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UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI.PIPING CONSTRUCTION(Check all that apply) UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE X 1. PRESSURE F 2. SUCTION F 3, GRAVITY F 1. PRESSURE F 2. SUCTION F 3, GRAVITY 459 CONSTRUCTION F 1. SINGLE WALL F 3. LINED TRENCH r'99- OTHER r 1. SINGLE WALL F 95. UNKNOWN 462 f X 2. DOUBLE WALL r 95. UNKNOWN F 2. DOUBLE WALL r 99. OTHER MANUFACTURE R MANUFACTURER 461 MANUFACTURER 463 F 1,BARE STEEL r S. FRP COMPATIBLE Wl 10O%METHANOL I 1, BARE STEEL F 6. FRP COMPATIBLE W1 100%METHANOL MATERIALS AND r 2. STAINLESS STEEL F 7.GALVANIZED STEEL r 2. STAINLESS STEEL F 7 GALVANIZED STEEL CORROSION PROTECTION F 3. PLASTIC COMPATIBLE VITH CONTENTS F95. UNKNOWN F 3. PLASTIC COMPATIBLE WITH CONTENTS F 8. FLEXIBLE(HOPE) F 99. OTHER X 4. FIBERGLASS F 8. FLEXIBLE(HOPE) r 99. OTHER F 4, FIBERGLASS I 9. CATHODIC PROTECTION F 5. STEEL W1 COATING F 9. CATHODIC PROTECTION 464 1 r S. STEEL WI COATING F95. UNKNOWN 465 VII PIPING LEAK DETECTION(Check all that apply)(A description o/the monde ing program shall be submitted to the local agency.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check an that apply): r 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR F 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, LEAK.SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS ALARMS F 2. MONTHLY 0.2 GPH TEST r 2. MONTHLY 0.2 GPH TEST F 3. ANNUAL INTEGRITY TEST(0.1 GPH) F 3.ANNUAL INTEGRITY TEST(0.1 GPH) r 4. GAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Check all that apply): F 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM*TRIENNIAL PIPING INTEGRITY r 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) F S. TRIENNIAL INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): r 7. SELF MONITORING r 7. SELF MONITORING GRAVITY FLOW GRAVITY FLOW(Check aft that apply): r 0. BIENNIAL INTEGRITY TEST(0.1 GPH) F S. DAILY VISUAL MONITORING r 9. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Chock at/that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(check one) (Check ane) - I' a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS r a.AUTO PUMP SHUT OFF WHEN A LEAK OCCURS X b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM r b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION r c. NO AUTO PUMP SHUT OFF F c. NO AUTO PUMP SHUT OFF X 11, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT OFF OR r 11. AUTOMATIC LEAK DETECTOR RESTRICTION ` F 12. ANNUAL INTEGRITY TEST(0.1 GPH) r 12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTION/GRAVITY SYSTEM. SUCTION/GRAVITY SYSTEM: F 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS r 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) r 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF-AUDIBLEAND F 14 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND VISUAL VISUAL ALARMS ALARMS r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 CPH TEST)W[THOUT FLOW SHUT OFF OR r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) RESTRICTION F 16 ANNUAL INTEGRITY TEST(0.1 GPH) r 16. ANNUAL INTEGRITY TEST(0.1 GPH) r IT DAILY VISUAL CHECK F 17. DAILY VISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT F 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE r 4. DAILY VISUAL CHECK DATE INSTALLED 468 F 2. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS F S. TRENCH LINER f MONITORING 1998 X 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+AUDIBLE AND VISUAL ALARMS r 6. NONE 469 IX OWNERIOPERATORRIGNATI IRE I certify that the information provided herein is true and accurate to the best of my knowledge. SIGN E OF OWN Rl RATO DATE 470 4/27/02 NAME OF OWNERIOPERATOR(print) 471 TITLE OF OWNER/OPERATOR 472 Bruce T. Marubashi for Shell Oil Products US H,S&E Analyst 925-766-3498 Permit Number(For local use only) 473 I Permit Approved(For local use only) 474 Permit Expiration Date(For locat use only) 475 6 •d - ->� tr96S GGS 60i; z se njeW '1 aanaH dSZ �EO ZO 6Z ad w