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12/29/20D6 16:06 209460 433 EHD ♦p�1PAGE 05 • UNIFIED PROGRAM ONSOLIDATED FORM l�ljJ'V ` I SANK! PR N: UNDERGROUND STO GE TANKS- TANK PAGE 2 FAC R: VL PEPING CONSTRUCTION(ow dl thm wpiv) files el) UrCeRGROU )PING IABOVEGROUND PIPING SYSTEM TYPE ❑jAwsuRE 26.SUCTION ❑ 2.GRAVITY .511 ❑ I,PRESSURE ❑ 2.SUCTION ❑ 7.GRAVITY tlh CONSTULNON 1.SINGLEWALL 07.LNEOTR£NCH ❑99.OTHER 46" ❑ I.SINGLE WALL ❑95,UNKNOWN 115 ❑2.DOUBLE WALL ❑95.UNKNOWN ❑ 2.DOUBLE WALL ❑9P.O'17(EK MANUT UREK 661 MANUFACTURER 665 L DARE STPPL ❑ 6,FN COMPATIBLE W INY.METIIANOL ❑ I,BARE STEEL ❑6.FRPCOMI•ATIBLEw'160KMRILANOL 2 SLVNLOSSTEEL ❑ 7.OALVANMEDSTEEL ❑2.STAINLESSSTM ❑7.OALVANIZPDSTBEI. ❑PLASTIC COMPATIBLE W/CONTENTS ❑ 95.UNKNOWN ❑ PLASTICCOMPATIBLEW/CONTENTS ❑ 95.UNKNOWN ❑ 1.FIBERGLASS ❑ O,FLUIBLE(Nom LI 99.OTHER E) 6.FIBEILGLAS5 ❑S.FLEMOLB(IIDPE) ❑ 99.OTHER ❑ 5.STEEL WICOATINO 9.CATHODIC)ROMCDON .FA ❑ 5,STEEL WICOATNG ❑R CATHODIC PROTEC'T'ION 465 VII.PIPING LEAH DE'fECT10N ICimk�m l6Nn 11 .r vl 1H�OI11¢ieewrin mann R.0 ke A.ON IO N.Iw111N ,j UNOLRGROVND PIPING ADp G0. SINGLE WALL PIPING 46 SINOLEWALLPIPING 467 PRESSURIZED PIPFNC(Ch..Y dl lhn.pplYL PRESSUAIZEDPVING(Ch.9k.)I Iher.pply): ❑ L ELECTRONIC LME LEAK DETECTOR 5.0 OPHMST WRN AUTO PUMP SHUTOPF C3 I.ELECTRONIC LINE LEAK DETECTOR 5.0 GPH TEST WITII AUTO PUMP SHUT OFF FOR LEAK,SYSTEM PAICURE,AND SYSTEM DISCONNECTION-AUDIBLE AND FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS. VISUAL ALARMS, ❑ Z MOVT/)LV 0,2 WII TBST ❑1 MONTHLY D.2 CPH TEST ❑1.ANNUAL INTEGRITY TEST(0,I GPM) ❑I ANNUAL INTSONTY MST(DA 01'H) ❑A DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SVCTION SYS'rems 10.1,'It Simi.pPly) ❑ 5DA1 VISUAL MONRORWGOFI'UMPINGSYSTEM+iNQNNIPAL PIING ❑S.DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INT NTY TEST(O.IOPH) ❑6.TRIENNI AL INMQItrTY 72ST(0 I OPII) SAf CTI ON SYSTEMS(NO VALUES IN BELOW GKOUNDIVINQ SAFE SUCTION SYSTEMS(NO VALUE S IN BELOW GROUND MING) $ELFMON)TORING GAAVMTY FLOW ❑7.SELF MONITORING ❑9.BILNNIAI.PfTBGRITY TEST(D.1)CPS GRAVITY PLOW(CDak