HomeMy WebLinkAbout12719 009495 101 06-08-2021 CHIOWN LAH CHANGE IN OWNER 72025.85 CHIOWN pDE4.f
ADEM REeffivitu
UNDERGROUND AND ABOVEGROUND STORAGE TANK p JUN 1 S 2021
TRANSFER OF OWNERSHIP FORM o I
Alabama Dept. of Environmental Management Phone#(334) 270-5655 oWgTER
Groundwater Branch/Land Division Fax# (334) 270-5631
P. O. Box 301463 E-mail: ustcompliance@adem.alabama.gov
Montgomery, AL 36130-1463 Web Site: adem.alabama.gov
FACILITY INFORMATION
Former Name of Facility:United Food&Fuel#5 1 ADEM Facility I.D. Number: 12899 - 101 - 9495
Location street or highway): 4685 Highway 80 W. I No. of USTs included in transfer: 2
City, County: Montgomery,Montgomery I No. of ASTs included in transfer: 0
Transfer of Ownership Date:
FORMER OWNER INFORMATION
Owner Name: McNeill Family Partners,LP Owner Phone Number: 334 263 - 9070
Address: 3241 Money Road
City, State, Zip Code: Montgomery,AL 36108
1 certify under penalty of law that I am familiarwith the above information,and 1 believe that this information is true,accurate antl wmplete.
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Si natureofformer owner' G .,C ' C Date: , V7 `"'(1
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NEW OWNER INFORMATION
Owner Com an Name: REM S Neil,LLC Contact Name:Kunal Kapadia
Owner Phone Number: 4 7 116 1 Contact Phone Number: 407 384 _ 1168
Address: 2018 S.Chickasaw Trait Contact Email: kuml@sunsmteoitcom
City, State, Zip Code: Orlando FL 32825
Company Email: kurml unst il.corn New Name of Facility: S q"
I certify under penalty71th a miliar with the above inform ion,antl I believe that[his information is true,accurate and complete.Si nature of new owne Date:
REQUIREMENTS
Any person who sells an unde ground storage tank (UST) or an aboveground storage tank(AST)
system must:
• Notify the Department of transfer of ownership by fully completing this form and returning it to the Department within
30 days from the date of transfer,
• Provide proof of transfer of ownership of the system by signing this form,
Any person who receives ownership of an existing underground storage tank(UST) or an aboveground
storage tank (AST) system must:
Provide proof of transfer of ownership of the system by signing this form
Please return the completed form within 30 days of transferring ownership to the Department by
mail, email or fax.
Once the completed form is received by the Department,the new owner will receive a letter acknowledging their new ownership.
With the letter will be an ADEM"Notification for Underground Storage Tanks"form#279 and/or"Notification for Aboveground
Storage Tanks"form#283 that will be partially completed.The new owner should check for accuracy and complete the form,
SIGN AND DATE the form, and submit to the Department within 30 days of receipt. Once this process is complete, ADEM will
send the new owner a copy of the tank certificate to be displayed at the site.
Please Note: If the former owner does not sign this form, you must provide a warranty deed or other approved
legal documents for proof of ownership. In addition, if there are any unpaid UST regulatory fees due at the time of
this transfer of ownership,the new owner is responsible for submitting payment to the Department.
ADEM Form 469 2/10 m2(revised 3/18)