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` Nu-13-2002 1:28am From-ARCO PRODUCTS +714-670-3095 T-817 P.001/007 F-536 + "NfFIF11 PRCICJRAM Cf1NC01.M.%TV,,n M- TANKS UNDERGROUND STORAGE TANGS-- TANK PAGE 2 VI.PIPING CONMUC'TION((hook J'that apply) UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE 1,PRESSURE ❑2,St1C-LION ❑3.GRAvrry 4s11 ❑1.PARS-SURF ❑2.SUCTION ❑3.GRAVITY 4.9, CONSTRUCTION/ C❑I,SINGLE WALL []3.LINED TRENCH ❑99.01'NFR qa0 ❑1.SINOLE WALL ❑95,UNKNOWN u6z MANUFACTURER ®2.DOMLL:WALL ❑9S.IIN =OWN ❑2.DOUBLE WALL ❑99.OTHER MANUFACTURER 401 MANUFACTURE It 463 ❑1,BARE STEEL ❑6.FRP COMPATIBLE W1100%1,12THANOL ❑1.BARF STEEL ❑6.FRP COMPATIBLE W/100'1 METHANOL C 2 STAINLESS STEEL [17.GALVANIyfD STEEL ❑2.STAINLESS S7'EL•t ❑7.CALYANIZED STEEL C3 PLASTIC COMPATISLR WITH CONTrNTS Ca 95,UNKNOWN ❑3.PLASTIC COMPA i 131E Wi CONTRITS ❑8.FLEXIBLE(HDPE) ❑99,OTHER ®4.FIBERGLASS ❑8.FLEXIBLE(1•lOpr) ❑99.07HER I ❑4.FIBERGLASS ❑9,CATHODIC PROTECTIOV ❑S STEEL WiCOAT1NG ❑9.CATHODIC PROTECTION 464. 1 ❑5.STEEL WiCOATIA 3 0 95,UNKNOWN 465 VIL PIPING.LEAK DETECTION who*Ill Inat h t)4A dwcri pn JPlhv MQ.6torinl6prngrun stu11,6e wbn1l6ca I4 do lecd swicy. UNDERG`ROMD PLPI'vGRBOVEGROl1:vD PIPING SINGLE WALL PIPING 466 SINGLE W,\LL PIPING q61 PRESSURIZED PIPING(Chock all that apply): I PRESSURIZI 0 PIPING(Check all that apply): i ❑I. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST vWIITT4 AUTO FEWf C]1, ELEC7,TONIC LINE LEAK DETECTOR 3.0 GPH TEST w AUTO PUMP SHUT-OFF FOR LEAK,SYSTEM FAILURE%AND SYSTEM DISCOKNIICTION SHUT,IFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTtUN AUDIBLE AND VISUAL ALARMS. T AUDIBLE:AND VISUAL ALARMS. ❑2, MONTHLY 0.2 GPH TEST Q I MONT,(LY 0.2 GPH TNST ❑3. ANNUAL INTEGRITY TEST(0.1 OPtq ❑3. ANNU.\L INTEGRITY TEST(o.l GPH) ❑4. DAILY VNUALCRECK CONYLNTIONAL SUCTION SYSTEMS CONVIiNT10i IAL SUCTION SYS'1791WS(Ghwk all that apply) ❑5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIEMgfAL PIPING INTEGRITY TEST(0.1 GPH) [3S DAILY VISUAL MONITORING OF DTP NG AND PU)vIP[NG SYSTEM SAFE SUC PION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): ❑6. TRIENOIAL INTEGRITY TEST(0.;GPH) ❑7. SELF MONITORING SAFE SIUCTI(tN SYSTEMS 4140 VALVES IN BELOW GROUND pIP1NC)- GRAVITY FLOW 07. SELF NIONITOWNG ❑9 BIENNIAL tNTFGRITYTEST(0.1GPH) GRAVITY F1.11W(Chwkall dwtapply): 138, DAILY JISUAL.MONIT011ING Z19. B1ENNI 4I.INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING I SECONDAR 1LV CONTAINED PIPING PRESSURIZED PIPING(Cheek all chat apply): PRESSURIZED PIPING(Check all that apply)! 