), and R2M r'.r_'~es LLC, an Oregon limited liability company. as to an undivided twenty-
four percent (24%) interest, all as tenants.in-e.....__... Grantor, conveys and warrants to laeksons
Food Stores. Ine,. a Nevada corporation, Grantee, the following described real property located in
Lane County, Oregon, free of encumbrances except as specifically set forth herein:
LOT 5. SYCAN COMMERCIAL PARK, AS PLATIED AND RECORDED IN FILE 73.
SLIDE 614. LANE COUNlY OREGON PLAT RECORDS, IN LANE COUNTY. OREGON.
AND FURTIIER DESCRIBED AS FOLLOWS:
BEGlNNINGAT A POINT ON TIlE EASTERLY RIGHT OF WAY OF GATEWAY STREET,
SAID POINT BEING SOUTH 000 04'07" EAST 894.44 FEET AND NORTII 890 55' 53" EAST
495.70 FEET FROM TIlE NORTIlWEST CORNER OF TIlE WILLIAM STEVENS
DONATION LAND CLAIM NO. 46 IN TOWNSHIP 17 SOlITH, RANGE 3 WEST OF THE
WILLAMETrE MERIDIAN; TIlENCE SOlITH 000 04' 07" EAST 260.00 FEET TO TIlE
TRUE POINT OF BEGINNING; THENCE SOUTH 000 04' ~'al~~M'8-mvE!l!f; THENCE
Page I Statutory Warranty Deed
3375 Gateway St., Springfield, OR
FEB - 5 2010
Original Submittal_
06289.0000.16geO<t2.1
NORTH 890 55'53" EAST 242.00 FEET; THENCE NORTH 00004' 07" WEST 180.00 FEET;
THENCE SOlITH 890 55' 53" WEST 222.00FEET; THENCE SOUTH 440 55' 53" WEST
28.28 FEET TO TIlE lRUE POINT OF BEGINNING, ALL IN LANE COUNTY, OREGON.
Subject to and excepting:
1. Taxes for the fiscal year 2009-2010, a lien due, but not yet payable
2. Basement on the recorded platlpartition as follows: public utilities
3. Easement, including terms and provisions contained therein:
Recording June 02, 1967, Reception No. 86879, Official Records of
Infonnation: Lane County, Oregon
In Favor of: Pacific Northwest Bell Telephone Company
For: Utilities
4. Restrictive Covenant, including terms and provisions thereof.
Recorded: August 19, 1987, Reception No. 87-36547, Official
Records of Lane County, Oregon
5.
Easement, including terms and provisions contained therein:
Recording October 08, 1987, Reception No. 87-44694, Official
L.:_..~tion: Records of Lane County, Oregon
In Favor of: Durward L. Boyles
For: Non-exclusive utility casement
Affeets: Easterly 7 feet
Cross Easement Agreement and the terms and conditions thereof:
B.;. ___: Sycan B Corp
And: Chevron U.S.A. Ine.
Recording December I I, 1987, Reception No. 87-53789, Official
Infonnation: Records of Lane County, Oregon
7. Option to Purchase and Right of First Refusal, including terms and provisions thereof, as
reserved in the Deed
From:
To:
Recorded:
6.
Chevron U,S,A., Inc., a Pennsylvania __.r_..tion
M & M Rentals, LLC and R2M Properties, LLC
October 09, 2003, Reception No. 2003-099139, Official
Records of Lane County, Oregon
8.
And:
Recording
Information:
Basement and Maintenance A,... ~.._,: and the terms and conditions thereof:
Between: M & M Rentals Inc., an Oregon limited liability
company, as to an undivided seventy-six percent (76%)
interest, as tenant-in-<:ommon, aod R2M r '.r..':es LLC,
an Oregon limited liability company, as to an undivided
twenty-four percent (24%) interest, as tenant-in-e. .._..._
Chevron U.S.A. Inc., a Pennsylvania corporation
October 09, 2003, Reception No. 2003-099140, Official
Records of Lane Col1l\l!(. Q'M9'I . d
Uale ~ecelve :
Page 2 Statutory Warranty Deed
3375 Gateway Sf., Springfield, OR
FEB .. 5 ZOIO
Original Submittal
08289.0090.1896042.1
nus TRANSACTION IS NOT INTENDED TO CONSOLIDATE ANY OF THE
INDIVIDUALLY DESCRIBED PARCELS OR TAX LOTS FOR LAND USE, TAX WTS,
OR ANY OTHER PURPOSE.
DEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON TRANSFERRING
FEE TITLE SHOULD INQUIRE ABOUT THE PERSON'S RIGHTS, IF ANY, UNDER
ORS 195.300, 195.301 AND 195.305 TO 195.336 AND SECflONS 5 TO II, CHAPTER424,
OREGON LAWS 2007. THIS INSTRUMENT DOES NOT ALLOW USE OF THE PROPERTY
DESCRIBED IN THIS INSTRUMENT IN VIOLATION OF APPLICABLE LAND USE LAWS
AND REGULATIONS. BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE
PERSON ACQUIRING FEE TITLE TO THE PROPERTY SHOULD CHECK wrrn THE
APPROPRIATE CITY OR COUNTY PLANNING DEPARTMENT TO VERIFY TIlAT THE
UNIT OF LAND BEING TRANSFERRED IS A LAWFULLY ESTABLISHED LOT OR
PARCEL AS DEFINED IN ORS 92.010 OR 215.010, TO VERIFY THE APPROVED USES OF
THE LOT OR PARCEL, TO DETERMINE ANY LIMITS ON LAWSUITS AGAINST
FARMING OR FOREST PRACfICES AS DEFINED IN ORS 30.930, AND TO INQUIRE
ABOUT THE RIGHTS OF NEIGHBORING PROPERTY OWNERS, IF ANY, UNDER
ORS 195.300, 195.301 AND 195.305 TO 195.336 AND SEcrIONS 5 TO II, CIIAPTER424,
OREGON LAWS 2007. '
Dated this zr -: of tJJ ,2009.
M & M Rentals LLC,
an Oregon limited liability company
By:
'-r ",(,on, /i1cIa Cummings Oil Co., an Oregon
By RSM 1m ..:.......18 Inc., an Ore
corporation
ard'M. "Rick" MikC5cl~
resident
Page 3 Statutory Warranty Deed
3375 Gateway St., Springfield, OR
Date Received:
FEB - 5 2010
06289.0090.1696042.1
Original Submittal
R2M Properties LLC,
an Oregon limited liability company
By RSM Investments Inc., an Ore
STATE OF OREGON )
) ss.
County ofLinn )
Date: ./0 -29-09'
Personally appeared Richard M. "Rick" Mikesell, who, being duly sworn did say that he is the
president ofRSM lnv_.~..__:'; Inc., an Oregon corporation, sole member ofM & M Rentals LLC,
an Oregon limited liability company, and that said inslnlment was signed in behalf of said limited
liability company by authority of its members; and he acknowledged said instrwnent to be its
voluntary act and deed.
~'7
~ublic for Oregon
~y c~mmission expires
OFFICIAL SEAL
. SUSAN C CREEL
, " NOTARY PUBUC.OREGON
" COMMISSION NO. 428956 I
_ __ _',~,";r~~~~I~.&..JUNe;',2~'2 i
Date Received:
Page 4 Statutory Warranty Deed
3375 Gateway SI., Springfield, OR
FEB .. 5 2010
originsl Subrnitt!ll
06289.0090.1696042.1
. "
STATE OF OREGON )
) ss.
County of Linn )
Date: -1-7'1 .? 9...=0 '7
Personally appeared Richard M. "Rick" Mikesell, who, being duly sworn did say that he is the
president of RSM Investments Inc., an Oregon corporation. sole member of R2M Properties LLC,
an Oregon limited liability company, aiid that said instrument was signed in behalf of said limited
liability W'''l'~i by authority of its members; and he acknowledged said instrument to be its
voluntary act and deed.
~z ~ II!.
NJfl'ary1>uVli~ for ar,eton '/. 2 / _ '"'I ", / " ~
~omrmsslOn expIres {/' .L-U , ~
r~ ~ - - -- ;~~~~'~~~E~~r"~
I -. NOTARYPUBUC-OREGON i
I ~ COMMISSION NO. 428956 I
!..,. eM,;~~I~~lq~~~~E.:1.2~ ~
Date Received:
FEB - 5 2010
Page 5 Statutory Warranty Deed
3375 Gateway St, Springfield, OR
Original Submittal
06289.0090.1(196042.1
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sPRlNQ'l(LD, OREGON.. '1i17477
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[PROJECT II
0110
i~M~ ..
,
.
J
SHEET
Al
Enhanced CPU processor
to support multi-tank and
multi-application systems. t.
Modular deslgn meets cunent Lead'" ",,' ,
busIness.and ~~ requ~ business <<
ments,wilh ,,,'" ,",<<Icapabnitles ,,< "'", ,I ~'
for fulur9 needs features
The T15-350 Plus takes
business management a
step beyond nonnal fuel
inventory management.
