Automobile Dismantlers Supplemental Application Form Page 2
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47. Provide the following information on your storage practices:
Type
Number of
Capacity
Age
Distance to
Above or Below
Tanks
(gallons)
buildings (yards)
ground
Used gasoline
Used motor oil
Used transmission fluid
Used radiator fluid
Other: __________________
All tanks are provided with secondary containment systems.
Yes
No
Barriers are installed to prevent collisions with aboveground storage tanks.
Yes
No
Fuel dispensing equipment is UL approved.
Yes
No
If smoking is allowed on premises, is it in restricted areas away from flammable materials and “No Smoking” signs
posted where smoking is prohibited?
Yes
No
How are fluids disposed of: ________________________________________ By whom? _______________________
8. If you perform cutting/welding operations answer the following. If not, skip to question 9.
Cutting and welding areas are free of combustibles and cutting and welding cylinders are secured.
Yes
No
Cutting and welding oxygen cylinders are segregated from fuel cylinders.
Yes
No
9. Batteries:
Battery charges are checked and fully discharged prior to storage.
Yes
No
Batteries are regularly checked for leakage.
Yes
No
Describe how and where standard batteries are stored: ___________________________________________________
_______________________________________________________________________________________________
Describe how and where batteries are handled when any leakage is identified: ________________________________
_______________________________________________________________________________________________
10. If you perform vehicle sales/service answer the following. If not, skip to question 11.
Vehicles are sold exclusively on an “as is” basis. (Attach copy of Bill of Sale)
Yes
No
Average annual number of used auto sales over past 3 years: ___________________
Salvage title sales for the last 12 months: $ _________ Number of sales: __________
If a dealer’s license is required by the state, what is the name appearing on the license? ________________________
License number: __________________
Does a salesperson accompany the customer when test driving on every test drive?
Yes
No
If No, describe exceptions: _________________________________________________________________________
SAFETY/SECURITY
1. The facility is (check all that apply):
Fenced
Lighted
Gated
Locked after hours
2. Check below all that apply:
Central Station Alarm system
Local alarm/gong
Surveillance cameras
Motion Detectors
Motion alarm
Fence alarm
Dogs
Other:
Security Guards
Armed
3. Soiled rags and flammable liquids are stored in self closing UL listed approved containers.
Yes
No
4. Check below any formal employee training/certification you have:
Forklift
Crane
Tire de-rimmer/sheer
Vehicle crusher
Hazardous fluids/materials
Fire extinguisher training
MAIL 014 02 12
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Parent category: Business