COMPLIANCE INFO_1999-2007 - Laserfiche WebLink

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ED PROGRAM CONSOLIDATED FO# TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI.PIPING CONSTRUCTION(check all that apply', Page 2 of 4 UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE 9 1 PRESSURE Q 2.SUCTION ❑3.GRAVITY 458 Q 1.PRESSURE ❑2. SUCTION 0 3.GRAVI`I-Y 459 CONSTRUCTION [3 1.SINGLE WALL 0 3.LINED'TRENCH [3 99.OTHER 460 0 1.SINGLE WALL 95.UNKNOWN 462 MANUFACTURER 0 2.DOUBLE WALL [3 95.UNKNOWN []2.DOUBLE WALL 0 99.OTHER MANUFACTURER A.0.Smith 461 MANUFACTURER 463 ❑1.BARE STEEL [j 6.FRP COMPATIBLE wA 00% METHANOL ❑I.BARE STEEL Q 6.FRP COMPATIBLE W00M.M. ETHANOL ❑2.STAINLESS STEEL []7.GALVANIZED STEEL Q Unknown ❑2. STAINLESS STEEL ❑7.GALVANIZED STEEL 1-13.PLASTIC COMPATIBLE W/CONTENTS Q 99. Other C]3 PLASTIC COMPATIBLE W1 CONTENTS ❑8-FLEXIBLE(HDPE) []99, OTHER 0 4.FIBERGLASS [18.FLEXIBLE(HDPE) [3 4. FIBERGLASS 0 9.CATHODIC PROTECTION ECTION E]5.STEEL W/COATING []9.CATHODIC PROTECTION 464 [11. STEEL W/COATING Cj 95.UNKNOWN 465 VII.PIPING LEAK DETECTION(Check sit that apply)(A dtscn'pijQn of the monitoring program shall t subminedto the local agency) UNDERGROUND PIPING ABOVEGROUNI3 PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply) PRESSURIZED PIPING(check all that apply) ❑1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT [3 1. ELECTRONIC LINT LEAK DETECTOR 3.0 GPH TEST WITH 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 GPH TEST [:12. MONTHLY 0+2 GPH TEST 0 3.ANNUAL INTEGRITY TEST(0.1 GPH) Q 3.ANNUAL INTEGRITY DIST(0.IGPH) ❑4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all that apply) ❑5-DAILY VISUAL MONITORING OF PUMPING SYSTEM ITRIEWAL PIPING [3 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUND PIPING): ❑6. TRIENNIAL INTEGRITY TEST(0.1 GPH) [3 7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING), GRAVITY FLOW [17. SELF MONITORING Q 9.BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Check all that apply): ❑8. DAILY VISUAL MONITORING 9. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check all that apply) PRESSURIZED PIPING(Check all that apply) 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(Check one) ALARMS AND(Check one) C3 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 [3 b AUTO PUMP SHUT OFF FOR LEAKS.SY SIEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION [3c. NO AUTO PUMP SHUT OFF []c NO AUTO PUMP SHUT OFF 11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT I I. AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION 0 12. ANNUAL INTEGRITY TEST GPH) 0 12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM ❑ 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ❑13. CONTINUOUS SUMP SENSOR,AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICTION [j.6.ANNUAL INTEGRITY TEST(0.1 GPH) ❑16.ANNUAL INTEGRITY TEST(O.I GPH) ❑ 17. DAILY VISUAL CHECK Q 17. DAILY VISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT [3 1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE Q 4.DAILY VISUAL CHECK DATE.INSTALLED 469 0 2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 3.TRENCH LINER JMONITORING 01/01/94 f9 3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR 6,NONE 469 DISPENSER+AUDIBLE AND VISUAL ALARMS IX.OWNER/OPERATOR SIGNATURE I atniFy that the information pto,-ided her is true and accurate to the best of my knowledge. SIGNA F To DATE 470 e 9/20/99 NANIECC4 TOR 0p 6 n 0 TITLE OF OWNER/OPERATOR 472 D.R.LERI Chevron Products Company Permit Number(For local use only) 473 Permit Approved(For local use only) Permit Expiration Date(For local use only) 475 UPCF(1/99 revised) 174 Formerly SWRCB Form B