The SileFax option pro-
vides auto-dial fax capa-
bility, letting you send up
to 16 different repons to 8 separate fax
machines on a programmable schedule. The
TI.S.-350 Plus sends alarm messages [0 your
fax instantaneously.
The TLS-350 Plus lets you choose the exact
set of compliance and fuel management fea-
turtS you need today. As regulatory require-
ments and your business needs change, the
fleXIble T15-350 Plus platform allows you to
add new features tomorrow. A safe invest-
roeor. A sman decision.
Leading-edge leak deteclIon
t,. ,".'Ii
The T1.S-350 Plus has defined the industry
standard for tank monitoring systems with:
advanced magnetostrictive probe technolo-
gies offering 0,2 GPH monthly monitoring
and 0.1 GPH volumetric tank testing; accu-
rate, automatic, electronic line leak delec.
tion; 4S1TE advanced technology sensors;
and a complete line of standard leak sensors
to monitor double-wall tanks. containment
sumps, and wet and dry wells.
For 24-hour stations and high-volume oper-
ations, Continuous Statistical Leak Detection
(CSLD). the most advanced leak detection
technology available today, provides H-hour
automatic leak detection without tank shut-
down. No lost business. No lost operating
lime.
Easy upgrade path
from existing TLS-350
o VEEDER-ROOT
.
The optional fuel manager software, available
for the ~350 Plus. allows you to track
average daily fuel usage, predict the days of
remaining inventory. and improve delivery
scheduling,
~ CapabIIlIes
. Continuous inventory monitoring
. Fast. 0.1 GPH in-tank leak detection
for up to 12 tanks
. CSLD option for continuous 24-hour
leak detection
. tine leak detection
, SiteFax auto-dial fax capability
. EthemetllP communications
. 4SITE advanced technology sensor
compatibility
. Interstitial and piping sump leak
sensing for up to 64 sensors
. Vapor and groundwater monitoring
for up to 40 wells
, External inputs
o VEEDER-ROOT
_e
~-
-
- - -
. - .
-~
_e
By utilizing Inform, Veeder-Root's tank
management software. all inventory manage-
ment and environmental compliance. can be
easily centralized on a personal computer in
one location.
The use of these time and money saving
options extend your investment in the TlS-
350 Plus beyond environmental compliance
requirements, improving your bottom line.
. Relay outputs
. programmable alanns
. Data communications
, All third-party tested
All proven in the field
, Easy upgrade to BIR
E'.; .1' ....:C. . 'I."
I,. .......,,;',
. Selectable via programming
, One system handles mix of standard
and emergency generator tanks
. Records generator activity
, Complete inventory repons before and
after generator operation
Date Received:
FEa - 5 20ID
Original Submittal.
Third party certification
exceeds EPA
performance standards
Certified . "":.,, ,ance for
1m "".;. ,.' .., ".1 and.ln-tank
leak detection In gasoIlnes,
diesel and a wide variety of
other approved fluids.
. Highly accurate MagnelOstrictive
measurement technology.
. Fast, accurate leak tests.
, MAG Plus Probe third-party cenified
to exceed U.5, EPA performance stan-
dards for 0,1 GPH Volumetric,
Tank TIghtness Testing as well as 0,2
GPH monthly and continuous testing.
, MAG Plus Probe is compatible with iill
11 S rnn"ol,... (Software Version II or
higher for TL5-3501300)
, Compatible with gasoline. diesel and
alher approved iluids,
" r.)" and 4. noat kits available.
, MAG Plus Probe is available in
standard and custom lengths up to 12',
Features
, MAG Plus Probe provides highly
accurate trouble free performance in
gasoline, diesel and a wide variety of
approved iluids,
. Magnelostrictive technology and five-
point temperature sensing make it
capable of extremely accurate inven-
tory control and in-tank leak testing.
(~ VEEDER-ROOT
~
Standard Models:
Mag PI... Probe
Fonn No. p""",~
846390-101 4'
846390-102 5'
846390-103 5' 4'
846390-104 6'
846390-105 7'
846390-106 7' 6"
846390-107 8'
846390-108 9'
846390-117 9' 6'
846390-109 10'
Leak test performance
With 4' Roats (Third Pany Cenified)
Probe T.......... P (Dl
MAG Plus 0,1 GPH 99%
MAG Plus 0,2 GPH 99%
MAG Plus with CSLO 0,2 GPH 99%
Mot PIua ""'be
Fonn No. -~
846390-110 10'6'
846390-111 11'
846390-112 12'
846390-113 2,OM
846390-114 2,5M
846390-116 2,667 M
846390-115 3,OM
'Floal hilS for the specific futl application
must bt ordutd Sl'parauly. Kits are
availablt for 4", 3" and 2" floats. Su the
Veeder-Rool price lisl for availability.
P (FA! T... Time
1% 3Hoi.Jos
,,0,1% 2 Hours
<0.1% Continuous
Mag Plus Magnetostrlctlve probe console compatiblllty**
Probe 'TL.S450R* TLS-35OPII.... TU-35Q- TLS-35OJ 1\.S.3001 TLS-3OOC
MAGPIus. . . . . .
. = Standard Feature
. A FO\.Ir-Inpul Probe lntnfo(.t Module is rtqt.tirtdforust of
mdgnt'loSlrictivt' probts with the JLS...J50 or TLS-J50R system..
.. SoJtwart VtrSion J I or hightr
Probe Improved Specs
Standard Mln. T-.np. MaL TMnp.
MAG -2Q"C +5CI'C
MAG Plus -40' C +5CI' C
'Widl4"jIoauDate Received:
Min. Fuel-
Mln. Water"'
0.750
0,630
8'
3.1"
For more information call
~l~~S~!I~
~~~ - ~ 2~t~
O~Q06 .Yet4tf:-~~Y. 125 Powdtr Faint Driw . Simsbury. CT 06070. USA
T~mw~~tbtjl~r. r,,^. 866.-6512119 . www.vetd~r.com
VR PIN 0576047.128 Rev. A VR 412006 Printed in USA
I ntegrated solution for cdntralized I
single system site monitoring.
Standard Models
Console Fonn Number: 848290-022
Description: TLS-350 Plus monitoring console with integral printer
Console Fonn Number: 848290-002
Description: TLS-350 Plus monitoring console without integral primer
Console Fonn Number: 84829\-02\
Description: 11.5.350 Plus PC version without printer, keyboard or display
TL5-350 Plus Interface Modules
The TL.5-350 Plus monitoring console contains three ............_.<5 in which individual interface modules can be installed, Interface modules
may be factory-installed in the console up:m initial ordering. or ordered separately as spare modules 10 expand an existing system.
'F..............~tat"~. .~ "... '" ,,' , "'r. .~"~_.~*", .~I.~''1.I',t:Pft'flll-JJ.'.v,.jI,,,.<.''.~. 'I'" ..;~'1.'T-"C";j.-.,,~~.:&.\...~' ,
onn "",,~f _':"0,- .;,:' .... ""'_ " .".' .L... !~~_~_ -- .". _r.;p:.~~':. '. Yt',u,,--s: ...r.;:::~.:-s~~~ ~"l '~""'S;-:'
F_~ 'J t,~ ,~~~,~ t.1f~~~:ri~'~..~(.".;~ ,,,,r~~ ~~f'
~=~... Ch_ . onc~:"~'-, ,~~~~~,<;,: '~.i~,;.'~:~i;;:::; ,!,~;>.D;.F~,.Com~IIlY.(wIl-.~~1 ,'"
,.... ,_ ...-.~ ~.. ,.j..:a",....~;..i:_,,~..'- _ . ..;......'~n,J[,.:6 ~~~ .- -
LOW.POWER COMPARTMENT (Limit eight per console. unless otherwise noted)
32935&-002 Four-Input Probe Interface Modu~ (Maximum three per
console. IncludeS terminal c::onnector br one l;1OUnd
temperature thermistor tor the volumetric lne leak delectOC').
