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

District: SWD Type: Fuel User/Non-Retail
County: Polk Status: Open
Facility ID#: 9812554 Latitude: 27:56:49.9200
Name: Hampton Inn & Suites-Lake Wales Longitude: 81:37:04.4400
22900 Hwy 27 LL Method: DPHO
Lake Wales, FL 33853 LL Status: REVIEWED
Contact: Manager On Duty Status Date: 07//19/2012
Phone: 863-734-3000

Account Owner Information
Name: Hampton Inn & Suites Effective Date: 04/24/2013
22900 Hwy 27 Placard#/Date: 582098 - 06/11/2020
Attn: David Glausser
Lake Wales, FL 33859
Phone: 863-763-7439

Tank Owner Information
Name: Kkm Enterprises Inc 100% Effective Date: 02/24/2011
2301 Longleaf Blvd
Attn: Storage Tank Regis
Lake Wales, FL 33859-2548
Phone: 863-734-3000

Tank
#		 Size Content Installed Placement Status Const Pipe Monitor
1 1500 Emerg Generator Diesel
02/01/2008
ABOVE
U
C
I
M
P
N
A
I
Q
F
2

***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
02/04/2015
02/04/2017
  Crum & Forster Indemnity
Insurance
02/04/2013
02/04/2015
  American Safety Indemnity Co
Insurance
02/04/2013
02/04/2015
  American Safety Indemnity Co

No OPEN violations found!

No Discharge Information Found!


End of Data for Facility #: 9812554