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UNIFIED PROGRAM CONSOLIDATED FORM L I TANKS NDERGROUND STORAGE TANKS - TANK PAGE 2 Raga of VI.PIPING CONSTRUCTION rhoc/l aUl lMtappyi UUDERGRO�U(ND PIPING I ASOVEGRCUND PIPING SYSTQA TYPE ❑ L PRESSURE UY 2 SUCTION ❑ ]. GRAVITY 458 ❑ 1. PRESSURE ❑2 SUCTIAAON� Q 1 GRAVITY - 459 CONSTRUCTTOW W SINGLE WALL G I LINED TRENCH ❑9S. OTHER 460 [11. SINGLE WALL 4819E UNKNOWN 462 MANUFACTURER 1.❑ 2 DOUBLE WALL ❑95. UNKNOWN ❑ 2 DOUBLE`NALL ❑99.OTHER MANUFACTURER 461 MANUFACTURER 460 1.BARE STEEL ❑ S. FRP COMPATIBLE W1100;6 METHANOL 1. EARS STEEL ❑ E PRP COMPATIBLE Wt 10M METHANOL MATERIALS AND ❑ 2 STAINLESS STEEL ❑ 7. GALVANIZED STEEL ❑ 2 STAINLESS STEEL ❑ 7.GALVANIZED MIL CORROSICN PROTECTION ❑ 1 PLASTIC COMPATIBLE WITH CONTENTS ❑95. UNKNOWN Q 1 PLASTIC COMPATIBLE MTH CONTENTS ❑ B.FLEXIBLE(HOPE? ❑99. OTHER ❑ 4. FIBERGLASS ❑ 8.FLEXIBLE(MOPE) Q 99. OTHER Q 4. FISERGLASS ❑ 9.CATHODIC PROTECTION ❑ S STEEL W COATING ❑ 9. CATHODIC PROTECTION 48d ❑ S. STEEL W COATING ❑95. UNKNOWN 465 VII.PIPING LEAK DETEC71ON(Clark ad Mat appy) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLEWALLPIPING 488 SWGLE WALL PIMNG 4E7 PRESSURIZED PIPING(Cneclt all Met aopy): PRESSURIZED PIPING(Check W Mat apply): ❑ t ELECTRONIC UNE LEAK DETECTOR 10 GPH TEST ATTH AUTO PUMP SHUT OFF FOR ❑ 1. ELECTRONIC LINE LEAK OETECT OR 0.0 GPM TEST W1T4 AUTO PUMP SHUT OFF FOR LEAK LEAK SYSTEM FAILURE AND SYSTEM OfSCCNNECnCN+AUDIBLE AND VISUAL SYSTEM FAILURE AND SYSTEM DISCONNECTION-AUDIBLE ANO VISUAL ALARMS' ALARMS ❑ 2 MONTHLY O?GPH TEST E3 2 N C37. ANNUAL INTEGRITY TEST(0.1 GPM) [3 S ANNUAL INTEGRITY TEST(0.1 GRH) 02 GPT TEST ❑ d, ONLY VISUALCHECK CONVENTIONAL.SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(ChPorW Mat appy): ❑ S DAILY VISUAL MONITORING OF PUMPING SYSTEM.TRIENNIAL PIPING INTEGRITY ❑ 5. ONLYVIBIIALMONRORINGOFPIPINGANOPUMRNGSYSTEM TEST(131 OPH) ❑ 6 TRIENNIAL INTEGRITY TEST Al GPM) SUCTION SYSTEMS MO VALVES IN BELOW GROUND PIPINGI: SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GRCUNO PIPING): 7. SELF MONITORING ❑ 7. SELFMONITORING GRAVITY FLOW. GRAVITY FLOW(Me 0M appy): ❑ 9. BIENNIAL INTEGRITY TEST(al GPHI Q B DAILY VISUAL MONITORING ❑ S. BIENNIAL INTEGRITY TEST(0.1 GPM SECONDARILY CONTAINED PIPING SECONOARB.Y CONTAINED PIPING PRESSURIZED PIPING(Clack W MY apply/: PRESSURIZED PIPING(Cheek aO Mat appy): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND to CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(ChdCk (CA one) ❑ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS poet ❑ G AUTO PUMP SHUT OFF FOR LEAKS.SYSTEM FAILURE AND SYSTEM ❑ a. AUTO PUMP SHUT OFF LUMEN A LEAK OCCURS OISCONNECTICN ❑ 0. AUTO PUMP SHUT OFF FOR LEANS SYSTEM FAILURE AND SYSTEM DISCONNECTION ❑ e NO AUTO PUMP SHUT OFF [211.AUTOMATIC UNE LEAK DETECTOR(19 GPH TEST)NTH FLOW SHUT OFF OR ❑ c ND AUTO PUMP SHUN'OFF RESTRICTION ❑ 1t.AUTOMATIC LEAK DETECTOR ❑ 12ANNUAL INTEGRITY TEST(MIGPH) ❑ 12 ANNUL INTEGRITY TEST Al GT+HI SULTIONKSRAVRY SYSTEM: ❑ 11 CONTINUOUS SUMP SENSCR+AUDIBLE AND VISUAL ALARMS SUCTION/GRAVITY SYSTE& ❑ W. CONTNUCUS SUMP SENSOR-AUDIBLE AND VISUALALARMS EMERGENCY GENERATORS ONLY(CNWW W MW appy) ❑'14. CONTINUOUS SUMP SENSOR�( ITfT AUTO PUMP SHUT OFF-AUDIBLE AND EMERGENCY GENERATORS ONLY(Cttack aN Mat appy) VISUAL ALARMS ❑ 14. CCNTNUCUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF-AUDIBLE AND VISUAL ❑ 15.AUTOMATIC UNE LEAK DETECTOR(ID GPM TEST)WTHOUT FLOW SHUT OFr OR ALARMS RESTRICnON ❑ ti AUTOMATIC LINE LEAK DETECTOR TIO GPH TESTI ❑ 16 ANNUAL INTEGRITY TEST(Gt GPM) ❑ 17. DAILY VISUAL CHECK ❑ 16. ANNUAL INTEGRITY TEST(B.1 GRH) ❑ 17. DNLYNISUALCHECK WILL DISPENSER CONTAINMENT DISPENSER CONTAINMENT ❑ 1. FLCAT MECHANISMTHAT SHUTS OFF SHEAR VALVE ❑ 4. ONLYVISUALCHECK ❑ATE INST ❑ 488 ❑ 2 CONTINUOUS DISPENSER PAN SENSOR-AUDIBLEANO VISUALALARMS Q S TRENCH LINER U MONITORING 1� C 0. CONTINUOUS DISPENSER PANSENSOR'MTM AUTO SHUT OFF FOR DISPENSER-ADIBLEANOVISUALAINRMS ❑ 8. NONE 469 IX OWNERUOPERATCR SIGNATURE Cd VIa1Me eLltamapM pMylpal n Ie MN ip ama8te m Ma OYt pf Aly ktgwlapla. � 111!%E 11 GWR ILLI _ DATE 470 Bw��l a cN. (o ivof i NAM FOWN RA R 471 TITLED ERIOPERATOR 472 a R w% sS a�• PeLmo Npmper lU=arlaol,,.e pMyi 4]3IF PamMAotaa^w0(FvlooN uta Only) 474 I PemllEmpatlon Oau7FprMot pae amY) 475 I UPCF(1199) Famerty SWRCB Farm B