Eight-Input InterstitiaVUquid Sensor
Seven Input Smart Sensor Module
with Embedded pressure Sensor
HIGH-POWER COMPARTh\ENT (Umir sight P'" consa/<J. unless _$8 norod)
329359-001 four-ntllUj QlJtput Interface Module
""'~.. ..w I l'Wo-lnpuVT'wo-Relay Output Interlace Module
329999-001 Pump Sense Interface Module
330374-001 Three-OJlpUt Pressurlzed line Leek
COntroller Interface Module (Two per coosoIe)
COMMUNICATlONS COMPARTMENT (Umit three per console. unless otherWise noted)
330149-002 SiteFax Interface Module
3293$8-001
329357-001
329399-001
3mS&{)01
329950-001
33<)843-001
32935&004
332250-001
33068&001
330148-001
329362-001
33()()00-001
330883-001
330Q200425
Frve-Input Vapor Sensor Interface Module
H_I~Groundwater Sensor Module
~~," _ _Type A Sensor Interlace Module
&x-U'IpU lypG B Sensor Interlace Module
Six-Input Pressurized l.kle Leak Interface
Module (One per consolel
Eight-Input Smart Sensor Module
Series 8473 0.1 GPH Magnelostrictive Probe
Series ll463 0,1 GPH MeO Plus __ Probe
Series 7943 Intet'StiliaI Sensot lor FlbergkW Tanks and
Interstitial Sensor tor Sleel Tanks
Series 7943 Piping Sump Sensor
Series 7943 HydroStatic Sensor
Series 7943 VOfI'X Sensor
4SITE Series 7943 Groundwater Sensor
4SITE Series 7943 [)isCriminati~nterstitial Sensor
4SITE SerIes 7943 Discriminating b~
SerieS 8484 Pressurized line Leek Oetec1kln Syslem
Requires TI.S-35O Ptus version 7.0 at highet software
Series 857080 Mag Pan Sump SensClf
Series 857280 Vacuum $enSO(
Some as ab<Ne
R5-4851232 Dual Port Communications Module (Slot 4 only)
~232 Intertace Module with Auxiliary Port
R5-232 Interface Module
Remote Printer Interface Module
WPLlO Comr'IU1icationS Module
(MaxImum one per console)
Ethernet - TCP/lP Communications module
Accepts up to four Inputs
Series 8484 Pressurizedli1e Leak Oe1eClkln ~em
Requires Tl.S-35O Plus version 7.0 or higher soltware
Allows hoOkup to most remote lacsimile. modem or teletype
equipment. Requires TlS-35O P1us version 3.0 or higher SQftware.
PrcNides twO 25-pln o-connectorS lor data 1 ." ". to
P.O.s. terminal. printing device at computer
ProvideS a 25-pin Q.conneCI:Ol' lor data tranSmission 10
P.O.S. terminal. printing deVice. ot c:orT1)uter
ProvIdes a 25-pin o-c:onnector for dala tranSI1llssion
to a remote serial printer
l1~tp Rp~p.ive(t
Provides~. ;~" .,tolocalandMdeareanet'WOl1ts{LANlWANS}
Specifications
Operating Temperature Range
Storage Temperature Range
32"F to 11lrF (O'C to 4S'C)
15'F to 1 1lrF (1O'C to 4S'C)
FEB - 5 ~more information call
~--1~8,!8-5~1:1.}42 \J)
Original Submittafp ""'-~ .! '-. '
o VEEDER-ROOT
02006 Veeder-Root Company . 125 Powder Forest Drive . Simsbury. CT 06070 . USA
Te:lepho~: B6().6S1.2700 . Fax: 860.651.2719 . www.vetder.com
VR 13679 PIN 0576047,022 Rev,E VR 412006 Printed in USA
Facility 10 Number:
022212
2009
OREGON STATE FIRE MARSHAL
HAZARDOUS SUBSTANCE INFORMATION SURVEY
__ ~RllOUS SUBSTAllr.F PA,=lleN~ Check lIle correct box 10 the left.
lliC YES a NO 1. Were hazarWlIl subslances present allHs site In repoI1able quanllties dlJrlng lhls SlJIVlly period?
Q YES S. NO 2. Were ExlremeIyHazardousSIl.."""'" (EHS) present at lhIs s1ta ater above1ha I1reshoId plaming lJl8IllIIas duri1gthis SWJeyperlod?
a YES ~ NO 3. is this facility subject to the reportW1g requirements of Section 112(q of the Clean Ai' Ac(/
)(YES a NO 4, Is lI1ls IaclIitysubject to 1ha Process Safely 1Ja", ,,(PSM) substance re~:",,, ,J of OA-OSHA?
IlIDilmIlI DEMOGRAPHIC DATA Cross off the old or incorrect Information and type or print changes or addillons i11ha IlilIIlI'llss.
1. NAlCS CODE 1: 44mO DEFINITION: GASOUNE STATIONS WITH CONVENIENCE STORES
2. NAICS CODE 2: DEFINITION:
3. BUSINESS ACTIVITY AT TliIS SITE: GASOUNE DlSlRl8UTOR a UINI MART
~~!if.~~Ji.ilJI!l.i_.ii!lIM~!!I>flI~ili\1'\~_clliI~~m
4, BUSINESS NAME: JACKSONS FOOD STORe ~-~~.iii~..MM~~~
5. OEPT OR DIY: 112 ~~1!l!lB~$JliIII._\11!~lr~1Eiliil~Wjm
6, OWNERiCEOIREGAGENT: ANOREAJACKSON ~~~.tm
7. SEND TO AffiNTION OF: RICHARD WRIGHT !i.l_I.~~~~
8. E-MAILADDRESS:RICHARD.WRIGHTClJACKSONSFOODSTORES.COM ~~!il~~~~
9, S1TEAODRESS: 337SGATEWAYST 10. MAiUNGAODRESS: 3450ECOIIIIERClALCT
""""'I'''''4\l~1>:~~~~,.,,,,';...Jil.''''~''_'.'.'~''''''''~'''''''''''''''( ~-~JL."'''~'-'='.''.'''';''''"''---''''''-'''''''''''''"''~J;
":l<Jr;'\',-W~~~~~~I~~#ljRtif:R-:t~. .,ilW~'IloU1iU'~~umo.'Q~i1~~i.
CITY: SPIllNGFIELD r~l1IIli!:IWIitMililt~.1; CITY: MERIDIAN
COUNTY: LANE er~~__~ ~~~~~~
STATE: OR ~1ilJ Z1PCOOE: f14T1 r~~t.f, STATE: ID ~ ZIPCOOE: 83642 ~"f_~
11. BUSlNESSPHONE: 541-741-0293 ~
12. DUN&B~,"ccllI: 161539903 i1II!li_!iI:IlllllJd~'il
13. NUMBEAOFEJ.IPLOYEESATTHISSJTE: 12 ~1
14. EMERGENCYCONTACT PERSON: RICHARD WRIGHT
ilJ.'lilIIW~~~~~_
15, EMEAGENCYCONTACTPHONES: DAY: 208 888~1 NIGHT: 2O/l-lI88.a1
.f_.~ ~_Jm
16. RfSPONSIBLE ARE DEPARTMENT: ..-" ,. ,FJElD FIRE UFE 8m
',., ~ "~I\WJIi!&iUiIiL\i!,~,liijilli~_jji~
17. WAITTENEMEAGENCYPlAN? IFYES,WHEREATSITE: JS:'ves a NO
~;;;~~~00Il~
18. AUTOMATIC ARE SuPPRESSION SYSTEM PRESENT? a YES Jiil. NO
19. ARE STORAGE BUILOINGSlTANKSIAREAS Pw:AROED A=RDiNG TO NFI'A 704? )Ii( YES Q NO
20. ARE OTHER TYPES OF PlACARDS USED? l!i YES a NO
I:W--C-:D
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Signature Requlnld:
I certify IlUlIIIIe informatiOn
pRlVided is lrue end lIXUfBte 10
Ihe beet.Pf1l1Y koowIedge, ThIs
Date RellSWr'tfiI .."., J lOans....r
any lJlOOIfOOS needilIg CiaIiIiC81lon,
FEB - 5 2010
__ PERSON COIlPll!TlNG FOIIU
1. PAlNTNAME: ~ ')
-- -
2, SIGNATURE (requlred):GcLvc:..1 W ....t"......
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3. DATE: i. -ZZ-Ol PHON&!W'm-la { 00:
-~4
Original Submittal
R8taIn a t:tJf1Y of lhia IWVIY lIllltJa fBcRy fa- 3 yen.
Return uveylo: OSI'M &ney F .." ," 1I Unit, 47llO PoItIand Ad HE, Salem, OR 97305
I.;neR'llca.
Fonn
Common Name or Trada Name: GASOUNE
2009
OREGON STATE FIRE MARSHAL
Hazardous Substance Information Survey
Cross off the old or i. .--,.. _1 Information and type or print changes or additions In the Ibracketed1 area
Facility ID Numbel
022212
SECTION 0
Hazardous Ingredient,. ,: I' ".EUM DlS11U..ATES
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Date Received:
FEB - 5 2010
Original Submittal
XERXES@
CORPORATION
a subsidiary 01 ZCl Composites Inc.
Fiberglass
Underground
Petroleum Storage
Tanks
Date Received:
FEB - S 10\0
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Xerxes@ Fiberglass Tanks
A proven tank choice for the petroleum industry
After years of installing bare steel underground storage tanks for
gasoline and diesel fuel, in the 19605 companies began to realize
that leakage from steel tanks - because of rust both inside and
outside - caused environmental problems, Since the mid 1960s.
fiberglass underground storage tanks (USTs) have provided tank
owners with a reliabie corrosion,free option that led to federal reg,
ulations in the late 19805 mandating corrosion-protected tanks,
There are even more reasons to choose a Xerxes fiberglass tank
today, It is compatible with new ethanol-blended fuels and
biodiesels, requires no maintenance to prevent corrosion, and,
unlike steel tanks, accommodates continuous hydrostatic moni.
toring, And in contrast to some other UST products. standing be-
hind every Xerxes petroleum tank is an industry-leading 30-year
limited warranty,
Today. more than 40 years after their introduction. a large per-
centage of USTs sold in North Amenca are made of fiberglass, In
fact, the tanks installed by the 50 largest fuel marketers in the
United States are overwhelmingly fiberglass tanks, In Canada, it
is estimated that more than 90 percent of tanks installed for pe,
troleum storage are made of fiberglass, As of 2008. more than
1 SO.ooO Xerxes fiberglass tanks had been installed, and the num-
ber continues to grow.
