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UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS -TANK PAGE 2 <br /> Pp. a _ <br /> VL PIPING CONSTRUCRON(CUMPL-0 MM Appy) <br /> UBDEROLOUNlD PIPING ABOVEGROUND PIPING <br /> SYSTEM TYPE ❑ 1. PRESSURE m 1 SUCIION ❑1 GRAVITY .SB ❑ 1. PRESSURE ❑2 SUCT IN ❑].GRAVITY - 459 <br /> CONSTRCTCW❑ 1. $INGIEIVALL ❑1 UNEDTRENCN ❑n. OTHER .e0 ❑ I. SINGLE WALL ❑9s. uNKRDWM .BZ <br /> MANUFACTURER E 2. DOUBLE WNL ❑91 UNKNOIVN ❑2 DOUBLE WALL ❑" OTINER <br /> MANUFACTURER .Bt MANUFACTURER AM <br /> ❑ t.BARE STEEL ❑5. FRP COMPATIBLE WI 100%METHANOL ❑ 1. BARE STEEL ❑ 0.FRP COMPATIBLE W/MOOR METHANOL <br /> MATERIALSANo ❑ z STAINLESS STEEL ❑ T, GALVANZEDSTEEL ❑ 2 STABAESSSTEEL ❑ r. GALVANIZEDSTEEL <br /> CORROSION <br /> 13LA <br /> PROTECTION ]. PSTIC COMPATIBLE WITH CONTENTS 13 95. UNIRNOWN ❑ ]. PLASTIC COMPATIBLE WITH CONTENTS B.FlE%IBLE INOpEI 99. DIALER <br /> .. FIBERGLASS ❑S.FLEXIBLE(HOPE) ❑99 OTHER ❑.. FIBERGLASS ❑ 9. CATHODIC PROTECTION <br /> ❑ S STEELVOCOATING ❑9. CATHODIC PROTECTION .SA 10 5. STEELW(COATNG 095. UNKNOWN .85 <br /> VII.PIPING LEAK DETECTION(CIAEA✓mM Appy) <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SMGLE WALL PPW6 .59 SINGLE WALL PIPING .Br <br /> PRESSURRPD PIPING(ChA Ymu appy): PRESSURIZED RRNG(GAO AF maT.ppy/: <br /> ❑ 1, ELECTROMC UNE LEAK DETECTOR 10 GPN TEST WM AUTO PUMP SHUT OFF FOR ❑ 1. ELECTRONIC UNE LEAK DETECTOR)0 GM TEST WITH NITO PUMP SHUT OFF FOR LEAH( <br /> LEAK SYSTEM FAWRE AND SYSTEM DISCONNECTION•AUDIBLE AND VISUAL SYSTEM FAILURE AND SYSTEM DISCONNECTR]N•AUDIBLE AND WSUALAARME <br /> ALARMS ❑ 2 MONTHLY 02 GPH TEST <br /> ❑ 2 MONTHLY 02 GPH TEST ❑ 1 ANNUAL INTEGRITY TEST(0.1 GM <br /> ❑ 1. ANNUALINTEGRIIY TEST(0.1 GPH) ❑ ., DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS/Check 00 Algyl: <br /> COWENTCHAL SUCTION SYSTEMS. <br /> ❑ S.ONLY VISUAL MONITORING OF PUMPING SYSTEM•TRIENNIAL RANG INTEGRITY ❑ S. MLYVLSUALMONTORINGOFRRNGANOPUMPMGSYSTEM <br /> MST(0.1 GPH) ❑ S. TRIENNIAL INTEGRITY TEST(0 GRH) <br /> SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING)- <br /> ❑ ]. SELF MONITORING ❑ T. SELF MONITORING <br /> GRAVITY FLOW GRAVITY FLOW(CM 0M Appq: <br /> ❑ S. BIENNIAL INTEGRITY MST(0.1 GPHI ❑ 1 GAILYVISILV.MCNITORING <br /> ❑ 9. BIENNIAL INTEGRITY TEST(0.1 GPM) <br /> SECONDIUNLY CONTAINED PIPMG 5ECONDARILY CONTI MED PIPING <br /> PRESSURIZED PIPING(CA.ck✓MAI appy): PRESSURIZED PIPING(C11eG'✓mN appy): <br /> 10.