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UNIFIED PROGRAM CONSOLIDATED FORM D� TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 2 VL PIPING CONSIRucnON o.d.0 na M-.f_ UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE 1.PRESSURE [32.SUC17ON ❑3.GRAVITY 459 ❑1.PRESSURE ❑2. SUCTION ❑3.GRAVITY 459 COPISIIDICDON I. INGLE WALL ❑3.LINED TRENCH ❑99.OTHER 1w ❑1.SINGLE WALL ❑95.UNKNOWN M2 MAMIFACft I ❑2.DOUBLE WALL 095-UNKNOWN ❑2.DOUBLE WALL ❑99.OTHER MANUFACTURER 461 MANUFACTURER .6) ❑1.BARE STEEL ❑6.FRP COMPATIBLE Swi1 IO:IFIANOL ❑1.BARE STEEL ❑6.FRP COMPATIBLE wnm mEntmi . ❑2.STAINLESS STEEL ❑7.GALVANIZED STEEL ❑Udm ❑2. STAINLESS STEEL ❑7.GALVANIZED STEEL J.J❑ PLASTIC COMPATIBLE W/CONTENTS ❑ IM [399. O3. PLASTIC COMPATIBLE W/CONTENTS ❑/.FLEXIBLE(HOPE) 1399. OTHER FIBERGLASS ❑S.FLEXIBLE(HDPE) ❑4. FIBERGLASS 139.CATHODIC PROTECTION .STEEL W/COATIIG ❑9.CATHODIC PROTECTION 461 ❑5. STEEL W/COATING ❑95.UNKNOWN 45 VII.PIPING LEAK DETECTION Cbr .U" A .fde e..i r.0 b.ebmv.dede ml. UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 166 SINGLE WALL PIPING 167 PRESSURIZED PIPING(Cb k.0".pPyk PRESSURIZED PIPING(Ckad.11 da ppy): ❑1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TESTVMM AUTO PUMPSHUT ❑1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST LVjj'b 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 01 GPH TEST ❑2.,MONTHLY 01 GPH TEST ❑3.ANNUAL INTEGRITY TEST(0.1GPH) ❑3.ANNUAL INTEGRITY TEST(0.1GPH) ❑4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Ckd:.O&a w*) ❑5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING ❑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 07. SELF MONITORING ❑9.BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Ch.k A WI q lyk ❑6. DAILY VISUAL MONITORING ❑9. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Ck«a•11"wpyY PRESSURIZED PIPING(Ckad.R w,Eppy): 10. CONTINUOUS TURBINE SUMP SENSOR y(1'DI AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WI'fN AUDIBLE AND VISUAL ALARMS AND(Chad-) ALARMS AND(Chad 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 [3b AUTO PUMP SHUT OFF FOR LEAKS.SYSTEM FAILURE.AND SYSTEM DISCONNECTION DISCONNECTION ❑<. NO AUTO PUMP SHUT OFF ❑c NO AUTO PUMP SHUT OFF 11, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)MM FLOW SHUT ❑11 AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION ❑1 . ANNUAL INTEGRITY TEST(0.1 GPH) ❑12. ANNUAL INTEGRITY TEST(0.1 GPN) SUCIIONK)RAVTTY SYSTEM SUCITON/GRAVITY SYSTEM ❑13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ❑ 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Cb k A6 Eppy) EMERGENCY GENERATORS ONLY(Ck .0 n wiy) ❑14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF• ❑ 14. CONTINUOUS SUMP SENSOR WITHOUT AI/TO PUMP SHUT OFF a AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS ❑15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW ❑15. AUTOMATIC UNE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICTION ❑16.ANNUAL INTEGRITY TEST(0.1 GPH) ❑16.ANNUAL INTEGRITY TEST(0.1 GPM [117. DAILY VISUAL CHECK ❑17. DAILY VISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT [11.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑4.DAILY VISUAL CHECK DATE INSTALLED 166 ❑2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS [15.TRENCH LINER/MONITORING �.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR ❑6.NONE 169 DISPENSER+AUDIBLE AND VISUAL ALARMS D(.O WNER/OPERATOR SIGNATURE l eatiy Ika e i pmvi6e4 Yuen u uue otmy Y.oM.d6a. 972 SIGNAT EO Ol DATE A U NAMED .a1) .71 TITLE OF OPERA R 9l3 P.rnh Nemhai( tr l aN a Y) 473 Pamh AP;-" PP b 1...1y) 471 Ptmu.EEpv..in Dae(F«I.ul.«aalYl 173 UPCF(12/99 revised) `/ 12 `/ Formerly SWRCB Form B