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UIPED PROGRAM CONSOLIDATED FORNM TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 Page �of 5 VI. PIPING CONSTRUCTION(check ar mai.apvlr) ABOVEGROUND PIPING UNDERGROUND PIPING 459 SYSTEMTYPE ®1.PRESSURE ❑2.SUCTION ❑3.GRAVITY 458 ❑1.PRESSURE ❑2. SUCTION ❑3.GRAVITY 462 ❑95.UNKNOWN CONSTRUCTION 1 ❑1.SINGLE WALL [:13.LINED TRENCH ❑99.OTHER a60 O 2.DOUBLEILSIWALL LL ❑99.OTHER MANUFACTURER ®2.DOUBLE WALL ❑95.UNKNOWN 461 MANUFACTURER a63 MANUFACTURER ❑6.FRP COMPATIBLE W1100%METHANOL ❑1.BARE STEEL ®6.FRP COMPATIBLE W1100% METHANOL ❑1.BARE STEEL 7 GALVANIZED STEEL ❑2.STAINLESS STEEL ❑7.GALVANIZED STEEL ❑UKNOWN ❑2. STAINLESS STEEL ❑ ❑3.PLASTIC COMPATIBLE WI CONTENTS ❑99. OTHER ❑3. PLASTIC COMPATIBLE WI CONTENTS [:18.CATHOBLE(HOPE)DIC PROTECTION N9 OTHER ❑4. FIBERGLASS ❑4.FIBERGLASS ❑B.FLEXIBLE(HOPE) AB ❑95.UNKNOWN 465 ❑S.STEEL WICOATING VII ❑(PING LEAK DETECTION'(Gheck all Thal all' ) Atlescri lion of the monitorin piorxmshellq'esubmitted to the local agency.).. a64 ❑5. STEEL W/COATING .CATHODIC PROTECTION OVEGROUND PIPING UNDERGROUND PIPING SINGLE WALL PIPING 467 rPRESSURIZED INGLE WALL PIPING ass IPING(Checkall tlhatapplyp, PRESSURIZED PIPING(Checksll that avply):M FAIL RE,AND SYS EM DISCONNECTION*AUDISEAND VISUALUTO PUMP SHUT OFF FOR ❑1' LEAK,SYSTEM FAILURE,AND SYS EMNIC UNE LEAK DETECTOR O DISCONGPH I NECTIONEST WITH AUAUODIBEPUMPANDPUMP UVISUALOR ALARMS. .2 GPH TEST ❑2. MONTHLY 0.2 GPH TEST 3. ANNUAL INTEGRITY TEST(O.1GPH) EGRITY TEST(O.1GPH) 04, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check 0 that apply) 05. DAILY VISUAL MONITORING OF PUMPING SYSTEM.TRIENNIAL PIPING INTEGRITY 05. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) ❑6. TRIENNIAL INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): [17. SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): ❑7. SELF MONITORING GRAVITY FLOW GRAVITY FLOW(Check all that apply): [39, BIENNIAL INTEGRITY TEST(0.1 GPH) EIS. 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 t0' (Check TURBINE SUMP SENSOR WITH AUDIBLEANDVISUAL ALARMS AND (Check one) ❑a AUTO PUMP SHUT OFF WHENA LEAK OCCURS ®a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM ❑b AUTON EP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCION DISCONNECTION ❑c NO AUTO PUMP SHUT OFF ❑c. NOAUTO PUMP SHUT OFF ®11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUTOFF OR [111. AUTOMATIC LEAK DETECTOR RESTRICTION [312. ANNUAL INTEGRITY TEST(0.1 GPH) ❑12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTIONIGRAVITY SYSTEM SUCTIONIGRAVITY SYSTEM ❑13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ❑13. CONTINUOUS EMERUMP GENCY GENERATORS ONLY(Check RMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) [114. CONTINUOUS SUMP SENSOR WITHOU AUTO PUMP SHUT OFF+AUDIBLE AND ❑14' VCONTINUOUS SUALALARMS MP SENSORWTH AUTO PUMP SHUT OFF+AUDIBLE AND VISUALALARMS [115, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR [315, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) RESTRICTION 1-116. ANNUAL INTEGRITY TEST(0.1 GPH) ❑16. ANNUAL INTEGRITY TEST[0.1 GPH) D 1. DAILY VISUAL CHECK ❑17 DAILY VISUAL CHECK -^I 'VIII.DISPENSER CONTAINMENT DISPENSER ®4,DAILY VISUAL CHECK CONTAINMENT ❑1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE DATEINSTALLED 466 ❑2. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS ❑5.TRENCH LINER(MONITORING q69 ❑3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+ ❑6.NONE AUDIBLE AND VISUAL ALARMS w..,. IX.OWNEWOPERATOR.SIGNATURE 1 certify that the information provided herein is true and accurate to the best of my knowledge, 470 SIGN TUBE OF OWN ER/OPERATOR DATE3/17/00 472 TITLE OF OWNER/OPERATOR ME 0 R/OPRATOR(print) A ent for Tosco Z a Gianino of RHL Desi n Grou IDC. pert it Fxpirallpn Dale(For to al use only) Permit Number(For local use only) 473 Permit Approved(Fo to el only 475 / Fo rtferly SWRC F rm B CF(1199 revised)