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UNIFCO PROGRAM CONSOLIDATED FORM IE_A'':k UNDERGROUND STORAGE TANKS - TANK PAGE 2 SYSTEM TYIPE 1. PRESSURE ❑ 2 sLICT10N U 1. GRAVITY 458 U 1. PRESSURE U 2. SUCTION U ]. GRAVITY a9 ❑ 1. SINGLE WALL ❑ I LINED TRENCH ❑ 90 OTHER 00 ❑ 1. SINGLE WALL ❑ 95. UNKNOWN a2 CONSTRUCTION/ MANUFACTURER p 2. DONEE WALL ❑ 0 UNKNOWN ❑ 2. DOUBLE WALL ❑ W. OTHER MANLFACTURER '161 MAMIFACTU ER a63 ❑ 1. BARE STEEL ❑ 6. FRP COMPATIBLE WY IDD% METHANOL ❑ 1. BARE STEEL ❑ 6. FRP COMPATIBLE WA 1(X%METHANOL MATERIALS AND ❑ 2. sT,VEEsssTEEL ❑ T GALVANIZEDSTEEL ❑ 2. STAINLESS STEEL ❑ T. GALVANIZED STEEL f.DIVICISION PROTECTION ❑ 0 PLASTIC COMPATIBLE VATM CONTENTS ❑ 95. UNKNOWN ❑ 0. PLASM COMPATIBLE WRH CONTENTS ❑ 6. FLEXIBLE MOPE) ❑ my OTa6R Ot A. %BERt:V35 ❑ 6 FLEXIBLE (HOPE) 09B. OTHER ❑ A. FIBERGLASS ❑ 9 CATHODIC PROTECTION ❑ 5. STEEL W/COATING ❑ 9 GTMOOIC PROTECTION aea ❑ 5. STEEL W/COATING ❑ 95. UNKNOWN A65 VII. PIPING LEAK DETECTION (CAa! Y MM nay PRESSIMIZEO PI%NG fGAMnMAf appy.' - PPESSUR2ED %PING (GNAO ap MMappy/' ❑ 1 ELECTRGNIC UNE LEAK DETECTOR D 0 GPM TEST VATH AUTO PUMP SHUTOFF FOR ❑ 1. ELECTRONIC ONE _EAK DETECTOR 5 0 GPH TEST WITH AUTO PUMP SHUT OFF FOR /FAA LEAK SYSTEM FAILURE. AND SYSTEM GISCPINECTON. AUDIBLE AND VISUAL SYSTEM FAILURE AND SYSTEM DISCONNECTION. AUDIBLE AND VI SUAL ALARMS �]a ALARMS ❑ 2. MONTHLY02GPHTEST MN 2 MONTHLY02GPHTEST ❑ 2. ANNUAL INTEGRM TEST (0 1 GEN) ❑ 0 ANNUAL INTEGRITY TEST (0.1 GPM ❑ A DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ❑ 5 OWLYVISUAL MONITDRINGOF PUMPING SYSTEM. TRIENNIAL PIPING INTEGRITY TEST(O I GPHI SAFE SLICTIOR SYSTEMS IND VALVES IN BELOW GROUND PIPINGU. ❑ T SELFMONITORING GRAVITY FLOW ❑ 9 BIENMAI_ WTEGRITY TEST (0 I GPM) SECONDARILY CONTAINED PIPING PRESSURIZED%%NG(CAWAA nMAwy)' 10 CONTINUOUS TURBINE SUMP SENSOR W_ AUDIBLE AND VISUAL ALARMS AND ,IC); drl L�7J AUTO PUMP SMR OFF WHEN A LEAK OCCURS pd0 AUTO PUMPPa OFF FOR LEAKS SISTEM FAILURE AND SYSTEM DISCONNE ❑ C NO AUTO PUMP SNR OFF ❑ 11 AUTOMATIC LINE LEAK DETECTOR U 0 GF -EST) WITH FLOW SHUT CFF OR RESTRICTUN ❑ 12 ANNUALINTEGRITY TEST (0.1 GPMI SUCTONCRAVITY SYSTEM ❑ 10 CCNTINUGUS SUMP SENSOR. AUDIBLE .10 VISUAL ALARMS CONVENTIONAL SUCTION SvSTEMS(ChaF aR mm AoFty, ❑ 5 DAILY VISUAL MON"ORING OF PIPING AND PUMPING SYSTEM ❑ 6. TRIENNIAL INTEGF.TY TEST( O. I GPM) SAFE SUCTION SYSTEMS NO VALVES IN BELOW GROUND PIPING): ❑ T SELF MONITORING GRAVITY ROW (CAMM Snappy: ❑ 6. ONLY VISUAL MONTOTIING ❑ 9. BIENNIAL INTEGR„ TEST (0 I GPM) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Ca aMN appYP 10. CONTINUOUS TCPINE SUMP SENSOR VAT) AUDIBLE ANO VISUAL ALARMS AND (Cnv pnal ❑ A. AUTO PUMP SMUT OFF WHEN A LEAK OCCURS ❑ 6 AUTO PUMP SHUT OFF FOR LEAKS SYSTEM FAILURE AND SYSTEM OSCONNEC-:N ❑ C NO AUTO PAP SHUT OFF ❑ 11 AUTOMATIC LEA,,='ECTOR ❑ 12. ANNUAL INTEGR-'-EST (0I GPM, SUCTION'GR VITY SYSTEM ❑ 15 CONTINUOUS SL -P SENSOR. AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Cft A 8 fAaf appy ❑ to CCNtINUOVS SUMP SENSOR VN HWiA -- PUMP SHUT OFF• AUDIBLE AND EMERGENCY GENERATORS ONLY (Che "Ih.,AodY) VISUAL ALARMS ❑ 14. CONTINUOUS SLVP SENSOR WITCH AUTO PUMP SHUT OFF. AUDIBLE AND VISUAL ❑ IS AUTOMATMUNELEAI(CETECTO14O.0G-ESTIVATHOUT FLOWSHUTOFFOR ALARMS RESTRICTION ❑ 15. AUTOMATIC LINE _AK DETECTOR O O GPM TESTI ❑ 16 ANNUAL INTEGRITY TEST (0 I GPM) ❑ iT CNLYVISUAL CHECK ❑ 16. ANNUAL INTEGR-•-EST (Ot GPM) ❑ 17. GAILY VISUAL C`__R VIII. DISPENSER CONTAINMENT D'SPENSER CONTAINMENT ❑ 1 FLOAT MEGH;\ SM THAT SHUTS OFF SHEAR VALVE ❑ A DAILY VISUAL CHECK DATE INSTALLED A66 ❑ 2. CONTINUOUS:SPENSER PAN SENSOR. AUDIBLE AND VISUAL ALARMS ❑ 5. TRENCHLINER_ ,,�OO I MONITORING C.^OU'_J ONNUSPENSER VAN5EN5CR NTH AUipSNUT OFF FCR O'SPENSER •-..3LE ANO VISUAL ALUMS J6 NONE IX. OWNER/OPERATOR SIGNATURE uMv na na mldmAuon orP+pAp IINan R oua arc aW/rou m mA oen pi mY .npwla69a. W/ 'nr1-�; +r.mo111Fd Iool u3e Mlvl •'3]']-mlilE¢r]IIpP O]Ia lFpr ipylu3l P/u• • _ I yPCF !''39) `110 m Formerly SVVRCB F: - 3