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ROGRAM CONSOLMA <br />TANKS <br />STORAGE TANK <br />- TANK PAGE 2 <br />7YSCEM711E 101.FRBWURE 4_Wv[32 m=ON <br />03. GRAVITY 4% '[3 <br />1. PRESSURE 02 SUCTION 03. GRAVITY <br />4M.. <br />CONSTRUCTION/ OI.SINGLEWALL 03. LINED TRENCH <br />099.OTHER NILE <br />01SINOIEWALL <br />095. UNKNOWN <br />1Q <br />MANUFACTURER B2COIlEEWALL 095. UNKNOWN <br />02. DOUBLE WALL <br />099.OTHER <br />MANUFAC URE& <br />161. <br />MANUFACTURER <br />40. <br />06 FRP COMPATIBLE WA00%METHAN0L <br />0 1. BARS MfEE. <br />[16. FRP COMPATIBLE W/100%MSINANOL <br />0 1. HARE STEEL <br />0 2 STAINLESS STK®. 0 7.0ALVANIZZED STEAL. <br />0 2 STAINLESS STEEL <br />0 7. GALVANIZED SCE®. <br />0 3. PLASTIC COMPATIBLE WITH CONTENTS ®95. UNKNOWN <br />0 3. PLASTIC COMPATIBLE WI CONTENTS <br />0 8. FIE7®LE (HDPE) <br />0 99 OTHER <br />0 4. FIBERGLASS 0 S. FUMOB7 R (RDPE) 0 99. OTHER <br />0 4. FIBERGLASS <br />[19. CATHODIC PROTECTION <br />161 <br />i7 5. STHffi. W/COATING ❑ 9. CATHODIC PROTECTION 161 <br />❑ S. st». WAX1A17N0 _. .095. <br />UNKNOWN ` <br />ffi1 mz WAIL PIPING 166 <br />PRESSURIZED PEMG (Ch -k.11 tbst apply): <br />13, ELECTRONIC LINE LEAK DETECTOR 3.0 OPH TEST MM AUTO POMP <br />SHUT-0FF FOR LIAR. SYSTFAL FAILURE AND SYSTEM DISCONNECTION <br />+AUDIffiE AND VISUAL ALARMS. <br />02 MONTHLY 0.2 GPE I= <br />[33. ANNUAL ITTEGkTIY TEST (0.l OPH) <br />CONVENTIONAL SUCTION SYSTEMS <br />[35. DAILY VISUAL MONITORING OF PUMPING SYSTEM+ TRIENNIAL PIPING <br />INTEGRITY TEST (0.1 OFR) <br />SAFE SUCTION SYSTEMS (NO VALVAS IN BELOW GROUND PIPINO)' <br />E17. SEF MONITORINO <br />GRAVTIY FLOW <br />[39. BIENNIAL INTEGRITY TEST (0.1 OPH) <br />SECONDARILY CONTADIED PIPING <br />PRESUR6ED PIPING (Check .11 d al.pply): <br />10. CONTINUOUS TIABIiE SUMP SENSOR MM AUDIBLE AND VISUAL <br />ALARMS AND (Cbeck aa) <br />®.. AUTO PUMP SHUT OFF WIE N A LEAK OCCURS <br />0 b. AUTO PUMP SHIJf OFF FOR LEAKSS, SYSTEM FAILURE AND SYSTEM <br />DISCONNIBCITON <br />Da NO AUTO PUMP SHUT OFF <br />❑ <br />11. AUTOMATIC LINE LEAK DETECTOR (3.0 OPH TEST) $M FLOW SHUT <br />OFF OR RESTRICTION <br />0 12 ANNUAL INTEORICY TEST (0.1 GPID <br />SUCTION4GRAVITY SYSTEM <br />0 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS <br />EMERGENCY GENERATORS ONLY (Check in tat apply) <br />014. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF <br />AUDIBLE AND VISUAL ALARMS <br />[315. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) FLOW <br />SHUT OFF OR RESTRICTION <br />1316 ANNUAL IiTIOR1TY TEST (0.l CPR) <br />017. DAILY VISUAL CHECK <br />ANGLE WAIL PIPING <br />PRESSURIZED PIPING (Check JI Wt apply), <br />01. ELECTRONIC LINE LEAK DETECTOR 3.0 OPD TEST YM AUTO PUMP <br />SHUT OFF FOR LEAK SYSTEM FAILURE, AND SYSTEM DISCONNECTION <br />+ AUDIBLE AND VISUAL ALARMS <br />0 2 MONTHLY 0.2 GPH TEST <br />03. ANNUAL INTEGRITY TEST (01 OPH) <br />0 4. DAILY VISUAL CHECK <br />CONVENTIONAL SUCTION SYSTEMS (Click aE tlaat apply) <br />[35. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br />0 6 TRIENNIAL INTEGRITY TEST (O.1 OPH) <br />SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): <br />07, SEPMONITORA0 <br />GRAVITY FLOW (Chat aU that aPPlyk <br />08. DAILY VISUAL MONITORING <br />0 9. EIEINIAL U TB(EUTY TEST (01 GPH) <br />HFCONDAEILY CONTAINED PIPING <br />PRESSURIZED PII'M (Chat NI tbt awNk <br />10 CONTINUOUS TURBINE SUMP SENSOR Y= AUDIBLE AND VISUAL <br />ALARMS AND (Chert an) <br />0 a AUTO PUMF SHUT OFF WEEN A LEAK OCCURS <br />0 b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM <br />DISCONNECTION <br />De NO AUTO PUMPSHUT OFF <br />011. AUTOMATIC LEAK DHTBCTOR <br />012 ANNUAL INTEGRITY TEST (0.1 OPH) <br />SUCTIONGRAVTTY SYSTEM <br />013. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS <br />EMERGENCY GENERATORS ONLY (Cbmk all that apply) <br />014. CONTINUOUS SUMP SENSOR WITHM AUTO PUMP SHUT OFF <br />AUDIBLE AND VISUAL ALARMS <br />015. AUTOMATIC LINE T,BAK DETECTOR (3-0 OPH TEST) <br />016 ANNUAL INTEGRITY TEST (0.1 GPh) <br />0 17. DAILY VISUAL CHECK <br />VIEL DL4EIYSEE (.VNl"ADEM A <br />DISPENSER CONTAINMHNi ❑ i. FLOAT THAT SHUTS OFF SHEAR VALVE 134. DAILY VISUAL CHECK 469. <br />DATE INSTAL -LED 02. CONTINUOUS DISPENSER PAN SENSOR+ AUD�E AND VISUAL ALARMS 05. TRENCLLIENEa MONITORING <br />N � n 03. CONTINUOUS DIEEISHR PAN SENSOR MM AUTO SHUT OFF FOR 0 6. NONE <br />T w Wl that the infmmahm prcmdvdhC is hoe and We MW w the but a my ananncaga 470. <br />SIGNATUAHO PEIATOR DATE:IMA D <br />�-� <br />17 <br />k�l TITLE OF OWNERIOPEIATOR 1 <br />NAME 0FOWNPRLOPERATOR(pick /I.a-in, Jr' SL AL&, FF <br />n�..e u...Or lAeem ae aaNl 175. 1 Paint App .dBy(As gwe.1y) 47a I Pe Expiaatm Dta(ABeay u only) 475. <br />UPCF haahm-b(M-LI httpJMww.mo6 orz <br />