Laserfiche WebLink
"'UNIFIED PROGRAM CONSOLIDATED FO'R"M <br /> TANKS <br /> UNDERGROUND STORAGE TANKS -TANK PAGE 2 <br /> t <br /> WING CONST that apply) <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SYSTEM TYPE 1.PRESSURE r 2 SUCTION 1-3. GRAVITY r 1. PRESSURE r 2. SUCTION r 3 GRAVITY 459 <br /> CONSTRUCT,.. r 1.SINGLE WWLL r 3. LINED TRENCH r99. OTHER r 1. SINGLE WALL 1'95. UNKNOWN 462 <br /> MANUFACTURE DOUBLE WALL 1-95. UNKNOWN r 2. DOUBLE WALL r99. OTHER <br /> R MANUFACTURER 461 MANUFACTURER 463 <br /> r 1.BARE STEEL r 6. FRP COMPATIBLE W 100%METHANOL r 1. BARE STEEL r S. FRP COMPATIBLE W 10D%METHANOL <br /> MATERIALS AND r 2 STAINLESS STEEL r 7. GALVANIZED STEEL 1-2 STAINLESS STEEL r 7. GALVANIZED STEEL <br /> CORROSION <br /> PROTECTION r 3.PLASTIC COMPATIBLE WTH CONTENTS 1-95. UNKNOVMI r 3. PLASTIC COMPATIBLE WITH CONTENTS 1-B FLEXIBLE(HDPE) r99. OTHER <br /> 4.FIBERGLASS r S FLEXIBLE(HOPE) r99. OTHER r 4. FIBERGLASS r 9. CATHODIC PROTECTION <br /> r 5.STEEL W COATING F9 CATHODIC PROTECTION 464 r S STEEL W COATING r95. UNKNOWN 465 <br /> GING LEAK DETECTION(y`�h <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 <br /> PRESSURIZED PIPING(Check ak&at AI PRESSURIZED PIPING(Check aM that apply): <br /> r 1. ELECTRONIC LINE LEAK DETECTOR 3.D GPM TEST WTHAUTO PUMP SHUT OFF FOR r 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPM TEST WITH AUTO PUMP SHUT OFF FOR LEAK <br /> LEAK SYSTEM FAILURE AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL SYSTEM FAILURE,AND SYSTEM DISCONNECTION*AUDIBLE AND VISUAL AURMS <br /> ALARMS - r 2 MONTHLY 0.2GPHTEST <br /> r 2 MONTHLYD2GPHTEST r 3, ANNUAL INTEGRITY TEST(.1 GPM) <br /> r 3. ANNUAL INTEGRITYTEST(D.1 GPM r 4. DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Check aM that AAPW-' <br /> r S DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING INTEGRITY r S DAILYVISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br /> TEST(0.1 GPM) r S. TRIENNIAL INTEGRITY TEST(0.1 GPM) <br /> SAFE SUCTION SYSTEMS(NO VALVES INBELOW GROUND PIPINGN SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING] <br /> r 7. SELFMCNITORING r 7. SELFMONITORING <br /> GRAVITY FLOW GRAVITY FLOW(CheckaM Mat apply'): <br /> r 9. B IENNIAL INTEGRITY TEST IDA GPM r B. DAILYVISUAL MONITORING <br /> r 9. SIENNIALINTEGRITYTEST(0.1GPM) <br /> SECONDARILY <br /> ZED PIPING(ChecPIPING kall hat applYl: SECONDARILY CONTAINED PIPING <br /> PRESSURIZED PIPING(Check aM that apply). <br /> tO. CONTINUOUSCheTIIRBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WWTL AUDIBLE AND VISUAL ALARMS AND(Neck Are) <br /> r AUTO PUMP SHUT OFF WHEN A LEAK OCCURS rA AUTO PUMP SHUT OFF WHEN A LEAK OCCURS <br /> b.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM r b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION <br /> DISCONNECTION <br /> I c NOAUTO PUMP SHUT OFF rc. NO AUTO PUMP SHUT OFF <br /> 5tII.AUTOMATIC LINE LEAK DETECTOR SD GPM TEST)WITH PLOWSHUT OFF DR r 11. AUTOMATIC LEAK DETECTOR <br /> RESTRICTION <br /> r 12. ANNUAL INTEGRITY TEST(0.1 GPM) r 12.ANNUAL INTEGRITY TEST(Ot GPM) <br /> SUCTIOWGRAVRY SYSTEM: SUCTION GRAVITY SYSTEM: <br /> r 13. CONTINUOUS SUMP SENSOR.AUDIBLE AND VISUAL ALARMS r13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY(Check aN that apply) EMERGENCY GENERATORS ONLY(Check aN Mat apply) <br /> r 14. CONTINUOUS SUMP SENSOR WTHOUT AUTO PUMP SHUT OFF+AUDIBLE AND 1- 14. CONTINUOUS SUMP SENSOR WTHOUT AUTO PUMP SHUT OFF AUDIBLE AND VISUAL <br /> VISUALALARMS ALARMS <br /> r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPM TEST)NTH WT FLOWSHUTOFFOR r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPM TEST) <br /> RESTRICTION <br /> r 16. ANNUAL INTEGRIIYTEST IDA GPM) 1- 16. ANNUAL INTEGRITY TEST IDA GPM) <br /> r 17. DAILYVISUAL CHECK 1-17. DAILY VISUAL CHECK <br /> u VIII.DISPENSER CONTAINMENT <br /> DISPENSER CONTAINMENT r 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE T 4. DAILY VISUAL CHECK <br /> DATE INSTALLED 468 F2 CONTINUOUS DISPENSER PAN SENSOR.AUDIBLE AND VISUALALARMS r S TRENCH LINER/MONITORING <br /> Jr-3. CONTINUOUS DISPENSER PAN SENSOR WTH AUTO SHUT OFF FOR DISPENSER-AUDIBLE ANDVISUAL ALARMS I'6, NONE 469 <br /> `d:Ai:'.i.:' i 'ir"fi.w. " :'a'+ '•`.£' '.'"f,- nr-'4N ?.1e�€�'Ses'..: v- <br /> I certify that the information provided herein is true artd accurate to the bast of my Nranvledge. <br /> -SIGN A OF ERATO DATE 470 <br /> � 6 <br /> 471 "' -""' ,,�_� �p 972 <br /> yly�i`7tiV1.TJF� <br /> I <br /> Permit Number(For/oca/use only) 473 Peune nppr.Ad(A�e/use oMy) �� 774 Permit Expiration Date(Forloca/useanly) 975 <br />