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`r 01/03/2003 10:23 2095776040 BOYETT PETROLEUM PAGE 04 i ll`- L--�R. UNT"ED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 2 of VI.PIPING CONSTRUCTION meek all that PaK- - UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE 4 1.PRESSURE [12.SUCTION ❑3.GRAVITY 430 ❑1,PRESSURE Q 2, SUCTION Q 3.GRAVITY 499 CONM.LIC TON ❑I,SINGLE WALL ❑3.LiNED TRF.NC14 [199.OTHER 460 ❑1.SINGLE WALL ❑95.UMCNOWN 4a7 MANUFACTURER 2.DOUBLE Wn❑95.UNKNOWN ❑2.DOUBLE WALL ❑99.OTHER MANUFACTURER 461 MANUFACTURPR 467 Q 1.BARE STEEL ❑fi.FRP COMPATIBLE w1l WA METHANOL ❑1,BARD.STEEL [3 6.FRP COMPATIBLE N'/100%MSiHANOL ❑2.STAINLESS STEEL 0 7.GAT,VANTZED STEEL O Unkmt ❑z STAINLESS.,rpt L7 7.GALVANIZED STFFL ❑3.PLASTIC COMPAT7ELE W/CONTENTS ❑99. Other ❑3, PLASTIC COMPATiBLF,W/CONTENTS ❑8.FLEXIBLE(HDPE) ❑99, OTWER 4,FIBERGLASS ❑8.FLEXIBLE(HDPkF ❑4, PIBL•ROLASS ❑9.CATHODIC PROTECTION ❑5.STEEL W/COATTNO ❑9,CATHODIC PROTECTION 464 ❑5. STEEL W/COATNG ❑95.UNKNOWN 4e5 VII.PIPING LEAK DiSTECTiON(d-k oll thnt A 4eaa oe of the mon shall!o epbmipee tfie bat UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURI71M PTPNO(Check nll rhm apply): ❑1.ELECTRONIC LINE LEAK DETECTOR 3.0 OPH TEST W.[TH AUTO PUMP SHUT ❑I. ELECTRONIC LINE LEAK DETECTOR 3.0 OPH TEST w[IkT 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 Gm TEST ❑2. MONTHLY 0.2 OPH TEST ❑3,ANNUAL INTEGRITY TEST(0.1 GPI 1) ❑3.ANNUAL INTEGRITY TEST(0.I GFH) Q 4, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check hll that 4rnly) ❑5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PiPiNG [15. DAILY ViSUAL MONITORING OF PIPING A14D7UMPTNO SYSTEM INTEGRITY TEST(0.1 OPH) SAFE SUCTION SYSTEMS(NO VALUES iN BELOW GROUNDPIPTNG): ❑6. TRIENNIAL INTEGRITY TEST(0,1 GPH) ❑7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW OROUND PIPING): ORAVITY FLOW ❑7. SELF MONITORING ❑9,111PNMAL INTEGRITY TEST(0.1 OPH) GRAVITY PLOW(Cheekall that wpb); p 8. DAILY VISUAL MONITORINO Q 9. BIENNIAL NTEORITY TEST(0,1 GPw) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED MING PRESSURIZED PIPING(Chock 4110d,apply): PRESSURIZED PIPING(Cheek en rhm-110 10.CONTINUOUS TLIRBINE SUMP SENSOR W1'T1I AUDIBLE AND VISUAL to. CONTINUOUS TURBINE SUMP SENSOR WM AUDIBLE AND VISUAL ALARMS AND(Peek nae) ALARMS AND(Check mt) a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM ❑b AUTO PUMP SIRJT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION ❑c, NO AUTO PUMP SHUT OFF ❑c NO AUTO PUMP SHUT OFF 11, AUTOMATIC LINE LEAK DETECTOR(3.0 OPH TEST)WJM FLOW SHUT ❑11. AUTOMATIC LAK DETECTOR I OFF OR RESTRICTION 12, ANNUAL INTEGRITY TEST(0.1 GPT`l) ❑12, ANNUAL INTEGRITY TEST(0,)GPM) SUCTTON/GRAVITY SYSTEM SUCTION/GRAViTY SYSTEM ❑13.CONTINUOUS SUMP SENSOR 4,AUDIBLE AND VISUAL ALARMS ❑13. CONTINUOUS SUMP SP.NSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENFRIATOWS OM.Y(Cheek all Umt apply) EMERGENCY GENERATORS ONLY(Cheek 0 that apply) ❑14, CONTINUOUS SUMP SENSOR MD_UJW AUTO PUMP SHUT OFF• ❑14, CONTTNUOUS SUMP SENSOR WITHO AUT.)PUMP SHUT OFF' AUD75LE AND ViSUAL ALARMS AUDiBLE AND VTSUAL ALARMS ❑I5. AUTOMATIC LINE LEAK DETECTOR(3.0 GPW TEST)WITHO FLOW ❑ 15, AUTOMATIC LINE LEAK DETECTOR(3A OPH TEST) SHUT OFF OR RESTRICTION ©16.ANNUAL INTEGRITY TEST(0.1 OPH) ❑16.ANNUAL INTEGRITY TEST(0.1 orm) a 17. DAILY ViSUAL CHECK E317, DAILY VISUALCHECK VITT_DI.SPF.NSFR CONTAINMENT DISPPNSF,R CONTANMP,NT 1.GLOAT MECt1ANNM THAT SHUTS OFF SHEAR VALVE, ❑4.DAiLY VISUAL.CHPCK DATE INSTALLED 468 CONTINUOUS DISPENSER PAN SENSOR+AUDTBLE AND VISUAL ALARMS ❑5,TRPNCW LINER/MONITORING +�✓7 a o,CO DISP6 DISPENSER AND PAN S[ENSALARMS R WM AUTO SHUT OFF PCR ❑6.NONE 460 iX.OWNER/OPERATOR SIGNATURr t c-Ify rhm the.wormm"0"dm hemin la tree and a=mlc to the hea of my kn ledge. SIONA O OP OA DATU Cm Z 03 NAME OF O TOR 'nl) 471 TTI'I,P,O O R'DPERATOR 4T.t 4, 4 ' PmnO NwT*w(Fnt Intal vee on 471 Pit Approval(For local Neo only) 474 Perron FVftRUnn Date(For'aal W aMy) 473 UPCF(12/99 revised) 12 Formerly SWRCB Form B