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IFIED PROGRAM CONSOLIDATED FO TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI.PIPING CONSTRUCTION(Check all that apply) Page 5 of 5 UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ®1.PRESSURE ❑2.SUCTION ❑3.GRAVITY 458 ❑1.PRESSURE [12. SUCTION [13.GRAVITY 459 ❑95.UNKNOWN 962 CONSTRUCTION/ ❑1.SINGLE WALL ❑3.LINED TRENCH ❑Nu.OTHER 460 ❑1.SINGLE WALL MANUFACTURER ®2.DOUBLE WALL [195.UNKNOWN ❑2.DOUBLE WALL [199,OTHER MANUFACTURER 461 MANUFACTURER 463 ❑1.BARE STEEL 0 6.FRP COMPATIBLE W00% METHANOL ❑1.BARE STEEL ❑6.FRP COMPATIBLE W1100%MEMANOL ❑2.STAINLESS STEEL [17.GALVANIZED STEEL ❑UKNOWN ❑2. STAINLESS STEEL ❑7.GALVANIZED STEEL [13.PLASTIC COMPATIBLE W/CONTENTS ❑99. OTHER [13. PLASTIC COMPATIBLE WI CONTENTS ❑B.FLEXIBLE(HDPE) [199. OTHER [:14.FIBERGLASS ❑B.FLEXIBLE(HDPE) ❑4. FIBERGLASS [19.CATHODIC PROTECTION ❑5 STEEL WICOATING [19.CATHODIC PROTECTION 464 1 ❑5 STEEL WICOATING ❑95.UNKNOWN 465 VII.:PIPING LEAK DETECT ION(Check all that apply)(A description of the monitoring program shelf be submitted to the local i ency.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): ❑1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR 01. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL LAEAKK,ASS STEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS. [_12. MONTHLY 0.2 GPH TEST ❑2. MONTHLY 0.2 GPH TEST ❑3. ANNUAL INTEGRITY TEST(0.1GPH) ❑3. ANNUAL INTEGRITY TEST(0.1GPH) 04. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all thatapply) ❑5. DAILY VISUAL MONITORING OF PUMPING SYSTEM-TRIENNIAL PIPING INTEGRITY [15. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): [16. TRIENNIAL INTEGRITY TEST(0.1 GPH) 07. SELFMONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW [17. SELF MONITORING ❑9. BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Check all that apply): ❑B. 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 all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ®a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [31c. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM Ob DISCONNECTION AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION Oc. NO AUTO PUMP SHUT OFF [3c NO AUTO PUMP SHUT OFF ®11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUTOFF OR 11, AUTOMATIC LEAK DETECTOR RESTRICTION 012. ANNUAL INTEGRITY TEST(0.1 GPH) 012. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTIONIGRAVITY SYSTEM ❑13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) ❑14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF AUDIBLE AND ❑14. CONTINUOUS SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND VISUALALARMS ❑15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR [115, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) RESTRICTION ❑16. ANNUAL INTEGRITY TEST(0.1 GPH) 016. ANNUAL INTEGRITY TEST(0.1 GPH) [117, DAILY VISUAL CHECK ❑17. DAILY VISUAL CHECK Vlll.DISPENSER CONTAINMENT DISPENSER Ell. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ®4.DAILY VISUAL CHECK CONTAINMENT DATEINSTALLED 468 ❑2. CONTINUOUS DISPENSER PAN SENSOR,AUDIBLE AND VISUAL ALARMS ❑5.TRENCH UNERI MONITORING ❑3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+ [1 6,NONE 469 AUDIBLE AND VISUAL ALARMS IX.OWNERIOPERATOR SIGNATURE I certify that the information provided herein is true and accurate to the best of my knowledge. DATE 470 SIGN TUREOFOWNeR/OPaRATOR 3/17/00 ME O R/OP.�RP.TOR(print) TITLE OF OWNER/OPERATOR 472 Za a Gianino of RHL Design Grou , Inc. Agent for Tosco Permit Number(For local use only) 473 Permit Approved(For local use only) Permit Expiration Date(For local use only) 475 UPCF (1/99 revised) Formerly SWRCB Form B