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r <br /> l,. FIED PROGRAM CONSOLIDATED FORT . <br /> + TANK <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 2 <br /> Ali <br /> VI.PIPING I CONSTRUCTION.(Chii tnao-appy) Pape_of <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SYSTEM TYPE 0 1.PRESSURE 0 2.SUCTION 0 3.GRANTY 458 01.PRESSURE 0 2. SUCTION 0 3.GRAVITY 459 <br /> CONSTRUCTION/ 0 1.SINGLE WALL 0 3.LINED TRENCH 0 99.OTHER 460 01.SINGLE WALL 0 95.UNKNOWN 462 <br /> MANUFACTURER (92.DOUBLE WALL 0 95.UNKNOWN D 2.DOUBLE WALL 0 99,OTHER <br /> MANUFACTURER 461 MANUFACTURER 463 <br /> 01.BARE STEEL 0 6.FRP COMPATIBLE w/160°6 METHANOL 0 1.BARE STEEL 0 6.FRP COMPATIBLE W/100%METHANOL <br /> 0 2.STAINLESS STEEL 0 7.GALVANIZED STEEL 0 UKNOWN 0 2. STAINLESS STEEL 0 7.GALVANIZED STEEL <br /> 03.PLASTIC COMPATIBLE All CONTENTS 099. OTHER 03. PLASTIC COMPATIBLE W/CONTENTS 0 8.FLEXIBLE(HOPE) 099. OTHER <br /> ®4.FIBERGLASS D 8.FLEXIBLE(HDPE) 0 4. FIBERGLASS 0 9.CATHODIC PROTECTION <br /> 0 5.STEEL W/COATING D 9.CATHODIC PROTECTION 464 1 0 5. STEEL W/COATING 0 95.UNKNOWN 465 <br /> VII.PIPING LEAK DETECTION(Check:all that apply)(A description of the mtonilonng Program shall be submitted.to the local agency) '. <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 <br /> PRESSURIZED PIPING ICheckall Matapply): PRESSURIZED PIPING(Check all that apply): <br /> D1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR 01. ELECTRONIC UNE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR <br /> LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION,AUDIBLE AND VISUAL LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION-AUDIBLE AND VISUAL <br /> ALARMS. ALARMS. <br /> 02. MONTHLY 0.2 GPH TEST D2. MONTHLY 0.2 GPH TEST <br /> 03. ANNUAL INTEGRITY TEST(0.1GPH) D3. ANNUAL INTEGRITY TEST(0.1GPH) <br /> 04. DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check Bl that amply) <br /> 05. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING INTEGRITY 05. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br /> TEST(0.1 GPH) <br /> SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): 06. TRIENNIAL INTEGRITY TEST(0.1 GPH) <br /> 07. SELFMONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): <br /> GRAVITY FLOW 07. SELF MONITORING <br /> 09. BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Check all that apply): <br /> 0 B. DAILY VISUAL MONITORING <br /> 09. BIENNIAL INTEGRITY TEST(0.1 GPH) <br /> SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING <br /> PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): <br /> 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND <br /> (Check one) (Check one) <br /> Da. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS Da AUTO PUMP SHUT OFF WHEN A LEAK OCCURS <br /> Ob. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM D b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM <br /> DISCONNECTION DISCONNECTION <br /> Dc. NOAUTO PUMP SHUT OFF Oc NO AUTO PUMP SHUT OFF <br /> 011. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUTOFF OR 011, AUTOMATIC LEAK DETECTOR <br /> RESTRICTION <br /> 012. ANNUAL INTEGRITY TEST(0.1 GPH) Q. ANNUAL INTEGRITY TEST(0.1 GPH) <br /> SUCTIONIGRAVITY SYSTEM SUCTIONIGRAVITY SYSTEM <br /> 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY(Check all that appy) EMERGENCY GENERATORS ONLY(Check all that appy) <br /> 014. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF AUDIBLE AND 014, CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND <br /> VISUALALARMS VISUAL ALARMS <br /> 015.AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR 015. AUTOMATIC UNE LEAK DETECTOR(3.0 GPH TEST) <br /> RESTRICTION <br /> 0 16, ANNUAL INTEGRITY TEST(0.1 GPH) 016. ANNUAL INTEGRITY TEST(0.1 GPH) <br /> D 17, DAILY VISUAL CHECK 017. DAILY VISUAL CHECK <br /> VIII;DISPENSER CONTAINMENT <br /> DISPENSER ®1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 04.DAILY VISUAL CHECK <br /> CONTAINMENT <br /> DATEINSTALLED 468 02, CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 05.TRENCH LINER/MONITORING <br /> [13. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+ 0 6,NONE 469 <br /> AUDIBLE AND VISUAL ALARMS <br /> IX.OWNER/OPERATOR SIGNATURE <br /> I certify that the Information provided herein is true and accurate to the best of my knowledge. <br /> SIGNATURE OF OWNER/OPERATOR DATE 476 <br /> 05I31I2007 <br /> NAME OF OWNER/OPRATOR(print) TITLE OF OWNER/OPERATOR 472 <br /> Tiana Andriamenarivo for ConocoPhilli s Co. HSE Specialist <br /> Permit Number(For local use only) 473 Permt Approved(For local use only) Permit Expiration Date(For local use only) <br /> 475 <br /> UPCF(1/99 revised) Formerly SWRCB Form B <br />