In addition to their functional benefits. fiberglass tanks are sig-
nificantly lighter and easier to install than steel tanks because
they eliminate the expense of renting heavy equipment during in-
stallation, Yet another benefit is that fiberglass tanks can often
be moved from an original installation site and be recertified for
installation at a new location.
At Xerxes, we believe in going the extra mile for our customers.
Headquartered in Minneapolis, Minnesota. with four manufac-
turing facilities strategically located for economical delivery and
quality service, Xerxes is committed to customer satisfaction
and quality products, Together with our parent company, ZCL
Composites Inc., we are North America's choice in underground
storage - for today and for tomorrow,
Xerxes is dedicated to delivering hg.atey~eQeiv
that help preserve the environment. whether In the mid.
die of a city. a suburban neighborhood or a rural setting.
FEB - 5 2010
r."";n'll Submittal
.Im
Xerxes - a long-time industry leader and pioneer
For decades. Xerxes has proven itself an industry leader in de-
veloping and fabricating fibergiass reinforced plastic (FRP) struc-
tural products. Xerxes' commitment to quality and innovation is
the foundation of the strong. long-lasting relationships we have
with our customers. Xerxes engineers were the first to utilize in-
tegrally constructed ribs in fiberglass tanks for added strength,
Xerxes was also the first to manufacture a Ul-listed, double~wall
fiber91ass underground storage tank (USn and the first to incor-
porate the unique benefits of hydrostatic monitoring into a fac-
tory-manufactured design,
As customers' needs change and as regulations become more
complex, Xerxes continues its history of innovation by develop-
ing products that meet the changing needs of customers in the
petroleum, water and wastewater industries, Today. the Xerxes.
tank product line includes double-wall, triple-wall and multicom-
partment tanks, as well as oiVwater separators, wet-wells and
prepackaged lift stations, Complementing these product iines is
a wide variety of Xerxes-supplied accessories that not only provide
for speed and ease of installation (such as prefabricated concrete
deadmen) but aiso respond to changing reguiations, Our innova,
tive double-wall containment sump is an example of this. Xerxes
is committed to developing new and complementary accessories
to our growing line of products.. with a careful eye on new in-
dustry demands and trends,
Today, as part of ZCL Composites Inc., Canada's leading provider
of fiberglass USTs, product innovations such as ZeL's Phoenix
System- and Prezerver™, and use of Parabeam-, further enhance
our premiere product line. (See pages 5 and 7 of this brochure for
more information,) Together, Xerxes and ZCL are widely recog-
nized as North America's leading provider of underground fiber-
glass storage tanks,
The Xerxes Mission Statement
To be the leading global provider of environmentally friendly liquid storage solutiorfS)ate Receivec:
while providing superior returns to our shareholders.
reo ~ [~1O
2
Original Submittal
The benefits of Xerxes~ fiberglass underground storage tanks
The best choice for underground storage of petroleum products
is a structurally strong, corrosion.resistant, easily installed and
cost-effective vessel. That's what a customer finds in every Xerxes
tank. which is designed and manufactured vvth high-quality resin
and glass. and features unique integral ribs, Like structural beams,
integral ribs add strength, and because the ribs and tanks are
made of the same materials and are manufactured simultane-
ously, the result is an extremeiy robust product,
The solution to new corrosion concerns
Made of corrosion-resistant materials, Xerxes fiberglass tanks
eliminate the possibility of either external or internal rusting of
the tank. For years, the concern in the petroleum industry was
about external corrosion. Since fiberglass doesn't rust, and steel
can, this gave fiberglass tank manufacturers a natural edge,
Today, corrosion concerns in petroleum tanks center on internal
corrosion, an even more pressing matter because of new fuels.
such as ethanol blends and biodiesels, Together. the removal of
lead from gasoline and the grovvng popularity of biofuels have
led to heightened awareness about corrosive environments inside
storage tanks,
A certain amount of water usually exists in the bottom of tanks,
and that can lead to the microbial-induced corrosion (MIC) in steel
tanks, Ethanoi increases the likelihood of water in tanks, and the
resulting microbial growth, To date. there is not a single reported
instance in a fiberglass tank. of failure due to internal corrosion
caused either by MIC or by water bottoms, Based on widely dis,
tributed advice, combatting internal corrosion in steel tanks re-
quires regular maintenance - in the form of frequent inspection
for and removal of water from tank bottoms, In contrast. fiber-
glass tanKS require no maintenance against corrosion.
Many believe that this new concern about internal corrosion is
the reason the Steel Tank Institue (STl) and some steel-tank man-
ufacturers have significantly reduced their warranty coverage,
from 30 to 10 years, Since Xerxes fiberglass tanks are compatible
vvth the new biofuels, including E 1 0, E85 and biodiesel blends,
Xerxes confidently holds to its longstanding 3D-year warranty,
which explicitiy provides 30 years of internal corrosion coverage
"WIth or vvthout water bottoms, " Date Received:
3
FEB - 5 2010'
Why choose a Xerxes. tank?
.
Fuel compatibility - Xerxes tanks are Ul-listed lor all ethanol-blended luels, including flG and f85. and
are fuily compatibie with new diesel blends, including ultra-low sullur diesel (UlSD) and biodiesel blends,
.
Maintenance-free - Xerxes does not require the frequent inspedion for and removal 01 tank water
bottoms, which is a time-consuming and expensive maintenance step that is strongly recommended by
the steel tank industry for its products. While some manufacturers' warranties limit coverage when
water bottoms are present, Xerxes' warranty specifically states .with or without water bottoms..
.
3D- Year warranty - While the warranty duration for many other storage tanks has been dramaticaily
reduced in recent years, Xerxes continues to provide a 30-year iimited warranty. backed by the financial
strength of North America's leading storage tank manufacturer.
.
Continuous monitoring - Interest is growing in the use of a . continuous monitoring. system in the
interstice of a new double-wail tank, In lad, states such as California have regulations requiring II.
Xerxes' TRUCHfK. hydrostatic monitoring system, with an outstanding 2D-year track record. is the perfed
solution. The alternative vacuum systems in the market (which can be expensive to maintain) have but a
smail fradion 01 the in-service history that TRUCHEK oilers,
.
Tank of choice - Fiberglass tanks represent the overwhelming choice of the 50 largest petro~m '.
marketers in the United States, based on their annual tank purchases, As the leading supplierlelate ReceIve d.
underground storage tanks, Xerxes is the tank of choice lor all petroleum applications, whether retail,
commercial. or industrial. FEB - 5 2010
~1:ri-~:! ~1_1~lYti.l'?I____.
4
Xerxes'" tanks now offer the benefits of Parabeam'"
Xerxes double-wall tanks now feature
Parabeamo 3D glass fabric. a lightweight
yet strong "sandwich" laminate that of-
fers excellent mechanical properties,
Parabeame is a unique glass fabric con-
sisting of two deck/ayers woven together
by vertical glass piles that form an inte-
gral sandwich structure, When the
Parabeamo is impregnated with a ther-
moset resin, the fabric rises to the preset
height, producing a unique laminate with
a defined interstitiai space that can be
mOnitored hydrostatically or with a dry leak.detection system,
Parabeamo is a wholly-owned subsidiary of lCL. allowing both
Xerxes and lCL to incorporate a proprietary material that has
been successfully used in Canada for more than 12 years,
ZCL's Prezerver™ System enhances Xerxes' product line
A new option for Xerxes customers is the lCL Prezerver™ Sys-
tem, This "system" solution for owners of petroleum fueling fa-
cilities provides a level of equipment reiiability and third-party
liability protection that is unique in the industry, At the center of
the Prezerver™ System are the industry's leading choices for
product storage: Prezerver™ double-wall tanks or the lCl
Phoenix System-, together with a unique and comprehensive
package of insurance protection, which is only available to Prez~
erver™ System customers. Additionally. each Prezerver™ System
installation has site inspections of critical steps that are docu-
mented by a qualified third,party firm and compiled into a pro-
fessional final inspection report (including photos). which is then
provided to the owner,
While this program goes beyond federal financial responsibility
(FR) requirements for tank owners, it is designed to comply with
various states' minimum FR requirements. (Check with the spe-
cific requirements of your state,) Owners in states that provide a
state fund intended to address FR requirements in lieu of private
insurance will find the broad coverage of the Prezerver™ Master
Program of Insurance to be very attractive, offering a level of cov-
erage that exceeds that of state funds, (See Xerxes' lCL Prez-
erver™ System brochure tor mOre information.)
Each Prezerver™ System includes the following components:
. Prezerver™ double-wall tank and required accessories
. TRUCHEKo hydrostatic monitoring system
. FRP containment collar and sump with a watertight lid
. prefabricated, engineered, concrete dead men
. FRP hold-down straps and galvanized turnbuckles
. approved double-wail piping system
. approved fiberglass dispenser sumps
. approved electronic monitoring system for the tanks,
piping and all sumps.
