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�U N"'EC PROGRAM CJNSO LIOAT EO tOftM i T1PoX5 9 UNCEIRGROUNC =F� A GE WANKS a ANK PAGE -2 Page V1.PIPING C-'NSTRUG'ICN fr1lk.11twappyl UDGERGRCUND PIPING ABOVEGROUND PIPING SYST^cM TYPE I[:.,. PRESSURE 2 SUCTION Q i GRAVITY 358 ❑ 1. PRESSURE ❑2 SUCCCN Q 1 GRAVITY 4591 CONS7RUCTTC 1. SINGLE WALL ❑ 3. LNEO TRENCR ❑94. CT'HER SBD Q 1. SINGLE WALL v ❑9i UNKNOWN 3621 MANUFACTURER'❑ 2 COUBLEWALL ❑95. UNKNOWN - Q 2 DOUBLE'NALL ��)'� Q99.OTHER MANUFACTURER 381 MANUFACTURER +fi2I 1.BARE STEEL ❑ a PAP COMPATIBLE W1100%METHANOL ❑ I. BMS STEEL ❑ IL FRP COMPATIBLE W/100%METHANOL MATERIALS ANC ❑ 2 SLVNL�SSTFi! ❑ 7. GALVANIZED STEEL Q 2 STAINLESS STEEL ❑ 7. GALVANIZED STEEL CORROSION PROTECTION ❑ i PLASTIC CCMPATIELEWITH CONTENTS ❑9i UNKNOWN ❑ 1 PLASTIC CMPATMLE'MTI CONTENTS ❑ 1 FIP]OBLE(HOPEI 13 99. OTHER ❑ i. FIBERGLASS ❑a. PLOOSL-(HDPM C2 29. OTHER ❑ 3. PBERGLASS ❑ 9.CAT1/OOIO PRw=cN ❑ S STEEL W/COATING ❑ 9. CATMCCC PROTECTION 363 ❑ i STEELW/COATING Q95, UNKNOWN Ms VILPIPING LEAX De"7ECTICN(Geea aN Nat appy) - UNDERGROUND PIPING ABOVEGROUND PIPING SINGLEWALLPIPfNG 36B SWGLEWALLPINNG +I7 PRESSURt=PIPING(Chc a0Matappy): PRESSURIZED PIPING(Cledt aI Nat appal: ❑ 1. ELECTRONIC LINE LEAK DETECTOR 10 GPM TEST WRM AUTO PUMP SHUT CFF POR ❑ L ELECTRONIC LINE LEA(DETECTOR 10 GPM TEST WITH AUTO PUMP SMUT OFF FCR LEAK LEAK SYSTEM FAILURE.AND SYSTEM CISCONNECTKUN•AUDIBLE AND VISUAL SYSTEM FAILURE AND SYSTEM DISCONNECTON+AUDIBLE AND VISUAL ALARMS ALARMS ❑ 2 MONTHLY Q2 GPM TEST ❑ 2 MONTHLY 0.7 GPH TEST ❑ 1 ANNUAL INTEGRITY TEST(0.1 GPM) I ❑ 3. ANNUAL INTEGRITY TEST Hat GPM) ❑ 3. DAILY VISUAL CNEGC I"'♦� CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Wectatl Mat appy): ❑ 5. DAILY VISUAL mmrrCRING OF PUMPING BYSTFAI•TRIENNIAL PIPINGINTEGRTY ❑ E. ONLY VISUAL MCNTCRNG OF PIPING AND PUMPING SYSTEM TEST((Ll GPM) Q i TRIENNLALINTEGRITYTEST(0.1 GPM) FE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPINGL SAP_SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): 7. SELF MONITORING Cl 7. SELF MONITORING GRAVITY FLOW. GRAVITY FLOW(0)ein 01MIZa000: Cl % BIENNIAL INTEGRITY TEST(G.1 GPH) ❑ B. DAILYMSUALMCNRORING ❑ A BIENNIAL INTEGRITY TEST(OJ GPH) SEDONOARILT CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(QM:*W/Ma(appy): PRESSURIZED PIPING Irl!: tag Mat appW, 10 (Gem anej CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND NSUALfLM ALA5AN0 to CONTINUOUS TURBINE SUMP SENSOR WITH AUCIBLEANO VISUALALARMS AND(=%II, Cl a AUTO PUMP SHUT CFF WHEN A LEAK OCCURS �) ❑ h. AUTO PUMP SHUT CP FOR LEAKS SYSTEIA FAILURE AND SYSTEM ❑ a. ALTO PUMP SHUT OFF WHEN A LEAK OCCURS - DISCOMEL7I0N Q R AUTO PUMP SHUT CFF FOR LEANS.SYSTEM FAILURE AND SYSTEM=CONNECTION ❑ e NC AUTO PUMP SHUT OFF ❑ e NO AUTO PUMP SHUT CFF ❑ 11. AUTOMATIC UNE LEAK DETECTOR(10 GPM TEST)WITH FLCW SHUT OFF OR RESTRICTION C2t I.AUTOMATIC LEAK DETECTOR IZ TEST(al GPH) [3 12.ANNUAL INTEGRITY TEST(at GPM SUCCCNNRAVTY SYSTEM: ❑ I1 CONTINUOUS SUMP SENSOR+AUOIBLEANOVISUALALARMS SUGPL'wGRAVfT/SYSTEM: ❑ 11 CONTINUCMSUMPSENMR•AUOWLEANOV=ALALARMS EMERGuNCY GENFJRATDRS ONL'l(!Crap:aptlm appy! ❑'13, CONTINUOUS SUMP SENSCR WITHCUTAUTC PUMPSMUTCFF•AUDIBLE ANO .MERIGENGY GENERATORS ONLY(Geck al Nat app/) VISUAL ALARMS ❑ it CONTINUOUS SUMP SENSOR WaTHCUT AUTO PUMP SHUT OF--AUDISLE,LNO VISUAL ❑ 15. AUTCMATICUNELEmcET7=R(SOGPMTESTI WRHCLIT FLOW SHUT OFF OR ALARMS RE$TBCT;CN ❑ ti AUTCMATIO LIME LEAK DETECTOR(I.O GPM TFS7) ❑ la ANNUAL INTEGRITY TEST Lai GPH) ❑ 18.ANNUAL IN(E($iT'TEST(at GPM) C3 17. ONLY VISUAL CHECK _ ❑ 17. CAILYVIBUALCHECK VIU.DISPENSER CCNTAINIIAENT DISPENSER CONTAINMENT ❑ 17TWAT THAT SHUTS CFF SMEAR VALVE Q 3. OALYVISUALGMECX I DATEINSTALLED ,as Cl 2 CONTNUCUSCLSPENSERPMSENSOR•AUOISLZM"SUA1. MS Cl i TREid61 LINER/ .MCNTORING (� i" ❑ 1 CONIINUCUSDIsp' sE4PAMSENSCR`M AUTOSHUTCF-,., DISPENSER•AUOUSLEANDVLSUALALARMS ❑ 1 NONE N89 CL O"MCPOtATCR SIGNATURE CA'tll>[mil maimptmaoon pLPvalatl Pagan is wa.YM amaSprollfe txa[pt mY maMea9e. SiffNATYRE OF LEA/OPERATOR DATE 370 i{`. /yL NAME OF OYrNRATON(pmtl 471 TTL OI_�yN TOR Yy +R (.t'n'»7'`^ ��IS�d J, .� PemM NWilpeT lFaTmo/ULo pNY) 373 I PUMKAppvwn(fwlpa/um Dory/ 373 I 3]5 11 PamtEmsamn Dau lFermeL ua wWU I )PCF(1199) =GrmeLty SCS Form 3