10. CONTINUOUS TURBINE SUMP SENSOR WITfi AVDIDLE AND VISUAL 10. CONT'D UOLIS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL AL&I MS AND(Check mu) ALARMIS AND(Check one) ❑a.AUTO PUMP ST-IUT OFF WHEN A LEAK OCCURS ❑a. Al)To PUMP SHUT OFF WHEN A LEAK OCCURS p�b.AUTO PUMP SHUT 06Y FOR LEAKS,SYSTEy1 FAILURE AND SYSTEM ❑b.A,ITE PUMP S:iUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DiSCONNECTTON L3* NO AUTO PUMP SMUT OFF ❑c. Ni)AUTO PUMP SUUT OFF 011. OFF OR RESTRICTION 11. DETECTOR(3 0 GFIf TGST)WITH FLOtV SHUT ❑11. AUTOAI ATIC LEAX DETECTOR [312. ANNUAL INTEGRITY TEST(0.1 GPI?) ❑12.ANNUA I.INTEGRITY TEST(0.1 GPI-1) SUCTEON/CRAVITY SYSTEM SUCTION/GR,.ViTY SYSTEM ❑13. CONTI-MOUS SUMP SENSOR*AUDIBLE AND VISUAL ALARMS 1113. CONTI1.1,-OUS SUMP SENSOR T AUDIBLE AND VISUAL ALARMS EMERGENCY GENKRATORS ONLY(Chock all that apply) EMERGXNCj CENERATORS ONLY(Check all that apply) ❑14. CONT'[NUOUS SUMP SENSOR m 101 T AUTO PUMP SHUT OFF ❑ 14,C:ONTI NUOUS SUMP SENSOR WITHOI UT AUTO PUMP SHUT OFF AUDIBLE AND V 1SUAI,.ALARMS AUDLb Lt AND VISUAL ALARMS ❑15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WIIHO(_U PLOW SHUT OFF OR RESTRICTION ❑15 AUTUt 1ATIC LINE LEAK OFTL•CTOR(3.0 GPH TE`;'[') ❑16. ANNUALINTECr1it'FY TEST(0.1 GPH) ❑16.ANNE:tL 1NTEGRITYTEST(0.1 QPF1) ❑17. DAILY VISUAL CHECK Ca 17,DAIL1 VISUAL CHkCI: VI1I.DISPENSER CONTAIINI►ME VT _ DISPENIkiR CONTAINMENT 46¢. ❑1 FLOAT MECHAN!SM THAT SHUTS OFF SHEAR VAL t E Q 4. DAILY VISUAL CFECK 4hp DATE INSTALLED ®2 CONTINUOUS DISPENSER P.qN SENSOR-AUDIBLE..ND VISUAL.ALARMS ElS. TRENCWLLVER MONITORING 10/1999 ❑3 CONTINUOUS DISPENSER PAN SENSOR WITH r UTO SHUT OFF FOR Q 6 NONE DISPENSER r AU01S AND VISUAL RMS - _fX,OW'NERr'OPERA7'()QR SiGNA,7 UItE I conify that the mrblrnadon provided herein is Crile and accurate to the tat of niy knowledge, sl NArU NEwo AT,tt DATE, -- -�-, NAME OF R/OPERATOR(print). JOHN'SCHETTER 1'IYE.F.OF OWN?R/OPERATOR: Environmental ComplldPCF 473. Permit Numbs(Agency use only) sr. Pa nit Approved By(Agency use wily) 474 1 Permit xpieattnn Ditto(Agency Ilse only) 475 UPCF hwfvyrc-b(1199)-314 httpJ/Aww.uuidues,t)rg Rcv.021161'10