Date Received:
Benefits of ZCL's
PREZERVER'
S'\ ~....M
FEB - 5 2010
Original Submittal
. may eliminate the need to purchase/renew annual insurance poiicies (with unpredictable premium costs) for 10 years
. provides confidence that the fueling system is correctly installed
. provides permanent record of key installation steps. with an inspection report that includes photos
. may avoid the need to purchase state-mandated private insurance - providing significant savings
. coverage for existing tanks may be available at below-market rates (subject to underwriting requirements)
5
TRUCHEK~ - state-of-the-art continuous monitoring
To enhance the double-wail protection of a Xerxes. tank, Xerxes offers the option of TRUCHEK, its state-of-the-art system of hydrostatic,
tank monitoring for double-wail tanks, TRUCHEK is an easy, precise and reliabie method for both continuous leak detection and tank-
tightness testing, Like the tanks that Xerxes manufactures, TRUCHEK provides a long, successful record of performance,
Continuous leak detection
For nearly two
decades, the
Xerxes'TRUCHEK
system has suc-
cessfuily moni-
tored thousands
of tanks in many
different types of
installations. In
fact, it has be-
come an industry
standard as a
state-of-the-art technique for continuous monitoring. Changing
regulations in some markets, such as California, require that new
double-wail tanks have continuous leak detection u~ng a constant
vacuum, air pressure or hydrostatic pressure in the interstice of a
double-wail tank, A Xerxes tank with TRUCHEK's continuous leak
detection is the ideal solution for complying with these strict new
requirements.
While being highly effective, TRUCHEK is also simple and trou-
ble-free in both design and operation, With TRUCHEK. simple
monitoring of the fluid level inside the reservoir of a Xerxes dou-
ble-wail tank is ail that is necessary, When you order a Xerxes
double-wail tank with the TRUCHEK option, the interstice be-
tween the two tank wails is fiiled at the factory with a monitor-
ing fluid, This water/cakium-chloride fluid also partiaily fiils a
reservoir on the top of the tank. This creates a hydrostatic pres-
sure throughout the interstice, enabling the operator to monitor
the wails of both the primary tank and the secondary tank, An
electronic probe placed in the tank's reservoir alarms when the
fluid level either fails below or rises above the acceptable level.
(See the Xerxes TRUCHEK brochure for more information,)
Tank-tightness testing
TRUCHEK also provides a simple, precise and reliable method to
perform a tank-tightness test. It takes into account the impacts
of thermal expansion or contraction of the product, vapor pock-
ets. tank deflection, evaporation, condensation and the location
of the water table, The 1 D-hour tightness'test procedure meets
the strict NFPA 329 criteria, A shorter 4-hour test (while product
is dispensing) exceeds EPA's criteria for a tank,tightness test,
How does TRUCHEK" work?
Primary,Tank leak in Wet Hole or Dry Hole
...- ~nl
Re-sefVOlr
Ll."VelDown
~
, ~
Secondary-Tank leak in Dry Hole
Vent
."""",
leovelDown
Secondary-Tank leak in Wet Hole
_ Rewl'VOlr
L~rup
ceived:
FEB :. 5 2010
6
Original Submittal
Guide Specifications - Xerxes~ Fiberglass Underground Storage Tanks
Short form:
The contractor shall provide a single.wall, double-wall or triple-wall
fiberglass reinforced plastic (FRP) Underwriters laboratories.labeled un-
derground storage tank. as shown on the drawings. The tank size, fit.
tings and accessories shall be as shown on the drawings. The fiberglass
tank shall be manufactured by Xerxes. Corporation.
The tank shall be tested and installed according to the Xerxes Installa-
tion Manual and Operating Guidelines for Fiberglass Underground
Storage Tanks in effect at time of installation.
Long form:
Part I' General
1.01 Quality Assurance
A. Acceptable Manufacturer: Xerxes Corporation
B. Governing Standards. as applicable:
1. Underwriters laboratories (UL) Standard for Safety 1316 for
storage of flammable liquids. A UL label shall be attached to
each tank.
2. National Fire Protection Association (NFPA) Standards:
NFPA 30: Flammable and Combustible Liquids Code
NFPA 30A: AutomotIve and Marine Service Station Code
NFPA 31: Installation of Oil-Burning Equipment.
3. City of New York Department of Buildings M.E.A.. Division
#161-89,M,
Part It: Products
2.01 Single-wail, Double-Wall and Triple-Wall Fiberglass Reinforced
Plastic (FRP) Underground Storage Tanks:
A. Loading Conditions - Tank shall meet these design (fIteria:
1. Internal load - Single-wall. double-wall and triple-wall tank
shall withstand a 5.psig air-pressure test with 5: 1 safety fac:.tor.
Contractor shall individually test tanks for leakage prior to in-
stallation. Maximum test pressure is 5 psig (3 psig for a t2'-di-
ameter tank).
2. Vacuum Test - To verify structural integrity, every standard 10'-
diameter tank and smaller shall be vacuum-tested by the manu-
facturer at the factory to 11.5" of mercury. AU 12'-diameter
tanks shall be tested by the manufacturer to 5.5" of mercury.
3. Surface Loads - Tank shall withstand surface H.20 axle loads
when properly installed according to Xerxes' current Installation
Manual and Operating Guidelines.
4. External Hydrostatic Pressure - Tank shall be capable of being
buried in ground with 7' of overburden over the top of the
tank, the hole fully flooded and a safety factor of 5: 1 against
general buckling.
5. Tank shall support accessory equipment - such as heating coils,
drop tubes, submersible pumps and ladders - when properly in-
stalled.
B. Product Storage:
1. Tank shall be capable of storing petroleum products with spe-
Cific gravity up to 1.1.
2. Tank shall be vented to atmospheric pressure.
3. Tank shall be capable of staTing products identified in the man-
ufacturer's current standard limited warranty.
C. Materials:
1. Tank shall be manufactured WIth 100% resin and glass-fiber re-
inforcement. No sand fillers.
D. Tank Dimensions (Refer to Xerxes literature 011 gallonage.).
1. Tank shall have nominal capacity of _ gallons.
2. Tank shall have nominal outside diameter of _ feet.
E. Interstitial Space
1. Double-wall and triple-wall tank shall have a space between the
walls to allow for the free flow and containment of leaked
product from the primary tank. The space also allows the inser.
tion of a monitoring device through a monitoring fitting.
2.02 Accessories
A. OptIOnal Anchor Straps
1. Straps shall be FRP anchor straps as supplied by tank manufac-
turer.
2. Number and location of straps shall be specifIed in current liter-
ature by tank manufacturer.
B. Manways
1. All manways shall be flanged and 22" I.D., comple.te with UL-
listed gaskets. bolts and covers. (30" and 36"1.0. manwa~ are
also available on certain larger tanks.)
2. Location is shown on tank drawings.
3. Optional manway extensions shall be FRP and _Inches
long.
4. All 12'-diameter tanks require at least one manway.
C. Optional Fill Tubes
1. Fill tubes shall be FRP. 4" in diameter, with a 6" x 4" double-
tapped reducer bushing, and include a 6- NPT fitting. Tubes
shall terminate a minimum of 4 - from the bottom of tank (a
minimum of 6- for a 12'-diameter tank).
D. Striker Plates
1. Striker plates shall be installed under each service fitting and
manwayopening.
E. Optional Heating Coils
1. Optional heating coils shaH be installed in a separate 22" -dIam-
eter manway and shall be as supplied by tank manufacturer.
F. Opttonal Ladders
1. Ladders shall be the standard ladder as supplied by tank manu-
facturer (aluminum, carbon steel or fIberglass).
G. NPT Threaded Fittings
1. All NPT threaded fittings shall be a material of construction con-
sistent with the requirements of the UL label.
2. All standard threaded fittings shall be half-<ouplings and shall
be 4. or 6" in diameter. Reducers are to be used for smaller
sizes where shown and provided by contractor.
3. Strength - NPT fittings shall withstand a minimum of 150 foot.
pounds of torque and 1,000 foot-pounds of bending, both with
a 2:1 safety factor.
H. Monitor Fittings
1. The monrtor fitting for a double-wall and triple-wall tank shall
consist of a 4 - NPT fining on the tank.
2.03 Optional Monitoring System
A. General
1. The tank manufacturer shall offer the option of a continuously
monitored, hydrostatic leak.detection system for its double- and
triple.wall tanks.
2. The monitoring system shall be designed by the manufacturer
to detect a leak in either the primary, secondary or tertiary tank.
at installations with or without groundwater.
3. The monitoring system shall include monitoring fluid in the pri-
mary interstice delivered to the insta))ation site. The contractor
shall be responsible for field installation of monitoring fluid in
the secondary interstice.
4. The reserVotr(s) shall be litted WIth one 4 - NPT fItting for instal-
lation of an electronic. reservoir-level sensor.
Part III: Testing and Installation
3.01 Testing
A. Testing - Tank shall be tested according to the applicable Xerxes
Installation Manual and Operating Guidelines in effect at time of
installation.
