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UNIFIED PROGRAM CONSOLIDATED FORM TAMM UNDERGROUND STORAGE TANKS - TANK PAGE z VL PIPING CONSTRUCTION (nplrarARPN - U$IER('AOl11D PING ABOVEGROUND PIPING SYSTEM TYPE 0 1. PRESSURE ❑ 2 SUCTION ❑ 3 GRAVITY AM ❑ 1. PRESSURE ❑ 2. SUCTION ❑ 3. GRAVITY 4591 CONSTRUCTX7fY ❑ I. SINGE WALL ❑ 3 LINED TRENCH ❑ 99. OTHER ASO Cl 1. SINGLE WALL ❑ 95. UNKNOWN 462 MANUFACTURER ❑ K UNKNWM ll 2. DOUBLE WALL132. DOUBLE WALL ❑ 99 OTHER MANUFACTURER 01 MANUFACTIiiBi 43 ❑ 1. HARE STEEL ❑ S FRP COMPATIBLE W410(% METHANOL ❑ 1. BARE STEEL ❑ 6. FRP COMPATIBLE Yet 1W%METHANOL MATERIALS AID ❑ 2. STAINLESS STEEL ❑ 1. GALVANIZED STEEL ❑ 2. STAINLESS STEEL ❑ ). GALVANIZED STEEL CORROSION PORROSION C [3. PLASTIC COMPATIBLE WITH C014TENTS ❑95. UNKNOWN 133. PLASTIC COMPATIBE WITH CONTENTS ❑ 6. FLEXIBLE(HOPE) [IN, OTHER 4. FIBERGLASS ❑ 6 FLEXIBLE(HOPE) ❑99. OTHER ❑ 4. FIBERGLASS ❑ 9. CATMODIC PROTECTION ❑ 5. STEEL WICOATING ❑ 9 DATHOOIC PROTECTION aw ❑ 5. STEEL WICOATING Cl 95. UNKNOWN ASS VII. PIPING LEAK DETECTION (Chia w that aopryl UNDERGROUND PIPING ABOVEGROUND PIPING 511GLE WALL PIPING 466 SINGLE WALL PIPING MT PRESSURIZED PIPING (Chaca At MA' Appy)' PRESSURIZED PIPING (CAAa all Mat appy): ❑ 1 ELECTRONIC LINE LVK DETEGG:3c GR1-EST YVITH AUTO PUMP SHUTC-FFOP ❑ 1 E: CTIIONICL'1c�8 DETECTCR?.a GPM TEST =TI- AUTO PUMP SHUT OFF FOR uiV LEAK SYSTEM FAILURE. AND SYSTEM OISCONNEOTION. AUDIBLE ANO VISUAL SYSTEM FAILURE AND SYSTEM DISCONNECTION• AUDIBLE AND VISUAL ALARMS ALARMS ❑ 2. MONTHLY 02 GPM TEST ❑ Z MONMLY 03 GPM TEST ❑ 3. ANNUAL INTEGRITY TEST (0.1 GPM) ❑ 1 ANNUAL INTEGRITY TEST 10.1 GPM ❑ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SvSTEMS (Chm* all that copy): ❑ 5. DAILYMSUAL MCNITORNGOF PUMPING SYSTEM- TRIENNIAL PIPING INTEGRITY ❑ 5. DAILY VISUAL MON-ORINGOF PIPING AND PUMPING SYSTEM TEST (0.1 GPH) ❑ 6. TRIENNIAL INTEGR'Y TEST (D 1 GPM) SAFE SUCTION SYSTEMS(NOVALVES IN BELOWGROUND PIPING)-. SAFE SUCTION SYSTEMS ^. VALVES IN BELOW GROUND PIPING): ❑ T SELFMCNITORING ❑ T SELFMCNITORIIG GRAVITY FLOW GRAVITY FLOW kept Y TY app'yl: ❑ 9. BIENNALINTEGRITYTEST(0.1GPH) ❑ 6. DAILYVISUALMCNTORING ❑ 9. BIENNIAL INTEGR TEST (0.1 GPM) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (ChMr Mat appy) PRESSURIZED PIPING (C4ca w Mafappy): 10. CONTINUOUS TURBINE SUMP SENSOR WW=- AUDIBLE AND VISUAL ALARMS AND IGAFA mal 10. CONTINUOUS 7.-BINESUMP SENSOR HATH AUDIBLE AND VISUAL ALARMS AND (ch. 1Ai. AUTO PUMP SHUT OFF ALE4KOCCURS mei 1A III AUTO PUMP SMR OFF FOR FOR IFAILS S"STEM FAILURE AND SYSTEM ❑ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS OISLONNECTIO4 ❑ c. NOAUTOPUMPSHUTOFF ❑ b AUTOPUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNEC-ON ❑ UG --ESTI WITH FLOW SHUT OFF OR ❑. IlO AUTO P_VP SHUT OFF 11 AUTOMATIC LINE LEN( DETECTOR I3 iESTRICTICN 0 1 AUTOMATICLE.•__:ECTOR ❑ 12. ANNUAL INTEGRITYTEST (O.1 GPH) ❑ R. ANNUAL INTEGR'•'cST (0.1 GPH1 SUCTIONIGRAVItt SYSTEM. ❑ 13 CONTINUOUS SUMP SENSOR -AUDIBLE a.NO VISUAL ALARMS $UCTION.GRAVITY SYSTEM ❑ 13 CONTINUOUS SLY: SENSOR. AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY ICft. an Mat.00yl ❑ 14 CCNTRIUOUS SUMP SENSOR VATHOUT ALTO PUMP SHUT OFF• AUDIBLE AND EMERGENCY GENERATORS ONLY (Che all that appy) 1 VISUAL ALARMS ❑ 14. CONTINUOUS SLVP SENSOR WITHOUT AUTO PUMP SHUT OFF. AUDIBLE AND VISUAL ❑ 15 AUTOMATIC UNE LEAK DETECTOR (3 OG -EST) WITHOUT FLCWSHUT OFFOR ALARMS RESTRICTION ❑ 15. AUTOMATIC UNE � DETECTOR (3A GPM TEST) Cl 16. ANNUAL INTEGRITYTEST (0.1 GPH) ❑ 18. ANNUALINTEGR- -EST IOGPM) ❑ 11 CAILYVISUALCMECK .I ❑ 1). DAILY VISUAL C -_]K Vill. DISPENSER CONTAINMENT DISPENSER CONTAINMENT ❑ 1 F_OAT MEGHA�.SM THAT SHUTS OFF $HEAR VALVE ❑ 4 DAILY VISUAL CHECK DATE INSTALLED A68 ❑ 2. CONTINUOUS :.SPENSER PAN SENSOR • AUDIBLE AND VISUAL ALAR S Cl 5. TRENCH UNER. K LUL% MONITORING �ry2 �aAA ©[N Fl3.CONT'NUCL6 JSPENSERPANSENSCR MTHAUTOSHUTOFFFCR 3---:4LEANOVtSUALALAPVS 0 NONE v; IX. OINNERUOPERATOR SIGNATURE I uMffft.t mA'Mp um pnNlOw M.. v Ow arc ..'. 10 TA oeaml my anoMap9a. SIGRE OF OWN PERATOR DATE ,•0 TE I a NAME C=OWNS OR IDMAI 471 TITLE OF OWNER/ TOR .-2I -^ L^ a- a 3/ PNmR'vumparyFot loo, uS'. 1) e3 iV -ermilEuva Wn Dab lFp/Iogl Usa Onn a _ UPCF (1/99) Formerly SWRCB F- 5