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06/01/20_07 22:54 12099549@92 ALL INJURY CLINICJG PAGE 07/09 <br /> - --- --- v Iwo i o 7 <br /> UNTRIED PROGRAM C SOLID ATED FORM TANKS <br /> UNDERGROUND STORA E TANKS-TANK FAGS 2 d <br /> VI PIPING CO f4Lv ' ABOYBOROUND PIPING <br /> UNDERGROUNDPIFINO p).PRESSURH ❑7. SUCTK)N ❑3.ORAVITY 'w <br /> SYSTGM TYPE 1.PRESSURE 0 2 STILTON C13.ORAvrN 4a <br /> s uNPDTRENCH ❑9P.OTHER I ❑l.SINGLE WALL O"I UNKNOWN <br /> DDNT,RULTION Q1.SiNOLEWALL ❑.g 02.DOUBLE WALL ❑�.OTHER <br /> MANt1FAMMA a _DOq <br /> UELE WALL 93.UNKNOWN MANUFACfURER <br /> 'C fl <br /> MANUFACTURER ❑4.ERP COMPATIBLE WAMMMSTtW�O� <br /> [I 1.BARE378IL 6.PRP COMPATIBLE w/100'% METHANOL �i.BA STMLL ❑7.GALVANufiD SCFA3. <br /> ❑2.STAINLCS9 BTSSL ❑T_GM1LV AN19HD STEEL ❑UAImoF++ Q t dT S STEEL <br /> p s.PLnsnc CGM A'TUILE w)�ONTMM [199. a°'9 D 3. TIC FOFBATISI.E w;CONTPxrs C)a tLE)DRLe(HDPE O _ ATF ER <br /> Q 4. FIB OLASS Q 9.CATHOINC PRDTECOON <br /> 4.PIBSROLASS 0 0.FLE)(IDLE(NDFE) 0 03.UNKNOWN °fd <br /> ❑3.STEEL w�DATING 13 0.CATHODIC FP0TBCTLON 9M ❑3. ST W(ODA07%)NG Nml Mfue011 <br /> VIL PSPINC AX C Cho�L ulPoe GROUND PIPIN <br /> u D61IG R SMrLE WALL PIPING 'm <br /> BrYCLEWALLPIPING a6 <br /> PRMUMM PIPING teak aU'NI-F*): PRESSURI2FA FlPING ICM�A aP T LEAK _TDI AUTO PUMP <br /> ❑I.S WUCNIC LRaE LEAK DETECTOR A.O GPH TEST A 7M AI70 PUMP SHUT [3 1. ELECTRONICHOFF EAK SKTTI•-L7 PNLUItR A,p 9YST�(SCONN8CrON r . <br /> OFF FOR LZAK SYSTEM FAILURE.AND SYSTEM PSCONNECT GN* AUDIBLE AND YIBUAL A1,ARb1S- <br /> AUMLS AND VISUAL ALARMS. (3 2 MONTHLY Db GW TEST <br /> a z.MONTFRY 0.1(m"t T <br /> Q 5.ANNUAL lNTSORrrY TTAT M.IGFHI I [3 7.ANNUAL INTEGRITY t(OIGm) <br /> I ? [3 4, DAILY vtsUAL CHJIECKK <br /> CONVENTIONAL SUCPIGN SYSTEMS CONVENriQNAIL SUCTION b]9T (On�m'm^MpIY} <br /> O5.DAILY VISUAL MONTORAFOOFFUMPTNOSYSTEM+TRIENNIAL PIPING 03. vmLYVISUAL MON IUMnOFPIPINGANDPUMPINGSYSTEM <br /> INTEORR'YTUT(O,1 OPH) 6 TRIENNLALINTEORITY TEST(D.1 Cl?") <br /> SAFE SUCTION SY9TtiMS(No VAL23 9ELOW GROUNOPIPMO): I OFL•SUCITON 6YSTE199N0 VALVES IN BELOW GROUWD PIPIIO)� <br /> 0 7.SELF MONTTORTNG <br /> ' ❑T.S71T.1'MONTTo1uNb <br /> GRAVITY FLOW <br /> OP.AV(T•/PLOW leek W tim