3.02 Installation
A. Installation - Tank shall be installed according to the applicable
Xerxes Installation Manual and Operating Guidelines in effect at
time of installation.
Part IV: Limited Warranty
4.01 Limited Warranty
A. Limited Warranty - Warranty shall be manufacturer's standard lim-
ited warranty in effect at time of purchase.
Date Received:
FEB - 5 201n
Original Submittal
Xerxes~ Underground Tank Data
Single-wall & Double-wall Tanks Double-wall Tanks Single-wall Tanks
Nominal Actual Number of Actual Dry Nominal Wet Nominal Actual Nominal
Capacity Tank length Hold-down Capa<ity Shipping Shipping Capacity Shipping
(gal) (ft/in) . Straps Req'd (gat) ** Weight (Ibs) Weight (Ibs) (gal) .. Weight (Ibs)
4-foot- I 600 6'-11 7/S" SW 2 1602 800 1,000 I 602 500
7'-3 1/2" OW
diameter
tanks 1',000 11'-3 7/S" SW 2 11.00g 1,100 1.400 1,009 700
1,'.71/2"DW
2,000 13'-53/4" SW 2 1- 12.376 1.000
2,500 13'-53/4" DW 2 12.324 1,800 2.400
3,000 16'-41/4" 2 12.910 2,100 2,800 2.973 1.200
6-foot-
diameter 4,000 21'-111/8"SW 2 3,789 2.500 3,500 14,,31 1.600
tanks 20'.S" rJ.N
15,000 26'-S' 4 4,961 3,100 4.300 15.064 1,900
16,000 30' - 8 3/4" 4 15.840 3.600 4,900 15,960 2.200
12.000 9'-112"SW 2 1- 12,189 900
3.000 12'-J"SW 2 1- 3.271 1.200
4.000 15'-112" 2 14,190 2.200 3,100 4.218 1,400
5.000 17'-81/2" 2 15,089 2.600 3,700 5,165 1,700
8,foot, 6.000 20'-6112" 4 16.044 2,900 4,300 16,084 2,000
diameter 8,000 126'.'/2" 4 17.899 3,600 5.400 17,950 12,500
tanks 10.000 131'061/2" 4 9.753 14,300 6,600 19.816 13,000
112.000 137'-112" 4 11.608 15.000 17.700 111.682 13,500
1'5,000 /46"9' 6 14.881 16.400 19.800 114.975 14,500
110.000 21'-51/4" 4 110.420 4,500 6,200 1'0.563 3.200
1'2,000 24' -1/4" 4 111.904 5,000 7.000 12.068 3,600
15.000 29' - 5 3/4" 4 115.041 6,100 8.600 15.248 4,500
10-foot- 20,000 37' - 8 314" 6 1'9,782 7.700 11,000 20.055 5,700
diameter
tanks /25,000 47'-6314" 8 125,431 10,000 14.300 I 25,783 7,900
30,000 55' - 9 3/4" 10 130.172 11,900 17,000 130.590 9.400
35.000 64'-3/4" 1'2 34,912 13,600 19.600 1 35.397 110.500
40.000 73' - 81/4" 1'4 40,443 16,000 23.000 I 41.004 1'2,'00
I 20.000 29'-4" sw 6 I 20.781 9.200
I 25,000 3S'-7"SW 8 1 25,541 10.600
12-foot- 30.000 43'-'"SW 10 31,253 1'2,500
diameter 35,000 49'-4"SW 1'2 I- I- 36,013 113,900
tanks 40,000 54'~4' sw 112 I- I- I- I 39.821 115.000
48,000 I 65'-rsw 1'8 I- I- I 48,389 117,700
I SO,OOO I 68'.,.SW 1'8 I- I- Vate Rebeived: I
Notes:
" Unless otherwise noted. the tank length applies to both single-wall (SW') and double-wall (OW) tanks. FEB - 5 2010
9 "" Use of overfill protection such as flapper valves or ball-float valves will reduce the actual capacity of the tank.
Original Submittal
Limited Warranty
Double-Wall and Single-Wall Storage Tanks for Petroleum or Alcohol Fuels
Xerxes Corporation rXerxes~) warrants to owner (.Owner~l that OUf double-wall and single-wall underground storage tanks. if Installed. used.
and maintained in the United States or Canada in accordance with Xerxes' published specifications, installation instructions and operating guide-
lines, and all applicable laws and regulations:
1) Will not fail for a period of thirty (30) years from date of original delivery by Xerxes due to natural external corrosion.
2) Will not fail for a period of thirty (3D) years from dale of ()(iginal delivery by Xerxes du@ to internal corrosion, providM the tank is used solely, (with
or without tank water bottoms). to store the following products at ambient temperature, or fuel oils at temperatures not to exceed 1500 F (650 C):
a. gasoline, jet fuel, aviation gasolines. motor oils. motor vehicle waste oils, kerosene, diesel fuels, or fuel oils
b. alcohol. alcohol--gasoline blends, and oxygenated motor fuels
1. ethanol and ethanol blends
. 100% ethanol
. E 1 0 (90% gasoline and 10% ethanol)
. E85 (85% ethanol and 15% gasoline)
2. methanol and methanol blends
. 100% methanol
. M8S (85% methanol and 15% gasoline)
. Oxinol-50' waiver (90.5% gasoline and 9.5% OXlnol-501 comprised of a 4.75% methanol and 4.75% GTBA mixture)
. Dupont EPA waiver (gasoline with 5% methanol and a minimum of 2.5% cosolvent - the blend may contain a maximum
concentration of up to 3.7%, by weight, oxygen in the final fuel)
3. other oxygenated fuels
. gasoline With up to 20%, by volume, of methyl tertiary butyl ether (MTSE), ethyl tertiary butyl ether (ETSE), di-isopropyl ether
(OIPE), tertiary amyl methyl ether (TAMEl, or tertiary amyl ethyl ether (TAEE)
(. biodiesel fuel as defined by:
1. ASTMel 0975-o8a (diesel fuel oils)
2, ASTMo, D396,08b (fuel oils)
3, ASTMo, D7467-o8 (d'esel fuel oil and blodiesel blend (B6-20))
3) Will not fail for a period of thirty (30) years from date of original delivery by Xences dlJ!> to structural failure (defined as spontaneous breaking or
collapse caused by material defects in materials or workmanship).
4) Will meet Xences' published spedfications and will be free of material defects in materials and workmanship for a period of one (1) year
fotlO\Ning the date of original delivery by Xerxes.
If any tank is to be removed from an installation, moved to ONner's new location and is intended for active service at the new location, the tank
must be recenlfled by Xerxes In order to maintain the limited warranty as Originally extended.
Xerxes warrants to ONne( that all Xerxes manufactured tank accessones, .f installed. used and maintained In the UnIted States or Canada In accor-
dance WIth Xerxes' published specifICatIOns, installation instructIOns and operating guidelines, and all applicable laws and regulations, WIll be free from
material defects in materials and workmanship for a period of one (1) year following the date of original delivery by Xences.
The foregoing limited warranty does not extend to tanks or accessories (collectively "Goods~) damaged due to acts of God, war, terrorism, or failure
of Goods caused, in whole or in pan, by misuse, unlawful use, improper installation, storage, servicing, maintenance, or operation in excess of their
rated capacity or contrary to their recommended use, whether intentional or otherwise, or any other cause or damage of any kind not the fault of
Xerxes. Xerxes only warrants repairs or alterations performed by Xerxes or its authorized contradors. Xerxes does not warrant any product, compo-
nents or parts manufactured by others.
Owner's sole and exclusive remedy for breach of warranty is limited at Xerxes' option to: (a) repair of the defective tank or accessory, (b) delivery of
a replacement tank or accessory. to the point of original delivery. or (c) refund of the onginal purchase price. In the event of a breach of warranty
claim. a daimant must give Xences the opportunity to observe and inspect the installation prior to the removal of any backfill below the tank top, and
the removal of the tank and any accessory from the ground, or the claim will be forever barred. AU claIms must be made in writing within one (1) year
after tank. andlor accessory failure or be forever barred.
