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. � � • • j L� �`d 62U� . UNIFIED PROGRAM CONSOLIDATED FORM TANK 11`410(� UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI.PIPING CONSTRUCTION a�o Ina - UNDERGROUND PIPING ABOVEGROUND PIPING SY57-M TYPE Q 1.PRESSURE .SUCTION 0 3.GRAVITY 4M ❑1.PRESSURE 0 2. SUCTION 0 3.GRAVITY 4M ' CONSTROCTON 04.SINGLE WALL 0 3.LINED TRENCH 0 99 OTHER 460 ❑L SINGLE WALL ❑95.UNKNOWN MANUFACTURER 0 2.DOUBLE WALL Q 95.UNKNOWN 0 2.DOUBLE WALL [199.OTHER MANUFACTURER v Iv /< Al G W N Ul MANUFACTURER w I.BARE STEEL 0 6.FRP COMPATIBLE WHm METHANOL Q I.BARE STEEL Q 6.FRP COMPATIBLE Wn W MET W10L [12.STAINLESS STEEL 117.GALVANIZED STEEL ❑Unknown 0 2 STAINLESS STEEL [17.GALVANIZED SIFFl. [13-PLASTIC COMPATIBLE W/CONTENTS 0 99. Odw ❑3. PLASUCCOMPATIBLE W/CONTE.NIS Q 8.FLE)BLE(HDPE) 1199. OTHER [14.FIBERGLASS ❑e.FLEHIBLE(}DPE) 0 4. FIBERGLASS 0 9.CATHODIC PROTECTION Q 5.STEE.W/COATING ❑9.CATHODIC PROTECTION 464 0 5. STEEL W/COATING 0 95.UNKNOWN VIL PIPING LEAK DETECTION a«t.118ul Adcci er8e ewry nmadl hesu6minedb4w brd UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(CA 91"apply): PRESSURIZED PIPING(a Al m Woyk.. C LINE LEAK DEI ❑ E T MM AUTO PUMP I.ELECTRONIC FRLEAK,NE LEAK SYSTEM FAILUREOR 3.0 GPH TEST AND SYSTEM DzsCoNNECnON+AUTO SHUT ❑1. ELESHUT OR LEAK,SYSTEM FAILU3.0 GPH RE AND ANDS STEM DDISCONNECTION+ AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS. 0 2.MONTHLY 0.2 GPH TEST 0 L MONTHLY 0.2 GPH TEST 0 3.ANNUAL INTEGRITY TEST(0.IGPH) 0 3.ANNUAL INTEGRITY TEST(o.IGPH) 0 4.DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(U AH wly) Q S.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING 0 5.DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): ❑6.TRIENNIAL INTEGRIY TEST(0.I GPH) Q 7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW Q 7.SERF MONITORING 09.BIENNIAL INTEGRITY TEST(Q.1 GPH) GRAVITY FLOW Eau aWa.pp1Y): 0 8.DAILY VISUAL MONITORING [19.BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING n/O N G SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(@ al aapPply). PRESSURIZED PIPING(Chat JI"-WY): 10.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10.CONTINUOUS TURBINE SOME SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(C w aee) ALARMS AND O@ me) 0 a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0 a AUTO P(R+IP SHUT OFF WHEN A LEAK OCCURS Q b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM Ob DISCONNECTION Pump SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION 0. NO AUTO PUMP SHUT OFF Oc NO AUTO PUMP SHUT OFF 0 11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) 1 FLOW SHUT Q 11.AUTOMATIC TEAK DBm(TOR OFF OR RESTRICTION Q 12. ANNUAL INTEGRITY TEST(0.1 GEN) _ 012. ANNUAL INTEGRITY TEST(o.)_GPH). . . - SUCION/GRAVrrY SYSTEM SUCf10WGRAVIY SYSTEM Q13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Chat S tl *Ply) EMERGENCY GENERATORS ONLY(CAak A"VPIY) 014. CONTINUOUS SUMP SENSOR WTfHOVf AUTO PUMP SHUT OFF014. CONTINUOUSLE WITH OVI'AUTO PUMP SHUT OFF' AUDIBLE AND VISUAL ALARMS RMS 015. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TFS I)WRHOUT FLOW 015. AUTOMATIC UNE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICBON [116.ANNUAL INTEGRITY TEST(0.1 GPH) 0 16.ANNUAL INTEGRITY TEST(0.1 GPH) 017. DALLY VISUAL CHECK 1 017.DAILY VISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT 0 1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 0 4.DAILY fft: N DATEINSTALLED ua Q2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS Q5.TRENCT No Q3.CONINUOUS DISPENSER PAN SENSOR 7 AUTO SHUT OFF FORNONE PENSL'/;!Z DISPENSER+AUDIBLE AND VISUAL ALARMS DL OWNERIOPERATOR SIGNATURE 1 aaey Bun OabfvwaianPwidd Actin u bueM aRLnle b tls Aeadmy lmo SIGNATURE OF GEN DATE 4A 6-0 () 1 - z �-oT NAMEOFOff` (P�nd /' GRN 471 TITLE OF6Wa�tlB K .Q- G- E J� 4n - r - Pu,rilNwMc(FwladuuMy) 473 PmrvT Apprmal(fw lad me My) 474 P Expi� Dae(F.local.MY) 475 UPCF(12/99 revised) 12 Formerly SWRCB Form B