SO'YY <br /> ❑9.BIENNIAL iNTEI'attTFYYEST(O.l DPH) <br /> []8. DAILY V15UALMONIT0RING <br /> [3 9. BIENNIAL INTEGRITY TEST(0-1 OPTa) <br /> SECONDARMY CONTAINED PIPING <br /> SRCONDARTLY CONTAINIn PIPING <br /> . ODNTINWUS NN ,., � LPIPS ( mrmew7)+ <br /> PRCSURFKEDPIMG(Owl N Rm 0*0 A %ISUAL 10. COMNUONTU IjNS MP9CVSORBOLAUDIBAANVUAL <br /> IOh(Ch -OO <br /> ALARM!ANO(aux-e) I O R A4-TG PUMP SHUT OFF WHEN A LEAK OCCURS <br /> �a AVTOMIFIP SNVf OIF WH47A LEAK OCCLRR LEAKS,SYSTEM FAMURS AND SYSTEM <br /> ❑d AUTO PUMP SHUT OFF FOR LEAKS.SY3TEM FAIu1RE AND SYSTEM D OFF FOR <br /> ISSCONNEMON <br /> DISCONNECTION ' [3�NO AUTO p"SHUT OFF <br /> 1 13a NO AUTO"t WSHUTOFF FLOW SHUT <br /> �1 R. AUTOMATIC UNG LEAKDSrpCTOR(;.O OPNTE5T)WnJ!+ ❑IL ALT[OMATIC LEAK DETECTOR <br /> 0" OR RHSTRICTION p 12. ANNUAL)NTL'GRITYTWT(O,IOPH) <br /> 12, ANMIAL INIEVWTY TEST(0.1 DPMI sUGTI0N4RAvrry SYSTEM <br /> O{y(','iAA V TTY 4YSTFDI <br /> 15.CO)iTiNU0U56UMP 9ENSORnAUD)HLE AND VISUAL ALARMS <br /> ❑13.C.OMLNL'OU9,'u=I%NSO9+AUDIBLE ANO V1WAL ALARMS ❑ IIHLROF.YCY Cr NENAT'OSR ONLY(Cnah in p^9W) <br /> yMGRGENCY G6h�MTORS ONLV 10e NI ON:oNY) <br /> [314, l;O3TI31TUOU5 SUMPSENSOR B�1'H4SII AUTO rUMP Sr1UT OFF• I ❑14. OPIT UCC8D VISUAL ALARMS AUTO PUMP SHUT OFF <br /> Al)D1ELE ANO VISUMP 510N <br /> SUAL ALARMS <br /> ❑15. A=4ATK cI*a<LRAKDETECT0Kg,OOPHTH9�MZCUjflOW I 0i3. AUTOMATIC LINK LEAKPETECTOR(SAOPH T-•sT) <br /> SHUT OFF OR MTRlCRON L)16,ANM)AL rKfEGRTTY TEST(0.1 GPM <br /> ❑16.ANNUAL TNTWR1TY TEST(O.1 OP)D E317. DAILY VISUAL CkjRCK <br /> pt7. DARvvLS ALCHtCK <br /> VSII.D16PEN � R CO?ITADNMENT <br /> O a.OA1LY NRUAL COIpG(( <br /> D)SPENSCRCONTAWMENT L FLOAT MECHANISM THAT SF UFF RVALVZ g.TRENCH IJNERrMONTTORTNO <br /> DATE INSTALLED A GVNTFNVOLM D18PSNb13RPANSENSOR+ VD16LK AND VISUAL ALARMS E3100 <br /> ❑}.GDNTmuOU3 D1MPHNRER PAN WASOR A MAUTO SIM OFF FOR I76.ND:YE <br /> DIE 1 AND VIRV 1'OR BIGNAT'CT4.E <br /> IX.owmzwur <br /> 170 <br /> [�atlflj A- tllrPlTN"•^Pb°IdNt�� wlaeM�amdmMd dm-u�avi�{yc pA <br /> l: <br /> I LE O OWNERPMEKATGR <br /> PxM[NmiL r(rM»rt^^N'i •+0 renin APOrwWCPor�oml mH1 <br /> 4 reiRO'Gw�IDde(Fn <br /> i <br /> UPCF(12/99 rcvis�r!) <br /> 1 ForMry 5 W RCB Form D <br />