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UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS- TANK PAGE 2 VL PIPING CONSTRUCTION creek m mu Pepe_ar_ UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ❑1.PRESSURE 0 2.SUCTION ❑3.GRAVITY 45e I.PRESSURE SUCTION ❑3.GRAVITY 4% coNsTRUc loN O 1.SINGLE WALL 0 3.LINED TRENCH 1399.OTI{ER a66 .SINGLE WALL ❑95.UNKNOWN 462 MANUFACTURER O 2.DOUBLE WALL O 95.UNKNOWN ❑2.DOUBLE WALL ❑99.OTHER MANUFACTURER 461 MANUFACTURER 463 STEEL ❑6.PER COMPATIBLE w/1004, METHANOL ❑).BARE STEEL (3 6.FRP COMPATIBLE w/100XMEIt1ANOL ❑2.STAINLESS STEEL Q 7.GALVANIZED STEEL ❑u h av E32. STAINLESS STEEL ❑7.GALVANIZED STEEL ❑3.PLASTIC COMPATIBLE W/CONTENTS ❑99. Otho ❑3. PLASTIC COMPATIBLE W/CONTENTS ❑8.FLEXIBLE(HDPE) ❑99.OTHER ❑4.FIBERGLASS ❑8.FLEXIBLE(HDPE) ❑4. FIBERGLASS ❑9.CATHODIC PROTECTION 1]5.STEEL W/COATING ❑9.CATHODIC PROTECTION 464 ❑5. STEEL W/COATING 0 95.UNKNOWN 465 VII.PIPING LEAK DETECTION L .fl"t A _W dib.mpti e6e0lz wlmivdmtbebal UNDERGROUND PIPING ABOVEURUUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(C a m.upply): PRESSURIZED PIPING(cb tW RatapplYY ❑1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT ❑1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST AUTO PUMP OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS. ❑2.MONTHLY 02 GPH TEST ❑2. MONTHLY0.2 GPH TEST 3.ANNUAL INTEGRITY TEST(0.1 GPH) ❑3.ANNUAL INIEGRIrY TEST(O.IGPH) AILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Cbaat.0 Thu apply) 13 5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING 0 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): ❑6. TRIENNIAL INTEGRITY TEST(0.1 GPH) ❑7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW (3 7. SELF MONITORING ❑9.BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Ch all Wat apply): ❑R. DAILY VISUAL MONITORING ❑9. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(mart W tbatapply): PRESSURIZED PIPING(Chat ell daa appy): 10.CONT24MUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR AUDIBLE AND VISUAL ALARMS AND(Cbxk..) ALARMS AND(Cbatam) O a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM ❑b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION 0..NO AUTO PUMP SHOT OFF 13c NO AUTO PUMP SHUT OFF ❑11. AUTOMATIC LINE LEAK DETECTOR(3.0 OPH TEST)MM FLOW SHUT [3 11. AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION ❑12. ANNUAL INTEGRITY TEST(0.1 GPH) ❑12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Cbak 91 ftt apply) EMERGENCY GENERATORS ONLY(Chat d"b "ply) 1314.CONTINUOUS SUMP SENSOR SYffiI4S1I AUTO PUMP SHUT OFF• [114. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS 0 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WffiIQ[II'FLOW E3 15, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF ORRESTRICTION ❑16.ANNUAL INTEGRITY TEST(0.1 GPH) ❑16.ANNUAL INTEGRITY TEST(0.1 GPH) [317.DAILY VISUAL CHECK 7.DAILY VISUAL CHECK VIII.DISPENS CONTAINMENT DISPENSER CONTAINMENT ❑1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑4.DAILY VISUAL CHECK DATE INSTALLED 46e ❑2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS ❑5.TRENCH LINER/MONITORING ❑3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFT FOR DISPENSER+AUDIBLE AND VISUAL ALARMS ❑6.NONE 4e) IX.O W NER/OPERATOR SIGNATURE I.arr a.t waa.eea ptovNed maavtaa®e.awuam 6•mt ay «Idea. SIGMAOF OWNER/OPERA'IgR _ DATE _ O 4 N F WNERroPRATOR(ptintt(J `r 471 TITLE OF OWNER/OPERATOR 472 P.Number(Fa meal use o Y) 473 P'mu APN. (Fa anal uee ody) 474 Pe t ElPiuupp Oue(Fac local as mly) 475 UPCF(12/99 revised) 12 Formerly SWRCB Form B