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FROM :W1GHT ENTERPRISES W00DBR�= FAX NO. :12093398225 In. 23 2003 03:04PM P3 aa/ v UNIFIED PROGRAM CONSOLIDATED FORM TANK: Ta0233I{n2 PR 9: PRO232388 UNDERGROUND STORAGE TANKS-TANK YACF z FAC#: FA0N16D7 V/.PIPHNG EN)N$TRVCMoN(EAS as fv apfy) ITS I ell UNDERGRO(IND PIPING _ AHW,VY9UR0UNDPIP "- SYSTEMTYPE LPRESSURE C12.SUI RTN p J,ORAVIT'y {'i ❑ 1.PRESSURE ❑ 2.SVC PION ❑1.<•.anvrry .xs (7CtNSTRI"m LILSINGIAWAI,), ❑i.I.INF,DTRENCN 099.07IIER a99 ❑ I.SINGLE WALL [C 13.L'NKNO NN Ie1 22.IX)UDI.EWAIX ❑95.UNKNOWN ❑3.DOUBLE WAIL ❑`K.OMER MANUFACTURER 'O _ af1 MANUrACTURFR ab ❑ 1.BARESMEL ❑G FRP COMPATIBLE.1991 METHANOL ❑ 1.BARE%Mm, ❑6.rRPCOMPAnBLE w ID9R,MFBWIOI [J 2.S'EMNLESSSTEEL ❑T.GALVAN127DSTF.F•L ❑2.STAINLESSSTFFI, ❑7.(JALVAPRZEDS'I'EEL. 0 PIASTICCOMPAMILE W/CONTENTS [3 9 N El5.UNKNOWPLAS'nCCOMPATIRLEW/CONnNTS ❑95.UNKNOWN Wd.F MCN-ASS ❑R,FLSXIBLE(IIDPE) 099,DTNER ❑a.MRERGLASS ❑R.11F IBLE QIDPR) ❑99.OJ'HER ❑S.SW-Fl-WIMATING ❑P.CATHODIC MOT M(IN ua ❑5.STEEL WMOATING E)9.CATHGD)C 'R0TEC ION ....._. VII.PIPING LEAK DETECTION Lrb AI notaoWrlel dserpr.reflMmnneaea w,roJ�..l.an..6..lydame UNOERGROTJND PIPING ABOVFGAUUNDPIPNC,: _ $174 ,,WALL FPIIY(: Mf � IN ' WALL IPI (; PREESUWLED PIPINC. Ckeckall than 7AUDIRLStj) ( PDIP): PRgS$URIL1KPIPLNG(E LEAN tETI :70R, ❑ ORLr 'K.SYSTEM INP.uAKMFAILV bF.ANDS SYSTEM GPNTES'I'gCTIONAUTO AU PUMP SHUT Oh'/' ❑ LELECIRVNIC LME LEAK DETItiTVR 3.0 CPR TEST:d IT11 PURLGAILAkM!EM FAILVN&ANU$YS'rEM DISCONNECT10N1 AUOIBLEAND FOR LEAK,SYSTEM PNLI IRk,AND SYSTEM 0ISCONNF(71VI.NALALnkMS. VISIJAi.AI,AWAS.❑I.MONTHLY0.1 MMIY I F 2.MONTHLY 0.2 GPH TEST ❑1.ANNUALINTL•URIT ❑ I.ANNUAL M n:I:Rfrv'I'F3'I'10.1 DPH) ❑a.DAILY VISUAL CHH(:K 4.GfQVENTIONALRUCTION SYSfEMS CrO}NVENTIONAL SUCTION SYS1I 5(Clack all,RH aPPI)) f3 5.DAILY VISUAL MGNITORING Of PUMPING SYSTR.M I TRIRMIEAL MPING uS.DAH Y VISUAL MONITORING OF M PING AND PI,MPINUSYSTEM ). ..C,.RRY TEST(0.1 GM ❑6.TRIENNIAL INTEGRITY TF$T 101 CM 1) li1ESLFMNITORI.M$(NO VALVESIN BELOW OROINDPIPINGk SAFE REJECTION SYSTEMS IND VALV.S IN BEI.Ow ;XoVNDPT PING); [17.SELF MONITORING GRAVITY Fi.