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i <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 2 <br /> VL PIPING CONSTRUCTION CFeck.11 HW P.8e <br /> UNDERGROUND PIPING I ABOVEGROUND PIPING <br /> SYSTEM TYPE PQ 1.PRESSURE 0 2.SUCTION 0 3.GRAVITY *R 0 1.PRESSURE 0 2. SUCTION 0 3.GRAVITY 459 <br /> CONSTRUCTION O 1.SINGLE WALL 0 3.LINED TRENCH 0 99.OTHER 450 0 1.SINGLE WALL 0 95.UNKNOWN 462 <br /> MANUFACTURER 02.DOUBLE WALL 095.UNKNOWN 02.DOUBLE WALL 099.OTHER <br /> MANUFACTURER ml MANUFACTURER 46E <br /> 0 1.BARE STEEL 0 6.FRP COMPATIBLE WAWA METHANOL 0 1.BARE STEEL 0 G FRP COMPATIBLE W/190%METHANOL <br /> 0 2.STAINLESS STEEL 0 7.GALVANIZED STEEL 0 Uuk. 0 2. STAINLESS STEEL 0 7.GALVANIZED STFEL <br /> 0 3.PLASTIC COMPATIBLE W/CONTEN'T'S OW. Otb 0 3. PLASTIC COMPATIBLE W/CONTENTS OR.FLEXIBLE(HDPE) ❑99. OTHER <br /> 9 4.FIBERGLASS 0 R.FLEXIBLE(HDPE) O 4.FIBERGLASS 0 9.CATHODIC PROTECTION <br /> 0 5.STEEL W/COATING 0 9.CATHODIC PROTECTION 454 0 5. STEEL W/COATING 0 95.UNKNOWN 4n5 <br /> VIL PIPING LEAK DETECTION FlE &Al mn. )(A I 'mafiamml d RU wn dwtnelP <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SINGLE WALL PIPING 456 SINGLE WALL PIPING 462 <br /> PRESSURIZED PIPING(C6ed.R Rar.M,): PRESSURIZED PIPING(Cried A fti Voy): <br /> 0 1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT 0 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TESTS AUTO PUMP <br /> OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ <br /> AUDIBLEAND VISUALALARMS. AUDIBLE AND VISUAL ALARMS. <br /> 0 1 MONTHLY 0.2 GPH TEST 0 2. MONTHLY 0.2 GPH TEST <br /> 0 3.ANNUAL INTEGRITY TEST(0.IGPH) 0 3.ANNUAL INTEGRITY TEST(0.1 GPH) <br /> 04. DAH.Y VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(LT i.u.M wy) <br /> ❑5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING 0 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br /> INIEGRITY TEST(0.1 GPH) <br /> SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): ❑6. 71UENMAL INTEGRITY TEST(0.1 GPH) <br /> 0 7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): <br /> GRAVITY FLOW 07. SELF MONITORING <br /> 09.BIENNIAL INTEGRITY TEST(0 I GPH) GRAVITY FLOW(ct .0 Inn t,): <br /> 0&DAILY VISUAL MONITORING <br /> 0 9. BIENNIAL INTEGRITY TEST(0.1 GPH) <br /> SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING <br /> PRESSURIZED PIPING(Qad.il O VptyY PRESSURIZED PIPING(C .11 nm Wly): <br /> 10. CONTINUOUS TURBINE SUMP SENSOR WIDI AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR W AUDIBLE AND VISUAL <br /> ALARMS AND(CTed we) ALARMS AND(cua o ) <br /> 0 a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0.AUTO PUMP SHUT OFF WHEN A LEAK OCCURS <br /> 0 b.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM 0 b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM <br /> DISCONNECTION DISCONNECTION <br /> bk NO AUTO PUMP SHUT OFF Oc NO AUTO PUMP SHUT OFF <br /> 0 11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) 1 FLOW SHUT O 11 AUTOMATIC LEAK DETECTOR <br /> OFF OR RESTRICTION <br /> 9112.ANNUAL INTEGRITY TEST(0.1 GPH) 0 12.ANNUAL INTEGRITY TEST(0.1 GPH) <br /> SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM <br /> 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY E:ro .0 Oawi,) EMERGENCY GENERATORS ONLY(Cried al ro .W,) <br /> O 14.CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF• 0 14.CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF' <br /> AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS <br /> 0 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW 0 15.AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) <br /> SHUT OFF OR RESTRICTION <br /> 0 16.ANNUAL INTEGRITY TEST(0.1 GPH) 0 16.ANNUAL INTEGRITY TEST(0.1 GPH) <br /> 0 17.DAILY VISUAL CHECK 0 17. DAILY VISUAL CHECK <br /> VIII.DISPENSER CONTAINMENT <br /> DISPENSER CONTAINMENT 01.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE O 4.DAILY VISUAL CHECK <br /> DATEINSTALLED 46R W2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 05.TRENCH LINER/MONITORING <br /> ❑3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR <br /> DISPENSER+AUDIBLE AND VISUAL ALARMS ❑6.NONE 469 <br /> DL OWNER/OPERATOR SIGNATURE <br /> 1c yfnntnein Pmv iclme= hlo the (mykm m'. <br /> SIGNATU OFTOR DATE Pro <br /> /s=o2 <br /> NAME-OF O OR(P^nU 471 TITLE OF OWNER/OPERATOR 472 <br /> Mr b Khon Direcror o{ M7lir/tc YWnCe <br /> Pamir Nu ErmW [lm y) Jli Pnm(IAPp W Fmt4 lu< y) 474 Pw st EnPminn Wft(Fm 10 1ue mly) 475 <br /> UPCF(12/99 revised) 12 Formerly SWRCB Form B <br />