Tank Information

Tank Owner:
Tank Location:
Tank Number:

Tank Size

Diameter:
Height:
Capacity:
Is the Tank Insulated?	YesNo
If Yes, Type of Insulation:

Shell Construction

Butt Welded	Number of Courses:
Lap Welded	Number of Courses:
Butt Rivited	Number of Courses:
Lap Rivited	Number of Courses:

Material of Construction for the Shell:
Date the Tank was Built:
Date Bottom was installed if different than Age of Tank:
Tank Manufacturer:
Product to be Stored in the Tank:
Product Gravity:
Maximum Safe Fill Height Used by the Facility:

Type of Fixed Roof

Cone:
Geodesic Dome:
None:
Other:

Type of Floating Roof

Aluminum Pipe Pontoon:	Internal Steel Pan:	Internal Steel Pontoon:
Internal Double Deck:	External Steel Pontoon:	External Steel Pan:
External Double Deck:	Unknown:	Other:

Seals

Type of Primary Seal:
Type of Secondary Seal:
Age of Primary Seal:
Primary Seal Maufacturer:
Primary Seal Maufacturer:

Owner/Contact Information

Name of Person Requesting Quote
Are you the Tank Owner or the Owner's Authorized Representative?	YesNo
Name of Owner's Contact:
Telephone Number of Contact:
Contact's Address: