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04/17/2007 09:24 916-373-1172 WALTON ENGINEERIM1(G O 9�S-��IOPAGE�KIZ ��D,7, UNIFIED PROGRAM CONSOLIDATED FORM [ll TANKS UNDERGROUND STORAGE WANKS - TANK PAGE 2 ;'.';VUi•YI 1NG'CONS7'R'FI(,Td(ON' urli9rc', P 2of2 UNDEROROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ❑1,PRESSURE Q 2,SUCTION ❑3.GRAVITY 459. ❑ [,PRESSURE ❑2,STICTION ED.GRAVITY 459. CONSTRUCTION/ Q I.SINGLE WALL Q 3,LINED TRENCH ❑99,OTHER 460, Q I,SINGES WALL ❑95. 462. UNKNOWN MANUFACTURER 2.DOUBLE WALL ®95.UNKNOWN Q 2.DOUBLE WALL Q 99.OTHER MANUFACTURER Unknown 4M1I. MANUFACTURER 4m. 0 1.BARE STEEL 116,FRP COMPATIBLE W/100%METHANOL ❑L BARE STEEP ❑4 FRP COMPATIBLE W/100%METHANOL 0 2,STAINLESS STEEL Q 7.GALVANIZED STEEL 0 2,STAINLESS STEEL Ll 7.GALVANIZED STEEL. ❑3.PLASTIC COMPATIBLE"TIT CONTENTS [195.UNKNOWN ❑3.PLASTIC COMPATIBLE W/CONTENTS ©a.FLEXIBLE(HOPE) ❑99.OTHER ❑4.FIBERGLASS ❑8,FLEXIBLE(HOPE) Q 99.OTHER Q 4.FIBERGLASS ©9.CATHODIC PROTECTION ❑5.STEEL W/COATING Q 9.CATHODIC PROTECT70N 454, Q 5,STEEL W/COATING Q 96.UNKNOWN 465. VII'.'PIPING'L '.'Y{i' F'iT'ECTION'EiNRNII YhnI:A I.'A21 Yro69Tmemcmic' ro' Po'd1inll5ebmirieede dte taal'- UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WAIL PIPING 466, SINGLE WALL PIPING 467, PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): ❑L ELECTRONIC LINT LEAK DETECTOR 3,0 OPH TEST WITk3 AUTO PUMP Q I. F;LECTRONIC LINE LEAK DETECTOR 3.0 GPM TEST V=AUTO PUMP SHUT-OFF FOR LIjAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS. +AUDIBLE AND VISUAL ALARMS. E12. MONTHLY 0,2 OPH TEST ❑2. MONTHLY 0.2 GPM TEST 03. ANNUAL INTEORITYTEST(0.1 GPM) ❑3, ANNUAL INTEGRITY TEST(0.I QFH) ❑4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Chock all that apply) Q 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING Q5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INMORITY TEST(0.1 GPM) SAFE SUCTION RVSTEMS(NO VALVES IN BELOW GROUND PIPING): Q 6. TRIENNIAL INTEGRITY TEST(0.1 GPM) Q 7 SELF MONITORING SATE SUCTION SYSTEMS(NO VALVES M EFLOW GROUND PIPING): GRAVITY FLOW Cl 1, SELF MONITORING Q% OIENNIAL TNTEGRITY TEST(al GPM) GRAVITY FLOW(Check all That APply)i 08. DAILY VISUAL MONITORING C39. BIRNNIAL INTEGRITY TEST(0.1 GPM) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(rhook all that apply): PRESSURIZED PIPING(Check an that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ID. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(Check one) ALARMS AND(Check one) Q p, AUTO PUMP SHUT OFF WHEN A LEAK OCCURS Q a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [3b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE.AND SYSTEM Q b.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION NO AUTO PUMP SHUT OFF r3e, NO ALTO PUMP SHUT OFF 011. AUTOMATIC LINE LEAK DETECTOR(3.0 OPH TEST)0W FLOW SHUT 011 AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION [112, ANNUAL INTEGRITY TTST(0,1 GPM Q 12,ANNUAL INTEGRITY TTST(O,I GPM) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM ❑U. CONTINUOUS SUMP SENSOR+AUDn3f F.AND VISUAL ALARMS ❑13.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check PIT that apply) EMERGENCY GF.NRRATORS ONLY(Check all that apply) Q14. CONTINUOUS SUMP SENSOR I)tg'TJgW AUTO PUMP SHUT OFF Q14. CONTINUOUS SUMP SENSOR WITMOIlT AUTO PUMP SHUT OFF AUDIBLE AND VISUAL AI..ARMS AUDIBLE AND VISUAL ALARMS 015. AUTOMATIC LINE LEAK DETECTOR (AO OPH TEST) Y/J.ULQU2 FLOW Q 15. AUTOMATIC LINE LEAK DFTFCTOR(3,O GPH TEST) SHUT OFF OR RESTRICTION 010, ANNUAL INTEGRITY TEST(0.1 OPH) Q 16. ANNUAL INTEGRITY TEST(D.I GPH) Cl 11, DAILY VISUAL CHECK Cl 17, DAILY VISUAL CHECK 'W'h'.I:If1SPE'1VJE1k'!�f11!1T'AdTVMCY41`I'. DISPENSER CONTAINMENT 461. QI. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 04. DAILY VISUAL CHECK 4w. DATE INSTALUiO Q2. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS Q5. TRENCH/LINER MONITORING N/A ❑3. CONTINUOUS DISPENSER PAN SENSOR WM AUTO SHUT OFF FOR 06 NONE DISPENSER+AUDIBLE AND VISUAL ALARMS 174 OIVNMOPETUTOR.SI0'NATIIRP, I certify that c infomaort prnvided her9in is trot gd accurate to the ben of my knowledge SIGNATt1RF: F DATE:4/16/07 °N1 NAME OF ANERIOPERAToR(pdat); Michael E. Walton TITLE OF OWNER/OPERATOR: Contractor Ponnit Number(Agency car only) 473, Ponnii Approved By(Agency ace only) 474. Permit Eapustion Date(Agency use only) 475. UPCP hwfwmb(It")-314 http://m w.Pnidom.oig Rev 02/16/00