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ABOVEGROUND STORAGE TANK ULLAGE LOG - DELIVERIES ONLY <br />Use a Separate Lo Sheet for Each Tank 11 <br />Use either this form or its equivalent to document ullage (available capacity *) calculations as required by §3-4-2(a)(4)(B) of Colorado's <br />Storage Tank Regulations. Use the correct tank chart to convert from inches to gallons. If ullage is calculated by an ATG, it is acceptable <br />to save the ATG inventory tape that shows the ullage in gallons. Keep these records at least six (6) months. However, it is advisable to <br />keep records indefinitely, since they may be required as part of the compliance review concerning a claim for reimbursement from the <br />Petroleum Storage Tank Fund The requirement to determine ullage be ore delivery begins applies to all ASTs, including ASTs equipped <br />with overfill prevention equipment that stops delivery or sounds an audible alarm <br />Facility Fac. ID # <br />.Name Connell Resources, Inc. (if known) 18440 <br />Street <br />Address 5150 SE Frontage Rd. Product in Tank Diesel <br /> <br />City Fort Collins ZIP 8052{ Tank Capacity <br /> (gallons) 12,000 <br />Start Date Aril 10 <br />2009 End Date 90 % Capacity <br /> , (gallons) 10,800 <br />Example: If your tank is 1,000 gallons the 90% capacity would be 900 gallons. To determine the Ullage prior to a <br />delivery you would stick your tank and then convert the inches to gallons. Then you would subtract the converted <br />gallons from the 90% capacity to calculate the proper Ullage (ie; 900- 300= 600). Once this is complete you can add the <br />fuel, but make sure not to exceed the 90% capacity. <br />Date rr Gau a or Stick;Readin Conversions to Gallons *Ulla a Quanti Added Initials <br />12/01/07 15" 300 900-300=(600) 500 CW <br />Date Gauge or Stick Reading Conversions to Gallons *Ullage Quantity Added Initials <br /> d0® <br />?'al o 17 <br />A? <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />J <br /> 0 <br />g2 <br />- <br /> <br /> <br />c <br />l <br />q <br />- tC S c` <br /> ? <br />ID r-> <br /> . <br /> aoo <br /> <br />S _ n CF??Q C] <br />. <br /> l <br />011 _ ic? C7 <br /> <br />_ <br />I Llq <br />` <br />? <br /> Sam ? <br /> <br />_ 2- So o <br />7-21 c <br />REPORT SUSPECTED OR CONFIRMED LEAKS TO THE Div. OF OIL & PUBLIC SAFETY WITHIN 24 HOURS: <br />303-318-8547 <br />Colo. Dept. of Labor & Employment, Div, of Oil & Public Safety, 633 17`h St., Suite #500, Denver CO 80202 <br />303-318-8500; http://ops.edle.state.co.us <br />hap:Iloil.cdle.state.co.us/OIL/Inspectors/Inspection Forms/ASTs/AST Ullage Log 12_2007.doc