@extends('master')
@section('content')
<div id="content">
   <div id="sortable-panel" class="">
      <div class="col-md-12 ">
         <div  class="panel panel-default">
            <div class="panel-heading">
               <div class="panel-title">
                  Add facility information
                  <div class="bars pull-right">
                     <!--<a href="#"><i class="maximum fa fa-expand" data-toggle="tooltip" data-placement="bottom" title="Maximize"></i></a>-->
                     <a href="#"><i class="minimize fa fa-chevron-down" data-toggle="tooltip" data-placement="bottom" title="Collapse"></i></a>
                     
                  </div>
               </div>
            </div>
            <div class="panel-body">
               <form  class="form-horizontal">
                  <div class="col-sm-12">
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Account Name
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Account Name" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           FID/State Clean Up
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here FID/State Clean Up" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Owener ID
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Owener ID" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Property Card Link
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Property Card Link" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Status of Facility
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Status of Facility" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Operator Company Name
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Operator Company Name" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Property Owener Company Name
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Property Owener Company Name" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           UST Owener Company Name
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here UST Owener Company Name" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Client Company
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Client Company" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="panel-title">
                     Facility Contact Information :
                  </div>
                  <hr style="height:1px;border-width:0;color:gray;background-color:gray">
                  <div class="col-sm-12">
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Address
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Address" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           county
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here county" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Phone
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Phone" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="panel-title">
                     Existing Client Information :
                  </div>
                  <hr style="height:1px;border-width:0;color:gray;background-color:gray">
                  <div class="col-sm-12">
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Existing Client
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Existing Client" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           MGT Project
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here MGT Project" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           MGT Paid Service
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here MGT Paid Service" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           USSBOA Project
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here USSBOA Project" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           USSBOA Paid Service
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here USSBOA Paid Service" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           UST Inspector
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here UST Inspector" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="panel-title">
                     UST Information :
                  </div>
                  <hr style="height:1px;border-width:0;color:gray;background-color:gray">
                  <div class="col-sm-12">
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Document Type
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Document Type" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Document Link
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Document Link" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           UST Last Update
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here UST Last Update" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Tank Installaton Year
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Tank Installaton Year" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Tank Type
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Tank Type" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Tank Status
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Tank Status" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           No Of Tanks
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here No Of Tanks" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Tank Substance
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Tank Substance" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="panel-title">
                     Golars Tank Compliance Management :
                  </div>
                  <hr style="height:1px;border-width:0;color:gray;background-color:gray">
                  <div class="col-sm-12">
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Release Detection Test
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Release Detection Test" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Line and Leak Detector Test
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Line and Leak Detector Test" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Operator A Certificate
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Operator A Certificate" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Operator B Certificate
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Operator B Certificate" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Operator C Certificate
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Operator C Certificate" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Notification Form
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Notification Form" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Tank Testing Report
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Tank Testing Report" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Cathodic Protection(Anode)
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Cathodic Protection(Anode)" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Cathodic Protection
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Cathodic Protection" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Internet Lining Inspection
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Internet Lining Inspection" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Repair Documents
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Repair Documents" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Finacial Responsibility
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Finacial Responsibility" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="panel-title">
                     Notification Form Information :
                  </div>
                  <hr style="height:1px;border-width:0;color:gray;background-color:gray">
                  <div class="col-sm-12">
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Facility Operator POA
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Facility Operator POA" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Property Owener POA
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Property Owener POA" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           UST Owener POA
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here UST Owener POA" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Operator Affidavit Of Lease
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Operator Affidavit Of Lease" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Deed or Land Contract
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Deed or Land Contract" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           SOS Status
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here SOS Status" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Payment Received
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Payment Received" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                     <div class="col-sm-6">
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Letter Of Nerworth or COI
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Letter Of Nerworth or COI" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           LON or COI Expiry Date
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here LON or COI Expiry Date" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Effective Date of Owenership
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Effective Date of Owenership" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Notification Form Summitted
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Notification Form Summitted" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Notification Form Approved
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Notification Form Approved" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           COFA Link
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here COFA Link" id="form-field-1" class="form-control">
                           </div>
                        </div>
                        <div class="form-group">
                           <label class="col-sm-4 control-label" for="form-field-1">
                           Tax ID Information
                           </label>
                           <div class="col-sm-8">
                              <input type="text" placeholder="Enter Here Tax ID Information" id="form-field-1" class="form-control">
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="form-actions text-right">
                     <button type="submit" class="btn btn-success" name="add_material">Submit</button>
                  </div>
               </form>
            </div>
         </div>
      </div>
      <!-- end panel -->
   </div>
   <!-- end .col-md-6 -->
</div>
<!-- end col-md-12 -->
@endsection

