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MN Allk I 10 lD UNIFIED PROGRAM CONSOLIDATED FORK, TANK: TA0160004 .t PR N: PR0231600 FAC#: F.AOOM57 s UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI.PIPING CONSTRUCTION(cl WIthmapph) Page 3 of UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ® 1.PRESSURE ❑ 2 SUCTION ❑ 3.GRAVITY 458 ❑ L PRESSURE ❑ 2.SUCTION ❑ 3.GRAVITY 459 CONSTRUCTION ❑I SINGLE WALL ❑3.LINEDTRENCH ❑ 99.OTHER 469 ❑ I.SINGLE WALL ❑ 95.UNKNOWN 462 M 2.DOUBLE WALL 095.UNKNOWN ❑ 2.DOUBLE WALL ❑ 99.OTHER MANUFACTURER A O SMITH J61 MANUFACTURER 463 ❑ I.BARESTEEL ❑ 6.FRP COMPATIBLE./100.METHANOL ❑ I.BARESTEEL ❑6.FRP COMPATIBLE xN IOW.METHANOL ❑ 2.STAINLESS STEEL ❑ 7.GALVANIZED STEEL ❑ 2.STAINLESS STEEL ❑ 7.GALVANIZED STEEL ❑ PLASTIC COMPATIBLE W/CONTENTS 09.UNKNOWN ❑ PLASTIC COMPATIBLE W/CONTENTS [3 95,UNKNOWN ® 4.FIBERGLASS ❑ 8.FLEXIBLE(HDPE) ❑ 99.OTHER ❑ 4.FIBERGLASS ❑ 8.FLEXIBLE(HDPE) [199 OTHER ❑ 5.STEEL W!COATING ❑ 9.CATHODIC PROTECTION 464 ❑5.STEEL W/COATING ❑ 9.CATHODIC PROTECTION 46t VIL PIPING LEAK DETECTION(Chmk all and K)(A4 plioa o(dn minim gpa,,un Shall In aubmiaW to thel«al ogam'.t UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 4M SINGLE WALL PIPING 467 PRESSURIZED PIPING(Chak all thet apply): PRESSURIZED PIPING(Check all thal apply): ❑ I.ELECTRONIC LINE LEAK DETECTOR 3 0 GPH TEST WITH AUTO PUMP SHUT OFF ❑ I.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND FOR LEAK SYSTEM FAILURE.AND SYSTEM DISCONNECTION-AUDIBLE AND VISUAL ALARMS. VISUAL ALARMS. ❑ 2.MONTHLY 0.2GPH TEST ❑ 2,MONTHLY O_'CPH TEST ❑ 3.ANNUAL INTEGRITY TEST(0.I GPH) ❑ 3.ANNUAL INTEGRITY TEST 10.1 GPH) ❑4.DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all that apply) El 5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIEAL PIPING ❑ 5.DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) ❑ 6.TRIENNIA.INTEGRITY TEST(0,1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPINC): ❑ 7.SELF MONITORING ❑ 7.SELF MONITORING GRAVITY FLOW ❑ 9 BIENNIAL INTEGRITY TEST(0.1)GPH GRAVITY FLOW(Check all that apply): (-18 DAILY VISUAL MONITORING ❑ 9.BIENNIAL INTEGRITY TEST(0.1)GPH SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check ell that apply): IO.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(C1,o&.0 ALARMS AND(Chock and ®a.AUTO PUMP SHUTOFF 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 SHUTOFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION ❑ c. NO AUTO PUMP SHUT OFF ❑ C. NO AUTO PUMP SHUT OFF ® It AUTOMATIC LINE LEAK DETECTOR DO GPH TEST)WITH FLOW SHUT OFF OR ❑ RESTRICTION I I AUTOMATIC LEAK DETECTOR ❑ 12.ANNUAL INTEGRITY TEST(O.I GPH) ❑ 12.ANNUAL INTEGRITY TEST(0.1 GPH) SUCTION/GRAYTTY SYSTEM SUCTION/GRAVITY SYSTEM ❑ 13.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ❑ 13.CONTINUOUS SUMP SENSOR'AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Ch au wl appy) EMERGENCY GENERATORS ON LY(Chatall that apph) ❑ t4.CONTINUOUS SUMP SENSOR WITHOUT AOTOPUMPSHUTOFF' ❑ 14.CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF' AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS ❑ 15.AUTOMATIC LME LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW ❑ 15.AUTOMATIC LME LEAK DETECTOR D O GPH TEST)WITHOUT FLOW SHUT OFF OR RESTRICTION SHUT OFF OR RESTRICTION ❑ 16.ANNUAL INTEGRITY TEST(0.1 GPH) ❑ 16.ANNUAL INTEGRITY TEST(0.1 GPH) ❑ 17,DAILY VISUAL CHECK ❑ 17.DAILY VISUAL CHECK VIIL DISPENSER CONTAINMENT DISPENSER CONTAINMENT ❑ I.FLOATMECRANISM THAT SHUTS OFF SHEAR VALVE ❑ 4.DAILY VISUAL CHECK DATE INSTALLED 468 ®2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS ❑ S.TRENCH LINER/MONITORING ❑ 3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR ❑ 6.NONE DISPENSER-AUDIBLE AND VISUAL ALARMS IN.O W NERIOPERATOR SIGNATURE N wtifi thatt6einf9mabnptaidedhacnutK otbc tmkmu SIGNATURE OF OWNER/OPERATO - DATE 12 2a L470 NAME OFOWNER/OPERATOR(pn^1 TITLE OF OWNER/OPERATOR JARNAIL KAMBOJ „' PRESIDENT 472 Pamir Nuaba(Fa local use a0a) 473 Pwmit AppmredlFalonlusamy) 474 P=it Eylmtien Date(Fa tical use mh'1 475 PT0004281 EE0000646 12/31/1993 12:0 :OOAM UPCF(12/99 revised)