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10 CONTINUOUS TURBINE SUMP SENSORS ALMBLEAHOVISUALALARMS AND(Mt <br /> ICI19G p1IAM ppA) <br /> ❑ L AUTO PUMP SHUT OFF"EN A LEAK OCCURS ❑A AUTO PUMP SHUT OFF VMEN A LEAK OCCURS <br /> ❑ p. AUTO PUMP SHUT OFF FOR LEANS.SYSTEM FAILURE AND SYSTEM <br /> OISCONNECTION ❑0.AUTO PUMP SIM OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION <br /> ❑ G NO AUTO RUMP SHUT OFF ❑c NO AUTO RUMP SIM OFF <br /> ❑ 11.AUTOATIC UNE LEAK OETECTOR Oa CIH TESTWITHFLOMI SHUT OFF OR <br /> RESTRICTION ❑ 11. AUTOMATIC LEAK DETECTOR <br /> ❑ IZAN9UALINTEGRITYTEST(0.1G'H) ❑ 13. ANNUAL INTEGRITY MST IDA GF" <br /> SUCTION IGRAV RY SYSTEM: <br /> 7 11 CONTNUOISSUMPSENS R.AUDIBLEARDVISULLAL SUCTIONGRAVITYSYSTEIt <br /> ❑ 11. COMINuOUSSWPSENSOR-AUDIBLE AND WSUALAWLNS <br /> EMERGENCY GENFJUTORS OILY(CIleC9✓pMt appy) <br /> EMERGENCY GENERATORS GILT(CMptNmu eget') <br /> ❑ 14. CONTINUOUS SUMP SENSOR wT1 AUTO PUMP SHUT OFF.AUDIBLE AND <br /> INU <br /> VISUAL ALARMS ❑ 1.. CDNTMUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF.AUDIBLE AND VISUAL <br /> 13 15.AUTOMATIC UGPH TNE LEAK DETECTOR GTEST TAT Rm SHUT OFF OR ALARMS <br /> 13 t5. AUTOMATIC LINE LEAK DETECTOR(].0 GPM TES <br /> RESTRICTION <br /> T <br /> ❑ N.ANN m,INTEGRITY TEST 10.1 GPH) ❑ 15 ANNuALINTEGWTY TEST(GI GRH) <br /> ❑ IT. ONLYVISUALCIRCK <br /> ❑ tT. DAILY VISUALCHECK <br /> VM.DISPENSER CONTAINMENT <br /> DISPENSER CONTANMENf ❑ t. FLOAT MECHANISM THAT SIMS OFF SHEAR VALVE ❑.. DAILY VISINLCNECK <br /> DATE INSTALLED NIS ❑ Z CONTINUOuS DISPENSER PAN SENSOR•AUDIBLE AND VISUAL ALARMS ❑9. TRENCH LINER) <br /> MONITORING <br /> ❑]. CONTINUOUS DISPENSER PAN SENSOR MTM AUTO SHUT OFF FOR DISPENSER-AUOUILE AND V15UAL ALARMS 0 B ROME U9 <br /> IK 099NERIOPERATOR SIGNATURE <br /> I HRTM,tl M.KIPTIMIRI IF Ta MIC IKCF6maW M4amy Iu1vMNp9A. 1 <br /> DATE <br /> TORE OF <br /> as owner agent 4/13/00 .JO <br /> NAME OF OWH TOR(PImO 471 TITLE OF pWNER,OPERATOR .r2 <br /> Barry E. Edmiston Administrative Assistant <br /> PlAtlr Nun9►IFnlplalur AWYI <br /> 4r1 pAMpMAppRM fFPINAW us prryl .T. 1 PH EMN DAM fFarMOMpv pnyl.r5 <br /> I <br /> UPCF(1199) Famledy SV%RCS FoaIT B <br /> v <br />