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:,01/03/2003 10:23 2095776040 BOYETT PETROLEUM PAGE 03 L� UNIFIED PROGRAM CONSOLIDATED FORM 'C'ANIGS UNDERGROUND STORAGE TANKS --TANK PAGE Z VI-PIPiNGCONSTRUCTTONllthw Palo Cheoknnr_ UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE 1.PRESSURE [12.SUC ION ❑ ESS 3.GRAV iTY 458 ©1.PRESSURE O 2, SUCTION p 3,GRAVITY 45e �t7NCTRucTtoN ❑1.SINGLE WALL ❑3.LINED TRENCH ❑99.OTHER 460 ❑I.SINGLE WALL 95, MANUFACTURER V,DOUBLE W Q 95.UNKNOWN C1 2.DOUBLE WALL D 99.OTHER, MANUFACTURER 461 MAMJFACTURER 4W Q 1.BARE STEEL ❑r,PRP COMPATIBLE w/IOM% METHANOL ❑1,BARR STEEL p 6,FRP COMPATIBLE W110VA METHANOL ❑2.STATNLESS STEEL p 7.GALVAN17YD STEEL p Unknown ❑z STAINLESS STEEL ❑7.GALVANIZED STEEL p 3.PLASTIC COMPATIBLE W1 CONTENTS ❑99. Oth« p 3, PLASTIC COMPATIBLP W/CONTENTS ❑B,FLEXIBLE(HDPE) Ci 99, OTTiEF, U4,T>MERGLARS ❑s.FLEXIBLE(HDPE) 0 4. FIBERGLASS p 9.CATHODiC PROTECTION p S.STEEL W/COATiNG Q 9,CAT740DIC PROTECTION 46t p 5. STEEL W/COATTNG ©95.UNKNOWN 465 Vii.PIPING LEAK DETECTION Chock all thm A dmmi 'w of the-hodmg proucan Omit be tubmmw to the heal UNDERGROUND PIPING ABOVEGROUND PIPTNC SINGI,R WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURi7M PIPING(Chock all iMu apply): ❑I,F,LECTRONIC LINE LEAK DETECTOR 30 GPH TEST Wr.IJH AUTO PUMP SHUT ❑I, ELECTRONIC LINE LEAK.DETECTOR 3.0 GPH TEST Vrj'W AUTO PUMP OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ SHUT OFF FOR LEAK,SYSTEM FAILURE,AN?SYSTEM DISCONNECTION' AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS, 0 2.MONTHLY 0.2 GPH TEST ❑2_ MONTHLY 0.2 GPH TEST ❑1.ANNUAL INTEGRITY TEST MA GPH) ❑3.ANNIIAT.INTEGRITY TEST(0.1 GPH) ❑4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all that apply) ©5.DAILY ViSUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING 0 5. DAILY ViSUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0,1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPTNG): ❑6. TRIENNIAL 1NTEGRiTY TEST(0.1 GPH) ❑7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW p 7. SELL MONITORING [19.BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Check all that apply); Q P, DAILY VISUAL MONITORING ❑9. BTF,NNIAL INTEGRITY TEST(0,1 GPH) STRCONDARILY CONTAINED PiPING SECONAARTLV CONTAINED PIPING PRESSURIZED PIPING(Ch ck ell out nppty): PRESSURIZED PIPING(Cheek all that aptly): 10, CONTINUOUS TURBINE SUMP SENSOR WITH AUDIF3LE AND VISUAL 10, CONTINUOUS TURBTNE SUMP SENSOR WIJi AUDIBLE AND VISUAL ALARMS AND(Chak One) ALARMS AND(heck a«) Xn. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0 n AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑h. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM Q h ALT-re PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNpCTION t�A ❑c. NO AUTO PUMP SHUT OFF 0.NO AUTO PUMP SHUT OFF uLl 11. AUTOMATIC LiNE LEAK OETECTOR(3.0 GPH TEST)W�j ROW SHUT p(I, AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION k2. ANNUAL INTEGRITY TEST(0.1 GPH) p 12. ANNUAL INTEGRITY TEST(0,1 GPH) SUCTTON/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM ❑13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 011. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMRRCENCY GENERATORS ONLY(Chea of thM apply) RMRRGENCY GENERATORS ONLY(Check ol1 that awlY) p 14, CONTiN10US SUMP SENSOR WITHOUT AUTO PUMP SHUT OPP• ❑t4.CONTINUOUS SUMP SENSOR WITHQL(S AUTD PUMP SHUT OFF AUDIBLE AND ViSUAL ALARMS AUDIBLE AND VISUAL ALARMS ❑15. AUTOMATIC LINE LEAK DETECTOR(3.0 OPH TEST)MaIH J FI.OW p 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPI''TEST) SHUT OFF OR RESTRICTION Q 16.ANNUAL INTEGRITY TEST(0.1 GPM ❑16.ANNUAL INTEGRITY TEST(0,1 GPH) ❑IT DAILY VISUAL CHECK ❑17, DAILYVISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT 1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑4.DAiLLY VISUAL CHECK DATE IPSZAL E� 460 CJ 2,CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUALALARMS CI 5.TRENCH LINER/MONITORING I/n` p 3,CONTINUOUS DISPP_NSPR PAN SENSOR VDJM AUTO SHUT OPF FOR 6,NONE 469 DISPENSER+AUDIBLE AND VISUAL ALARMS iX.OWNER/OPERATOR SIGNATURE I certify that the information pwvjtW hacin a mte wo actuate to the kat of my knpwlotlm SIGNATURE OP PE DATE lb- 0.3 4� NAME OF O ER/QPRfA ( 'nt) 471 TITLP OF OWNERtOPERATOR 4n A,(�„ r� Perron Number(Fa loot)um only) 47,1 Pernik Appmvea(Fm Ia0a1 we only) , 474 {4tMi(Exp on Dme(For"anal we onty) 475 UPCF(12/99 revised) 12 Fcrmcrly SWRCB Form 3