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N Vocv rnu%an~ AaVAYOVLNuAar cu r%an Hv <br /> TANK <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 2 <br /> ;;��;•,''� ,/ F,'��ri%.•.�'+.e.ry�.rr r!. r¢i . r'.,�,1 . .. . . �3 �S•' % :�i:•+!��%�?'!./��%'•�%r'%�.f+r vu0a _el <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SYSTEM TYPE I.PRESSURE 02.SUCTION 03.GRAVITY asp Q1.PRESSURE ❑2.SUGTXRL ❑3.OMVITY U9 <br /> CONSTRUCTION/ O L SINGLE WALL ❑3.LINED TRENCH 0 Sp.OTHER ae0 ❑1.9WOLE WALL ❑p5.UNKNOWN ret <br /> MANUFACTURER ®2.DOUBLE WALL 095.UNKNOWN 112 DOUBLE WALL 099 OTHER <br /> MANUFACTURER MI MANUFACTURER_ Ip3 <br /> ❑I SAKE STEEL IN 6 FRP COMPATIBLE Wh00% METHANOL 01.DARE STEEL 06 FRP COMPATIBLE W/100%METHMIDL <br /> 02.STAINLESS STEEL 07.GALYAMZED STEEL ❑UKNOWN 02. STMNILESSSTEEL 07.GALVANIZE D STEEL <br /> 03,PLASTIC COMPATIBLE W/CONTENTS 1199. OTHER Q3 PLASTIC COMPATIBLE W/CONTENTS O 1.FLEXIBLE(HOPE) 099. OTHER <br /> ❑4.FIBERGLASS ❑B.FLEXIBLE(HDPE) 04 FIBERGLASS ❑9.CATHODIC PROTECTION <br /> r.. NG 0 S. STEEL W/COATING 465 <br /> r s sTEELwrcWn IL+ PIN 4EhIK'0[:TEG710N' . aa,uiM.,' ,:KaNre'�. ", �9s.uNXNDwH . <br /> 9.CATHODIC PROTECTION 4Ba <br /> r , <br /> UNOERGROUND WIN •d Ik'McAll'oflA " ''a9BOVEd (bUPI <br /> A WEOROUND PIPING <br /> SINGLE WALL PIPING aea SINGLE WALL PIPING +er <br /> 7PFFPIPINGIOpwAY ft,WMI'. PRESSURIZED PIPING(Check as IMI=M: <br /> IC LINE LEAK DETECTOR 3.9GPH TEST MM AUTO PUMP SHUTOFF FOR 01. ELECTRONIC LINE LEAK DETECTOR 3.O GPH TEST=AUTO PUMP SHUT OFF FOR <br /> EM FAILURE,AND SYSTEM DISCONNECTION.AUDIBLE AND VISUAL LEAK,SYSTEM FAILURE.ANDSYSTEM DISCONNECTION.AUDIBLE AND VISUAL <br /> ALARMS. <br /> .2 GPH TEST 02. MONTHLY 0I GPH TESTTEGRITY TEST(D.IGPHI 03. ANNUAL INTEGRITY TEST III IGPH) <br /> 01, DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS Ichwh 41ft.ppW) <br /> 05, DAILY VISUAL MONITORING OF PUMPING SYSTEM,TPIENNIAL PIPING INTEGRITY <br /> TEST(0,1 GPH) OS WILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br /> SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GAOUNDPPEIGp O S TRIENNIAL INTEGRITY TEST(0.t GPH) <br /> 07. SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES)N BELOW GROUND PIPING): <br /> GRAVITY FLOW 07. SELFMONRORING <br /> 09. BIENNIAL INTEGRITY TE3Y(G7 GPH) GRAVITY FLOW(LTrck smov ).. <br /> O B DAILY VISUAL MONITORING <br /> 09. BIENNIAL INTEGRITY TEST(OT GPH) <br /> SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING <br /> PRESSURIZED P IPING(Check at tlwl appy): PRESSURIZED PIPING(Check Pe Ihm appy): <br /> 1D. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARM SAND <br /> (Chwh me) (ChwA mN <br /> ❑a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑a WTO PUMP SHUT OFF WHENALEAK OCCURS <br /> DISCONNECTION <br /> TION <br /> [36. OSHUTOFF FOR LEAKS.SYSTEM FAILURE AND SYSTEM Ob WTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM <br /> DIS <br /> ®c. NO AUTO PUMP SHUTOFF DISCONNECTION <br /> QP NO AUTO PUMP SHUT OFF <br /> ❑tt. WTOMATICLINE LEAH DETECTOR TDO GPH TEST) FLOW SHUTOFF OR <br /> RESTRICTION ❑tt. AUTOMATIC LEAK DETECTOR <br /> 912. ANNUAL INTEGRITY TEST(0.1 GPH) 012. ANNUAL INTEGRITY TEST TO I GPH) <br /> SUCTIOWGRAV(TY SYSTEM SUCTIOWGRAWTY SYSTEM <br /> 017. CONTINUOUS SUMP SENSOR,AUDIBLE AND VISUAL ALARMS LI13. OONTINUOUSSUMP SENSOR.AUDIBLE AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY(Check aA IIA appy) EMERGENCY GENERATORS ONLY(CMek aL mM appal <br /> 014. CONTINUOUS$UMP SENSOR WITHOUT AUTO PUMP SHUT OFF.AUDIBLE AND 014, CONTINUOUS SUMP SENSOR WITHOU AUTO PUMP SHUT OFF.AUDIBLE AND <br /> VISUAL ALARMS VISUAL ALARMS <br /> O IS. AUTOMATIC UNE LEAK DETECTOR ISO GPH TEST)WITHOUT FLOW SHUTOFF OR <br /> RESTRICTION 1115. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) <br /> 016. ANNUAL INTEGRITY TEST(D.1 GPH) 016. ANNUAL INTEGRITY TFST(0.1 GPH) <br /> 0 I DAILY VISUAL CHECK 017. WAY VISUAL CHECK <br /> •.DISPENSER j / j.:.. '.: ':: C11MM'RI9P.)_EISER..CdJ�i1UNIfAEyi' •' <br /> CONTAINMENT 01, FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE C A WILY VISUAL CHECK <br /> DATE XMSTALLEO 469 132. CONTINUOUS DISPENSER PANSENSOR.AUDIBLE ANDVISUAL ALARMS 05.TRENCN LINER/MONITORING <br /> 12/98 ❑3. CONTINUOUS DISPENSER PAN SENSOR b'jjGAUTO SHUT OFF FOR DISPENSER. <br /> AUDIBLE MND VISUAL ALARMS 0 D NONE a69 <br /> .. „r. r. ^. ��:�� .t ./.,: F! ;Ori PENAA7U,E(E,'s�%�,'%','nn l`�'�iiY�'..%rig'�'%%i,;:y.;��':/',n•� '''.4,... <br /> �svniry Ilial Iha.nernvinh pe.NMe herein s ws end amerce Ieoa MH PI my InPwM9e, <br /> SIGNATURE OF OWNER/OPEgATOR DATE 470 <br /> NAME OF OWN (Pv"U TITLE EROPRATOR TITLE O <br /> OF OWNER/OPERATOR an <br /> Dennis Smith Operations & Environmental S ecialist <br /> PerTh Nemker(Fpr bn use only) 473 PamMI ADwend(rvr bnl we oW PaAWI E>peadch bm(Fpr bul we ehly) <br /> 475 <br /> UPCF(1/99 revised) FoffrWrly SWRCR Form 0 <br />