The information required to be submitted by Env-Or 506.02 shall be as follows:

1. (a) The name, physical address, mailing address, main telephone number including area code, main fax number including area code, and site number of the gasoline distribution facility;
2. (b) The name, mailing address, daytime telephone number including area code, fax number including area code, and email address of each owner of the gasoline distribution facility;
3. (c) The name, mailing address, daytime telephone number including area code, fax number including area code, and email address of the individual who is responsible for the stage I system at the gasoline distribution facility;
4. (d) A description of all stage I equipment at the gasoline distribution facility, including but not limited to the 2-point or coaxial stage I system and, if there is a 2-point system, a statement as to whether the dry break adaptor is located on the manifold or on the tank;
5. (e) The number of gasoline storage tanks at the gasoline distribution facility and for each tank, the size of the tank and the grade of gasoline contained in the tank;
6. (f) The date when construction, installation, or substantial modification of any stage I equipment at the gasoline distribution facility occurred.

Source. (See Revision Note #1 and Revision Note #2 at chapter heading for Env-Or 500) #10229, eff 11-17-12; ss by #13458, eff 10-7-23