THE FOREGOING LIMITED WARRANTY CONSTITUTES XERXES' EXCLUSIVE OBUGATION AND XERXES MAKES NO OTHER WARRANTY OR REPRE-
SENTATION, EXPRESS OR IMPUED, WITH RESPECT TO THE TANK. ACCESSORY OR ANY SERVICE, ADVICE, OR CONSULTATION. IF ANy' FURNISHED TO
OWNER BY XERXES OR ITS REPRESENTATIVES. WHETHER AS TO MERCHANTABIUTY. FITNESS FOR A PARTICULAR PURPOSE. OR OTHERWISE, THE
SELLER (XERXES) UNDERTAKES NO RESPONSIBIUTY FOR THE QUALITY OF THE GOODS. EXCEPT AS OTHERWISE PROVIDED IN THIS CONTRACT. THE
SELLER (XERXES) ASSUMES NO RESPONSIBILITY THAT THE GOODS WILL BE FIT FOR ANY PARTICULAR PURPOSE FOR WHICH you (OWNER) MAY BE
BUYING THESE GOODS. EXCEPT AS OTHERWISE PROVIDED IN THE CONTRACT. THE REMEDIES SET FORTH IN THE ABOVE LIMITED WARRANTY ARE
THE ONLY REMEDIES AVAIlABLE TO ANY PERSON OR ENTITY FOR BREACH OF WARRANTY OR FOR BREACH OF ANY OTHER COVENANT. DUTY. OR
OBLIGATION ON THE PART Of XERXES, XERXES SHALL HAVE NO lIABIUTY OR OBLIGATION TO ANY PERSON DR ENTITY FOR BREACH Of ANY OTHER
COVENANT. DUTY OR OBLIGATION UNDER THIS LIMITED WARRANTY EXCEPT AS EXPRESSLY SET FORTH HEREIN, IT IS EXPRESSLY AGREED THAT THIS
LIMITED WARRANTY DOES NOT FAIL OF ITS ESSENTIAL PURPOSE, XERXES SHALL HAVE NO UABIUTY FOR COSTS Of INSTALLATION QR REMOVAL OF
GOODS. ENVIRONMENTAL CONTAMINATION. FIRES. EXPlOSIONS. OR ANY OTHER CONSEQUENCES ALLEGEDLY ATTRIBUTABLE TO A BREACH OF
WARRANTY. OR INCIDENTAL. CONSEQUENTIAL, PUNITIVE OR OTHER DAMAGES OF ANY DESCRIPTION, WHETHER ANY SUCH ClAIM OR DAMAGES
BE BASED UPON WARRANTY, CONTRACT. NEGLIGENCE, STRICT lIABIUTY OR OTHER TORT, OR OTHERWISE, IN NO EVENT SHALL XERXES' TOTAL L1A-
BIUTY HEREUNDER EXCEED THE ORIGINAL PURCHASE PRICE OF THE GOODS WHICH GAVE RISE TO SUCH lIABIUTY.
Consumer Notice: This limited warranty gives you CONner) specifiC legal rights. You (Owner) may also have other rights which vary from state to state.
1 T~ Arco Chemical Co. . ,.{ .
t ASTM' and ASTM INTERNATIONAL- are trademark.s owned by the American Society foli).aterRecSjve~ofit corporation, and are used
here for reference_
Xerxes. Corporation
FEB - 5 2010
Effective: : 2/15/09
10
Original Submittal
','
"
>
>'i:---:.' :i;l'.
"
00....
;!'~;"
,.~ ,;~.-
, ..
,
'5;
..
XERXES@
CORPORATION
a subSidiary 01 ZCL Composiles Inc.
7901 Xerxes Avenue South
Minneapolis I MN I 55431
Ph: 952.887.1890 Fax: 952.887.1882
FEB - 5 2010
~ . es Corporation
'xpb02l09pp
.J
www.xerxes.com
Original SubmittaL
',.
j}'
-{
. ~~
~.
:'"j
'.
..
NOTE:
1 OPTIONAL PREFABRICATED D[AQU[N SHOWN.
IF oEAOu[N ARE AOOEo TO THE ORDER.
ACC()l,MJ()AT IQNS lolAY BE REQUIRED TO
SECURE THE STRAPS TO THE oEA[lt,lEN.
~
9J
11'_11
1/4'
I
1+1
( - ~-r -'1,1
t :J (::I ~
.
8'-5 3/8'
-845/8-'
-677/8-
--175/8
,,~
,l! ~
~t
~
0
..,
cO'
:3' 0
~ III
C/) "T1 -
c: ITl CD
a- OJ :::0
3 I
:= U"I CD
~ '" 2
= :;::.
2$ CD
0.
i
7 ~~~"I 12 13 14~~
18 1/2~ --163/4(TYP)
::L::':~::~I:::~~::~':':; ::~:::}::::::!::::::I:>: :':;;::;:::::::~;'::::T: ~:::;;:;~~::~::}:::::
~
,~
2
3
, 6
~-
.
.... --~..........._.
:.:::::"0::::
......,,---.-.......
-623/4--833/4_.
85 1/2
833/4-
,31'-6 1/2'
A 4'NPT ~tTOR .ITrINe
'? ."NPT SERVICE "ITrINC WITH 12" . 12" STRII(ER PLATE
~ 22'OlA WANWAY WITH 5-4'NPT FITTINGS IN COVER & .-12' . 12' STRII(ER PLATES
o I 48'olA . .a"HICH a SIDED sw CONTAINUEHT SUUP WITH 30'OlA LEVER lOCI( WATERTIGHT TOP
E)llIFTINC lUG
f) I 16' PREFABRICATED CONCRETE OEAOUEN (4 OEAOt,I[N REQUIRED PER TANI<) (OPTIONAL)
t><lll-lOlO ~ STRAP LOCATION
I~,I~'~~~('~;
L-J''''1':-~ ""
i-' - CAP 10,000 GALLONS
I~- -' J!, ~i.!r rOOD ST .1if.
i::.', ..:J.'J63~-06?_~~~
..Large Mouth.. LM Series Dispenser Sump
~~I'I~
== . =-
The large Mouth series dispenser sump modular design provides versatility and
ease of installation,
There are six polyethylene bases in three lengths and two depths, These bases
have a large 22" wide by 24", 36" or 48" long openings, easing the installation
of entry boots and piping connections, The ribbed riser can be cut down in 3"
increments in the field to achieve proper pipe slopes with respect to grade,
A variety of large Mouth Tops (lMTs) are available to match nearly every
dispenser model. The lids are corrosion resistant painted steel to which shear
valves and dispenser frames are mounted.
Design Highlights & Advantages
~.;.Io< .''''\4.-!k'-1-:;--._...~,,,,.,,:''-1'1i't'ii;'
.:~~;:'~d~:Pf:.l~~.~~t-ji9~;~'~i".,I~n'Q.: -; ,
'..?e~Jl1rg~n p~,~e'g~~ F?JFrt!Y:Qk=-"r}' 1
. 'W"~~I.,JO,.~c~~"t;.,:fi.-_~t,l~g,m~.: ~~I~)1;~
Jnstal at~on.~~. _ ,..' ~~,.I J- - ~"";'
.-? ,." ~ - " .~,...
,~~v!iJ1p('^~i~ :a!,cY,~--e'p:l>ttf 1',
" deptl1\t~rope~lJ'm,intalfSlo1>e,!~'et
iJg:: ,':J;"'~.~ti'__{:;.,.. ".'~~::',",,~' J:' ~
.. l1l~_,,ba_sewidensto'asP'acio-us(~. ...-s,-:.lt
.:' 26.t:wt\ereient~_bOOis;tnd"\1 ><.,~~,
,', "."-.",..-J"d'" -,l1;~ ~ ;;.C"
, _ cohnectlol'ls<are ma e. - -, 7~ -' ~r_
\'~'Ji<v"""';;yr ' 'I" ."/,, M'
"-:t1F,li9,f1t.iriod,',' ilka, tion5)~f,,_~'~,,0>,',' .rryPi~I"hOd
<~ "*lfimgiJni~~]ij1;.~,~t.1~~fj]>s,(, ,-
qlfb~er!l<lrl'.lt~jS~Ks).WP~~ti!ll or
l'!~I~e~,~e~han/lel;iotshi!aJ',;Y~IV~' 'If
. ,lNnfirig~o.n.e.S8"!n'liillite"d;16~~:r,,
..~;_e..~-c~.,!hea~i1Ye ~.~d,i5 p~~ch~e~:~~
~s~~r~;I~p~~:~ ~1,~~~~. ~?"':~
"'me ,Large MOl4h'Plffleri>er stinj,lml-l
~ah;~rUlCliste>d.~.~~~,~~
,
Date Received:
FEB - 5 2010
Original submittal
@b9US1ED
42
Large Mouth Polyethylene Dispenser Sumps
~'
- '
- -
- -
- -
- -
- . =
-----
lMM,1410 28" lMD-14l0 43" 13,50" ~ 28- 58K-2
I;j....,~~..,~"", . . ~.'''''.<7..,,~ "...."N.,". "'~-'5 m1]. ,g, ",';."',' ~,rn,"1'0!],38l~,"~~.~,2~1.-:'~'" ~'''''''',-''~2'8'.~,~'.'.!1.1'' '_I' ,i,~"'''<V,C"~2;F
t~JAi)J.1O:~";;,, - - <~f!28.!.o;JiifA': .~;::t.:t:2.lMD-;1~JP 'f', -'. (43 _ - " .l'_~, . - ,....~ _ - - --,. _ ~_'"
_ -. ..-...'" .ii!1i-.;,~.,-;::r"". .Iit"""-.' _"'~_'M_,,,
lMM,1913-T 28" lMD-1913-T 43" 19,00" 12,00" 24" 28- 58K,25
~"'''''J!!m''~'''''~ ~~~" >-11~' '". ......~.~ ~...' "'~'!1:-';~ ~~ ~~n":!'m f,fi'~''''''Jj IQ;-!'-',n ~~"""''''''''
~~M~'J!t~:~};~~~ ~~11 M:~1~~~,9J&~~ ~~3~ - ~~iiiillS:i:IU::MY;~' - -, '2~.~~ rr~~ ~;~~!LK~2~.