(1W ❑],SELF MONITOCNG ❑9.RIHNNIAI.INTEGRITYTE9T(O.1)GPH GRAVITY FLOW(C,g ak all IM, My) ❑k.DAILY VISUAL MONITORING ❑9.NIENNIAL NTFOM1iI Y'1 EST(0.,)GPX SECONpAR1LY CONTAINED PIPINGSFCONDANIL.Y CON'AINED MPING PREASU W LEU PIPING(Cheek.11 111.11 apply); MESSUISILCD PIPING(CM9k all Ihat aPpty): 10.CONTINUOUS IURBRIE SUMP SENSOR WITH AUDIBLE AND VISI)AT. IO.CONTNUOVS NRONR SUMP$P2ISOR W ETH AV2NBLL ANY,vISVAL AIARMS ANY)ICheLok) ALARMS ANL)1(.1Ke1,xK) 1 a-AUTO PUMP SHUT OFF WHEN A LCAK OCCURS ❑a AUTO PUMP SHUT Orr WN EN A LEAK OCCURS ❑b.AUTO PUMP SI JUT OFV IRe I EAKS,SYSTEM FAILURE AND SYS'I'EM ❑F.AUTO PUMPSNUT UFFFOR LLA",SYSTEM FAILUREAND SYSTEM DISMNNF(:UUN DISCONNECTION ❑c NO AUTO PUMP SHUT UPF ❑C.NO AV rO PVMP 51NT OFF ❑ 11.AUTOMATIC LtNII LEAK DETECTOKI3.0 UPII TEST)WITH FLOW SENT OFROR 11ESl1ULTION ❑ I I.AUTOMATIC LEAK OE-tiCT R ❑ t2.ANNUALIMEGRITVTES'f(O.I GPH) ❑ 1I.ANNUALNMGRII'Y'1'EST(O.IOPH) SUCTIONtiMVTTY SY'n KAI S(ICTIUISR:RAVITY SYSTEM ❑ LL CONTINUOUS SUMP$ENSOK+AUDIBLE AND VISUAL ALARMS ❑ 13.CION'I'INVOVS SUMPSFNSUR I AUDIBLE ANO VISUAL At ARMS MSERGE CY GENERATORS ONLY(cm ak mwI wly) EMERGENCY GE.NF RATORB ONLY PNk a2 Mtn Fd I (7 )a.LW+TINUUVS SUMP SLNSUK YDTW)11 A l)TO PI IMP SIB IT Off• ❑ d.MN'I'INUULS SUMP SENSOR wJTIIOIrt AUTO PVMI•suuT OFF• AU(NtlL6 AND VLSI)AL ALARMS AUDIBLE AND VI$VAI,ALARNIS ❑ 13.AU WM.ATICI INF,UAK DUE 9CIUR(30 UMI TEST)WTiIioull FLVW ❑ IS.AIITOMAI IC'LME LEAK DPECTOR(J.O 6w TESD wMCDVTFLOW SHUT OFF OR RFSTR1C71ON SHUTOFF OR RF$TRJCTION �] 10.ANNUAL INTRGRRY TES'f(9.1 OPN) ❑ 16.ANNVAL INTEORITV'fES'1'(9.I GPID 11.DAILY VISUAL CW. ..CK ,.„• _- ❑ E.DAILY VISUAL CI IF.CK VIII.UI$PEN$ER CONI'AINMENT DLSPFN$ERCONTANMENTI.FLOAT MECHANKM THAT SHUTS OFF SHR.AR VALVE UA'I k INSTALLED (]a,DAILY VI.CIIAI.CHECK 02.CONTINUOUS DISMNSER PAN SENSOR I AL'DIDLE AND VISUAL ALARMS ❑5.'IRFN(,NLINER/MONITOPUNO 0I-O)NI'INUUVSDISPLNSC1t PAN SHNSVRTfTIIAtJTDSHCROFf EOR El 6.NVNk U15PENEERIAUDIDLEANDWItUALALARM$ > � ..___ • a9 _ D(.OWN:RIVPERATORSIGNAMPE SILmYuATwVlRllFeO:FOmWNERID1dE4dElanns uv uq Ae..,r[in ilrl.nr_yfm//y��kro�+'Wx _ DATE _ 4v zq- rar Iao oto• !^J'.Bl� VT NAMF.IWUWNEWmPEMTO IPnn 'I'I'O.E OF OWNFRIOPFRATOR 14e 471 M !lTtF a�•!�_ Pnma NuaaolFs aui.a mdr) {]: DI r omlr AVtliwNl•rrr 4Yil Y1[M[tI 11/ PenihF)irain;yr<IFer lRd we nrip) a„ 1'1'0003729 GE0003804 12/31/".002 UP(T(12/99 revised)