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UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS- TANK PAGE 2 VL PIPING CONSTRUCTION au Wa PaM-2 of UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEMTYPE PO(.PRESSURE 02 SUCTION 03.GRAVITY asa 01.PRESSURE 02 SUCTION 03.GRAVTIY aw COMSfRUCT 111.SINGLE WALL 0 3.LINED TRENCH 0 99.OTIiFR 460 0 L SINGIE WALL 0 95.UNKNOWN 4R MANUFACTURER O 2 DOUBLE WALL 095.UNKNOWN 02 DOUBLE WALL 099.OTHER MANUFACTURER 561 MANUFACTURER 4M 0 I.BARE STEEL 0 6.FRP COMPATIBLE W11W% METBANDL ❑1.BARE STEEL ❑6.FRP COMPATIBLE Wll0 METHANOL 0 2 STAINLESS STEEL 0 7.GALVANIZED STEEL 0 UMmowo ❑2. STAINLESS STEEL 0 7.GALVANIZED STEEL [13.PLASTIC COMPATIBLE W/CONTENTS 0 W.Odw 0 3. PLASTIC COMPATIBLE W/CONTENTS 0&FLEXIBLE(HDPE) El%.OTHER 104.FIBERGLASS 0 R FLEXIBLE(HDPE) 0 4. FIBERGLASS 0 9.CATHODIC PROTECTION ❑5.STEEL WCOATING 0 9.CATHODIC PROTECTION 4M 0 5. STEEL W/COATING 0 95.UNKNOWN 565 VIL PIPING LEAK DETECT'ION(c .aw A ouonbemmm� amuxw6o,mxa,lee loml _ UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 566 SINGLE WALL PIPING 567 PRESSURIZED PIPING(Oaad.R Mal goyY PRESSURIZED PIPING(O .Il m.l apply): 0 1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WULi AUTO PUMP SHUT 0 1. ELECTRONIC LME LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS. ❑2 MONTHLY 0.2 GPH TEST 0 2 MONTHLY 02 GPH TEST 0 3.ANNUAL INTEGRITY TEST(0.1 GPH) O 3.ANNUAL INTEGRITY TEST(0.1 GPH) 00. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Oadiau PonNply) �5.DAILY VISUALMONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING 05. DAILYVISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW OROUNDPIPING): 0 6. TRIENNIAL INTEGRITY TEST(0.1 GPH) 0 7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW 07. SELF MONITORING ❑9.BMN NIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(L7aatlaa Mm applyY 0&DAILY VISUAL MONITORING ❑9. BIENNIAL INTEGRITY TEST(OA GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(O At awhk PRESSURIZ.FD PIPING(I>,.a.a 76m appy): 10- CONTINUOUS TURBINE SUMP SENSOR F'fIFI AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMSAND(C .) ALARMS AND(G oa<) 0 a. AUTO PUMP SHOT OFF WNFIN A LEAK OCCURS 0 a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS Db. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM 0 b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION Zc. NO AUTO PUMP SHUT OFF Oc NO AUTO PUMP SHUT OFF ❑11.AUTOMATIC LINE LEAK DETECTOR(3.0 OPD TEST)WI FLOW SHUT" 11. AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION IA 12.ANNUAL INTEGRITY TEST(0.1 OFF) 0 12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTIOWGRAVITY SYSTEM SUCTIOWGRAVTIY SYSTEM 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Cunt 014m apply) EMERGENCY GENERATORS ONLY(ctr x e l n apPIY) 0 14.CONTINUOUS SUMP SENSOR WrIHOUi AUTO PUMP SHUTOFF• 0 14.CONTINUOUS SUMP SENSOR WITHOVI'AUTO PUMP SFM OFF AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS 015. AUTOMATIC LINE LEAK DETECTOR(3.0 GFH TEST)WITFLOUT FLOW 015.AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICTION [116.ANNUAL INTF.GRTIY TEST(0.1 GPH) 0 16.ANNUAL INTEGRITY TEST(0.1 GPH) 0 17.DAILY VISUAL CHECK 1 0 17. DAILY VISUAL CHECK V ILL_DISPENSER CONTAINMENT DISPENSER CONTAINMENT OI.FLOAT MECHANISM THAT SHUTS OFF SHEARVALVE O 4.DAILY VISUAL CHECK DATE INSTALLED 46B Id 2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 0 5.TRENCH LINER/MONITORING 03.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR 06.NONE 4PN DISPENSER+AUDIBLUANDVISUAL ALARMS DL.OWNER/OPMUTOR SIGNATURE SIGM SIGNA RENW TOR O fim urtmaab acro ormylmwk64e. n ERADATE ao zq N OP OR MT) 471 TITLE OF OWNERlOPERATOR 4R r- 8o Kivh Diredtar of Ma7nTerwhC e I'enmP N,mtc(F oae xdY) 4T5 Pvmit Al (I.lom .my) 4T4 Pa®I Ccpifdion Oak(Fmlpml uze ooh) 475 UPCF(12/99 revised) 12 Formerly SWRCB Foam B