lMM-2018 28" lMD,2018 43" 20,81" 18.31" 24" 28" S8K-3
!17~""""""""""- ~'., j~, ," ...~," ~ !l;f'-"" ....~1iI ~"'::""l K"_~" ...".","I"oi 1Il;.~. =-
ill\1M;)21~,~:!1ilQ'B~ 1ll"Jj!:,,;~~ ';%~~i:!:~1.2.",,~;t'.:! ~!~4~~j ~f~'~~ ;i,i]WS~ ~w..3.6:".J.'..;~ ~'"-1 ~~;7.ic.;.,
lMM-2212'24 28" LMD,2212,24 43" 22.5" 11.2S" 24" 28" S8K-2S
~~~"'m ~1lit.! ::a;ifup'1:iY3~ ~3~ ~3.():o~ EV~g t:~~1i~ ~:r~1I ~~fllil
lMM-2407 28" lMD,2407 43" 23,75" 7,50" 36" 40- 58K-1
~',.,~~~~~ ""-""~""~~~"",,';r.=.~~III'~:~~"!mI"!!"f~
t~;2p02.oi~ :I>~k~~ l'i~r:!ID')1n~ ~!l3"'Qiili.~.p"",,,,Q.0";.... _,~tt., '40~i~ ~~K'2.r...
lMM-2518 28" lMD,2518 43" 24,75" 17,75" 36" 40" 5BK,3
~ """'-'a~" ~~~'~~''''I';.~iB~~''-''''~''''''''''''''''mJ~..~1lt~''''1~''''''''"''''
lMM,271S"~!:-i""" ,,'28~" ~j;'Gc"LMl?-271Sj<, ,,-,,', .A"" '2',,~~~;OO""li,.~6::'C.'l' ,c.'40....'," '~5BK;3,~'i';
~""'''iIIll5lUt'"''X "W""" ~..,,",_'L_';......_.'..-_.... .~_ .~. " . .-......~.... "--__.,..<'1' ._\~- . . ':oc;,I>iI_'"
lMM-2811 28" lMD-2811 43" 28,50" 11.00- 36" 40" 58K-25
~~~~~~~!?Jj~~~1~~s~1.J~~~~~mI:J~gn(~
lMM,2915 28" lMD,2915 43" 29,75" 15,75" 36- 40- 5BK-3
fj:~J31~i_*A~~W2~_~1l~mt!3iOO~~1l~~i'~';3r~j:
lMM,3610 28" lMD,3610 43" 36,00" 10,25" 48" 52- 58K-2
F:l;""":C:-RRi'-' ~' 'tE"'''~'-'''''''~~' ~'~ llID-~' ~"~'1'''~~~-r.1E''''"'
'M"b617,~' '" 28 '. ,;")'.lMI>'3617"""'J '-43"',, ,..oo~, "1.',25'" "J6.".I.,,'Ii'40~* ,'S8K'3....
.....r~,,;,.;Ioo:. '.....:....,..,,; ...~.-...- .... r"7.i ~;..<~ . . -. 'l;.' ~ U!' ,.c;:.~'lI-' ~ . ,.._.-,;>.._
lMM,3914 28" lMD,3914 43- 38,75" 14,00- 48" 52" 58K-25
m:'I':>;;m~j".""~ ~..]a.~,"'" ~, ,,~~';I ~~ t~,-.;>~~ Iii' "....',y... ""'" ,'. ~'-~
~~~_' <~~8"f~i~'~~~lM!L-tQ~~L4~;:~ '~~A ~ JI~~ ~15~~:' .\ !}~~'}~
lMMA109 28" lMD,4109 43" 41,50" 9,38" 48- 52' S8K-2
[(;'i~;iW~a~id~ Et.:.t~M.P~F1J;:~~ "4150'." ~~ ~~.~ ~~:;J f~~~~
lMMAl13 28" lMD,4113 43" 41.50" 13,25" 48" 52" 5BK,25
ti;Mt,4;!l~~ r~~1fm_~1~ ~~f:50, ,'J,1~'i5r';~~'3 ~t~ C!K.:~~
..
DEEP MODEL
Medium and Deep Model numbers listed include base and top, stabilizer bar kits. (SBK) sold separately.
1.
4,00
IT
GROUND LEVEL
~ CONCRETE
DISPENSER
JJ -~L
.. . ~ .~.
I <,~ _ "..
43
Original submittal
XP Pressure and Suction
Product Piping
The 1 R size of APT piping can be used in both pressure and suction applications. and is ideal
for providing remote feed and fill for heaters, boilers and emergency generators. The lYz",
13/4" and 2- sizes of APT product piping can be used in both pressure and suction applications.
and are ideal for underground service station fuel delivery systems. The D-Series piping is a
single wall, direct bury piping. while the SC.Series piping provides additional environmental
security as a secondary contained direct bury pipe. Both feature controlled flexibility. even in
low temperatures. permitting fast, easy installation.
Model
DeSCription
XP.100,SC
'" secondary con-
tained
XP,l00,D
l"slnglewa~
XP.150,SC
117" secondary
contained
.',
'.
XP-150,D
l~.slngle~a.1I
XP,175.5C
1~. secondary
contained
'f~~
XP-17S,D
'.. ",
1 v... ,Single wall
,
XP,200-SC
2~ secondary con.
talned
XP,200-D
.;. 2- single 'wail
.-
\~
l:r::r::I"'lU..-
Small '86. 24 .64Y2
standard
rStandard
,(Std,)
large
standard
(L~Std,)
.MaSter
Super tna5ter
(S,M.,t,)
Notes: 1. Do not store piping In direct sunlight.
2. Ul971 listed to the .1anuary 2004 standards.
'Reel dia. . width x hub dia.
213,3 , 60,9 . 163.8
86 x 42~ . 63~' 218,4, 107,9 x 161,2
86 . 52 . 63Y2
;~, 91 l( 33 x.74
91.52.74
"
''1 ~
FEB - 5 2010
~-'-:~~I C:"hmittal
218.4 , 132,1 . 161,2
231,1 .83.8 x 187.9
231,1.132,1' 187,9
Weight
lbs. Kg
486
593
1.478
443
50S
435
518
655
965
1,240
1.535
410
455 ';,
530
715
865 ,
1.035
485
655
830
1.355
455
" 580
680
1,115
585
690
848
1.250
',545 ..
I:
219
267
665
199
227
196
233
295
434
558
691
185
205
239
322
389
466
218
295
374
610
205
261
306
502
263
311
381
S63
24S
215
318
431
--
250 Small
500 Small
2.500 Std,
250 Small
500 Small
100 Small
250 Small
500 Small
1.000 Std.
1.500 Std.
2.000 Lg. Std.
100 Small,
!"~. L,,250 Sffiall''''~
500 .~ ~ Sma" ~ f
1.000 {cStd.
1.500 Sid.
2,000 Lg, Std,
100 Std.
250 Master
500 Master
1.000 S. Mast.
100 5"1, ,
250 "';... Master
500 ~.
'1,000 S, Mist,
100 Master
200 Master
350 Master
700 S.Mast.
100 Mastfu-. ~.\
~ ,. ~ ..-'~
200 .~ ~ Master~, ~ 610,
350 " ~ 1'MasteriID \ '=< 708'1"
, 9ate.R8e8ived;910
,
~
"';"".:(;,;,i;;:>: ,;. -r~,~"
,Vl"',,,,""" '...'.
r~,~?;~~j;'F:f.;r.._.
,k;i,lr;1".:t....If}_~,"
_'I'!:'h'~fr..,&: ,,~_~ ~
XP Piping Construction
NYLON 12
MYLAR
NYLON
FIBER
MYLAR
,
NYLON 12
NYLON 12 NYLON 12
XP Piping Dimensions
00 SCUFF
rf~t~Received:
FEB - 5 2010
10 PRIMARY
LAYER
Original submittal
"
------
XP,100-0 1.00" 1,27' nI. nI. 36,00- "''1.
l Xp-100-se, -", 1.oo"C 1,S02" 36,00- ,
1,27' 1,47'
nI. 36,00- ,
XP,1S0,O 1.40" 1,70- nI.
XP-150-SC 1:40' .. 1,70" 1,90" 1.925' 36.00"
XP,17S,O 1,6S" 1,9S" nI. nI. 36,00" f
! XP-.17S;SC . .' ,l.6S" 1,95" 2.1S' 'J 2,175' 36,00"
..
XP,200-0 2,04" 2.45" n/. n/. 36,00-
. Xf-200-SC . 2.!l4;" " 2.45" 2,65" 2,67S" '36,00"
~ Franklin Fueling Systems
www.franklinfueling.com
3760 Marsh Road' Madison, WI 53718, USA
Tel: + 1 6088388786. Fax: + 1 6088386433
Tel: USA & Canada 1 800 225 9787' Tel: Mexico 001 800 738 7610
~PE,.
MEMBER