All that Apply): ❑S,DAILY VISUAL MONITORING ❑9.BIENNIAL INTEGRITY TEST(0.1)GPH SECONDARILY CONTAINED PIPING SECONOARFLV CONTAINED RPING MESSMZfD PIPING(C1.,k all Skim apply): PRESSURIZED PIPING(Chak.111h.1.pply): 10.CONTINUOUS TURBINE SUMP SENSOR Wl TM AURID LB AND VISUAL IS CONTINUOUS TURBINE SUMP SENSOR WIDI AUDIBLE AND VISUAL ALkKMT AND IChnY.Nl ALARMS ANU(Oxk m0 ❑ 1.AUTO PUMP BUT OFPWHEN A LEAK OCCURS A.AUTO PUMP SHUT OR WHEN A LEAK OCCURS ❑ 6.AUTO PUMP HUT DF FOR LEAKS,SYSTEM PAILURP AND SYSTEM C)IS.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURD AND SYSTEM DISCONNECH DISCONNECTION C].. NO AVTOPU PSHV'( ❑C. NO AUTO PUMP SHUT OFF ❑ IL AUTOMATIC LM LEAKD T 0 '.D G9N TEST)WITN FLAW YNUi OFF OK ILAVTOMATIC LEAK DETECTOR RESTRICTION ❑ C3 (1 TEG VTE .)G ) ❑ 12.ANNUAL NTEGRITYMS7(o)GPH) SUCDD, TY SYS SUCTION'IGRAVITY SVSfEM ❑ U C TN $S P SENSOR♦AUDIBLE AND VISUAL ALARMS ❑ 1 S.CONTNUOUS SVMP SENSOR AUDIBLE AND VISUAL ALARMS EMERG NCY GENERATORS ONLY(C .J11Se1 e9.N) EMERGENCY GENERATORS ONLY(CS.,k w e,ay,py) ❑ 14 ON INUOVSSUM ENSOR WITHOUT AUTO PUMP SHUT OFF' ❑ 16,CONTINUOUS SUMP SENSOR aMLQ,a AUTO PUMP SHUTOFF' AVOIDIE ANU VISUAL ALARMS AUDIBLE AND VISUAL,UARMS ❑ IS AU70MA71C LINE LEAK DEFECTOR f.,.0 GPII TEST)WITPIOVT FLOW E315.AUTOMATICLNEI XDPTECTOR().QCPH'1'BST)WITHOUTPWW SHUT OFF OR KESTRICT(ON SHUT OFF OR RESTRICTION ❑ 16.ANwuAL NTEGN T Y TEST(0.1 OPH) ❑ 16.ANNUAL INTEGRITY TEST(0 1 GPH) I ❑ 17.DAILY VISUAL CHECK ❑ 17.DAILYVISUAL CHECK VN.DISPENSE4 CONTAGYMENT DISPENSER CONTAINNT ❑ I,FLOAT MECHANISM THAT SHUTS OPP SHED VALVE ❑e.DAILY VISUAL CIIECK DATE INSTAL LED JLY ❑2.COM'INUOV$D.ISPENSER,PANSENSOR+A IBLEANDVISUALALAAMS ❑5, CH LNERIMON]'TONKG ❑ 7.CONTINUOUS DISPENSER PAN SENSOR AUTO SHUT OFF POR CT60NE DISPENSER'AUDrOLE AND VISUAL ALARMS 165 Ill.OWNEIvOrEr ATOR SIGNATURE IiM,F iA,i •.(o�a�np,wle,Jn al'nC 4'nen+.ip. / SIGN OW 0 M'I' r� DATE / - O +7n ty^ I�MJEOFOIANERIOPERA R(,.m) t tl 171 TITLE OJ'6y'N�K/QPEI�MG;OA ^ all hwh n..en IV.,W .N wo ` .175 ionk APP,.'d(Porbwluns 10 111 C�J' T�'S.1k Ewim_ien Do.(I,,Ie 1)f UPCF(12199 rcyiscd)