FDEP Storage Tank Inspection Cover Page for: 8943418

Florida Department of Environmental Protection
Bureau of Petroleum Storage Systems
Facility Inspection Cover Page

Facility Information

District:	SWD	Type:	Retail Station
County:	Polk	Status:	Open
Facility ID#:	8943418	Latitude:	28:10:43.2433
Name:	Polk Nrg Llc	Longitude:	81:49:45.7383
	501 Commonwealth Ave Sw	LL Method:	DPHO
	Polk City, FL 33868-9704	LL Status:	REVIEWED
Contact:	Lucas Velez	Status Date:	07//26/2011
Phone:	786-888-3310

Account Owner Information

Name: Polk Nrg Llc Effective Date: 12/17/2013

4014 Chase Ave Suite 220 Placard#/Date: 588375 - 06/25/2020

Attn: Storage Tank Regis

Miami Beach, FL 33140

Phone: 305-434-0001

Tank Owner Information

Name: Polk Nrg Llc Effective Date: 10/31/2016

4014 Chase Ave Suite 220

Attn: Storage Tank Regis

Miami Beach, FL 33140

Phone: 305-434-0001

Tank
# Size Content Installed Placement Status Const Pipe Monitor

6 12000 Unleaded Gas 05/01/2006 UNDER U E
M
N
O
P
I
N
M
J
K
F
H
2
K
4
1

7 12000 Vehicular Diesel 05/01/2006 UNDER U M
N
P
O
I
E
N
M
J
K
H
F
4
K
2
1

5 15000 Unleaded Gas 05/01/2006 UNDER T E
A
N
M
O
P
I
N
M
J
K
F
H
K
2
1
4

1 10000 Unleaded Gas 04/01/1989 UNDER B
2 10000 Unleaded Gas 02/01/1989 UNDER B
3 10000 Unleaded Gas 02/01/1989 UNDER B
4 10000 Vehicular Diesel 02/01/1989 UNDER B

***Note: Construction, Piping, and Monitoring Info not shown
for CLOSED tanks (Status of A or B).

Most Recent Insurance Document

FR Type Effective
Date Expiration
Date Company Name

Insurance Ace American Insurance Company

Insurance 07/17/2019 07/17/2020 Crum & Forster Specialty Ins.

Insurance 07/17/2018 07/17/2019 Crum & Forster Specialty Ins.

Insurance 07/17/2017 07/17/2018 Crum & Forster Specialty Ins.

Insurance 07/17/2016 07/17/2017 Crum & Forster Specialty Ins.

Insurance 07/17/2015 07/17/2016 Ace American Insurance Company

Insurance 07/17/2013 07/17/2014 Ace

Insurance 12/31/2011 12/31/2012 Liberty Mutual

Insurance 12/31/2010 12/31/2011 Zurich-American

Insurance 12/31/2009 12/31/2011 Zurich-American

Insurance 12/31/2007 12/31/2008 Zurich-American

Insurance 04/26/2005 04/26/2006 Zurich-American

Insurance 09/01/1989 10/01/1998 Fplipa

Open Violations

Insp Date Viol # Sig
Level Violation Text

04/22/2005 1077 B Single Walled Pressurized Piping Does Not Have Mechanical Leak Detectors / Annual Tightness Test, Or Electronic Leak Detector

04/22/2005 1103 N Ust Line Leak Detector Cannot Detect 3.0 Gph Discharge, Not Tested Annually

Discharge Information

Discharge
Date Cleanup
Status Score Eligibility Info Site Manager Phone

12/17/1992 Completed 75 Petroleum Liability And Restoration Insurance Program-Eligible Sinback_Ga

04/16/1994 Completed 75 Petroleum Liability And Restoration Insurance Program-Eligible Sinback_Ga

End of Data for Facility #: 8943418

Name:	Polk Nrg Llc	Effective Date:	12/17/2013
	4014 Chase Ave Suite 220	Placard#/Date:	588375 - 06/25/2020
	Attn: Storage Tank Regis
	Miami Beach, FL 33140
Phone:	305-434-0001

Tank #	Size	Content	Installed	Placement	Status	Const	Pipe	Monitor
6	12000	Unleaded Gas	05/01/2006	UNDER	U	E M N O P I	N M J K	F H 2 K 4 1
7	12000	Vehicular Diesel	05/01/2006	UNDER	U	M N P O I E	N M J K	H F 4 K 2 1
5	15000	Unleaded Gas	05/01/2006	UNDER	T	E A N M O P I	N M J K	F H K 2 1 4
1	10000	Unleaded Gas	04/01/1989	UNDER	B
2	10000	Unleaded Gas	02/01/1989	UNDER	B
3	10000	Unleaded Gas	02/01/1989	UNDER	B
4	10000	Vehicular Diesel	02/01/1989	UNDER	B

FR Type	Effective Date	Expiration Date	Company Name
Insurance			Ace American Insurance Company
Insurance	07/17/2019	07/17/2020	Crum & Forster Specialty Ins.
Insurance	07/17/2018	07/17/2019	Crum & Forster Specialty Ins.
Insurance	07/17/2017	07/17/2018	Crum & Forster Specialty Ins.
Insurance	07/17/2016	07/17/2017	Crum & Forster Specialty Ins.
Insurance	07/17/2015	07/17/2016	Ace American Insurance Company
Insurance	07/17/2013	07/17/2014	Ace
Insurance	12/31/2011	12/31/2012	Liberty Mutual
Insurance	12/31/2010	12/31/2011	Zurich-American
Insurance	12/31/2009	12/31/2011	Zurich-American
Insurance	12/31/2007	12/31/2008	Zurich-American
Insurance	04/26/2005	04/26/2006	Zurich-American
Insurance	09/01/1989	10/01/1998	Fplipa

Insp Date	Viol #	Sig Level	Violation Text
04/22/2005	1077	B	Single Walled Pressurized Piping Does Not Have Mechanical Leak Detectors / Annual Tightness Test, Or Electronic Leak Detector
04/22/2005	1103	N	Ust Line Leak Detector Cannot Detect 3.0 Gph Discharge, Not Tested Annually

Discharge Date	Cleanup Status	Score	Eligibility Info	Site Manager	Phone
12/17/1992	Completed	75	Petroleum Liability And Restoration Insurance Program-Eligible	Sinback_Ga
04/16/1994	Completed	75	Petroleum Liability And Restoration Insurance Program-Eligible	Sinback_Ga