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_IFIED PP.OGRAM CONSOLIDATED F014± TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 2 VL PIPING CONSTRUCTION(CAack aT Nat aypy) UNOERGROUNOAPING ABOVEGROUND PIPING SYSTEM TYPE 1 PRESSURE ❑ 2. SUCTION ❑ ]. GRAVITY ❑ 1. PRESSURE ❑ 2. SUCTION ❑ ].GRAVITY CONSTRUCTION ❑ 1.SINGLE YdLL ❑ 3. LINEDTRENCH 0 9 OTHER ❑ 1. SINGLEWALL ❑95. UNKNOWN MANUFACTURER Z DOUBLE4 A, ❑95 UNKNONRI ❑ Z. DOUBLE WALL [399. OTHER MANUFACTURER MANUFACTURER ❑ 1.BARE STEL ❑ B. FRP COMPATIBLE W/IM%METHANOL ❑ 1. BARE STEEL ❑B. FRP COMPATIBLE WI 1=%MET MANDL MATERIALSAND ❑ 2. STAINLESS STEEL ❑ T,GALVANIZED STEEL ❑ 2. STAINLESS STEEL CORROSION ❑ T.GALVANIZED STEEL PROTECTION �❑-/p. PLASTIC COMPATIBLE PATH CONTENTS 1195, UNKNOWN ❑ ]. PLASTIC COMPATI BLE VATH CONTENTS ❑ !. FLE)OBLE(HOPE) 0S9.OTHER Itl l FIBERGLASS ❑ B FLEXIBLE(HOPE) ❑99. OTHER ❑ /. FIBERGLASS ❑ 9.CATHODIC PROTECTION ❑ 5 STEELWICOATING ❑ 9. CATHOOICPROTECTION ❑ 5. STEELWJCOATING 095. UNKNOWN VIL PIPING LEAK DETECTION(Cha4 art MaNypy) _ UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING SINGLE WALL PIPING PRESSURIZED APING(CMck"Nat"'w PRESSURIZED PIPING(Check a9 PaNPpNk ❑ 1. ELECTRONIC UNE LEAKOETECTOR 0.0 GPM TESTMATH AUTO PUMP SHUT OFF FOR ❑ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPM TESTWITH ACRO PUMP SHUT OFF FOR LEAK. LEAK,SYSTEM FAILURE AND SYSTEM DISCONNECTION a AUDIBLE AND VISUAL SYSTEM FAILURE.AN O SYSTEM DISCONNECTION•AUDIBLE AND VISUAL AIAR.MS ALARMS 112. MONTHLY 02 GPM TEST 2. MONTHLY 0.2 GPM TEST 113. ANNUAL INTEGRITY TEST(0.1 GPM) ❑ ]. ANNUAL INTEGRITY TEST(01 GPM) ❑ a, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check ab Nat appy)' ❑ 5 DAILY VISUAL MDNITORING OF PUMPING SYSTEM•TRIENNIAL PIPING INTEGRITY ❑ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(01 GPM) ❑ B. TRIENNIAL INTEGRITY TEST(0.1 GPM) SAFE SUCTION SYSTEMS(NO VALVES IN SELOWGROUNO PIPING)'. SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING). ❑ Z SELF MONITORING ❑ Z. SELF MONITORING GRAVITY FLOW GRAVITY FLOW(Chack an Nat appy): ❑ 9. BIENNIAL INTEGRITY TEST(II GPM) A ❑ 8. DAILY VISUAL MONITORING ❑ 9. BIENNIAL INTEGRITY TEST IDA GPM) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING IG«A M?at appy): PRESSURIZED PIPING(Lack aR Nat appy): 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (C Ee ona) 10.CONTINUOUS TURBINE SUMP SENSOR KITH AUDIBLE AND b SUALAURMS AND kma one) a AUTO PUMP SHUT OFFµHEN A LEAK OCCURS ❑ a. AUTO POMP SHUT OFF WHEN A LEAK OCCURS OOO❑aO,SOPUMPSHUTOFF FOR LEANS.SYSTEM FMLL'REAND SYSTEM ❑ 9_ AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION OSCOPUMP SHUT ❑ t NO AUTO PUMP SHUT OFF ❑ c. NO AUTO PUMP SMUT OFF 11 AUTOMATIC LINE LEAK OETECTOR(O,O GPM TEST)WITH FLOW SHUT OFF OR ❑ 11. AUTOMATIC LEAK DETECTOR RESTRICTION 12 AMNUAUNTEGRRY TEST 101 GPH) ❑ 12. ANNUAL INTEGRITY TEST(0 1 GPM) SJCTI@YGRAVITY SYSTEM: SUCTIONIGRAVITY SYSTEM: ❑ 13 CONTINUOUS SUMP SENSOR•AUDIBLE AND VISUALALARMS ❑ 13, CONTINUOUS SUMP SENSOR a AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(CA*Ek 0 Nat appy) EMERGENCY GENERATORS ONLY(Crtack N Nat appy) ❑ ta.CONTINUOUS SUMP SENSORµ1THOUT AUTO PUMP SHUT OFF-AUDIBLE AND ❑ 1t. CONTINUOUS SUMP SENSOR WTHOUT AUTO PUMP SHUT OFF•AUDIBLE AND VISUAL VISUALAIGRMS ALARMS ❑ 15.AUTOMATIC UNE LEAK DETECTOR(].0 GPM TEST)WTHOUT FLOW SHUT OFF OR ❑ 15. AUTOMATIC UNE LEAK DETECTOR(3.0 GPM TEST) RESTRICTION ❑ 16.ANNUAL INTEGRITY TEST III i GPM) ❑ 1S. ANNUAL INTEGRITY TEST(0.1 GPM) ❑ 17. DAILY VISUAL CHECK ❑ 1T. DAILY VISUAL CHECK VOL DISPENSER CONTAINMENT DISPENSER CONTAINMENT 1 FLOATMEOMNISM THAT SHUTS OFF SHEAR VALVE ❑ a.DAILYVISUAL CHECK DATE INSTALLED ❑1.CONTINUOUS DISPENSER PAN SENSOR•AUDIBLE AND VISUAL ALARMS ❑ S.TREMCHUNER/MONITORING ❑ 3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER•AUDIBLE AND VISUAL ALARMS 119. NONE OL OYAIER(OPERATOR SIGNATURE I..a"Men P aYn aOH.anin is 9Va an0amnlab Na bat of Ty krp.Naega. SIGNATOR OOR DATE K �� NAAEOF PEM R TITLE FOWNEMOPE T 1 G � F/1✓ Pamu WfF«bW.»aWj2 / ParmiIA,AcNwfFprr*Ew.pmy) Pamvt tlpn O«e(FprbW uaaP ) wt - CUPAFORM(49S) o-w aflPtm Formerly SWRCB Form 8