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X07/25/2005 15:07 2094683433 EHD PAGE 03 UNIFIED PROGRANI CONSOLIDATED FORM , TANKS UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI.PIPING CONSTRUCTION Ch killihatbPelu Pelle_of_ UNDERGKOUND PIPING ABOVEGROUND PIPING PRESSURE O 2.SUCTION � ❑).GRAVITY +fB ❑I.PA):SSURE ❑2. SUCTION SYSTtM HP 1 CI 3.GRAVITY 057 CONSTRUCTION ❑tl SINGLE WALL ❑5•LMEO TRENCH O 99,OTFIER +do ❑I-SINGLE WALL ❑95,OTHER MfN 462 ANUFACTURER Q 2•DOUBLE WALL ❑95.UNKNOWN Q 2.DOUBLE WALL ❑99.OTHER MANUFACTURER �.tJ . c .b 461 MANUFACTURER Ks ❑1.BARE STEEL ❑6.FRP COMPATIBLE w/100% METHANOL ❑1.BARE STEEL ❑6.FRP COMPATIBLE WADOY.METNANOL Cl 2.STAINLESS STEEL ❑7.GALVANIZED STEEL ❑Unknown O 2. STAINLESS STEEL ❑7.GALVANIZED STEEL ❑3, STC COMPATIBLE W/CONTENTS C]99. Other ❑3. PLASTIC COMPATIBLE d+/CONTENTS ❑R.FLEXIBLE(HDPE) ❑99.OTHER 4.FIBERGLASS ❑S.FLEXIBLE(HOPE) [34 FIBERGLASS ❑9.CATHODIC PROTECTION ❑5.STEEL WICOATING ❑9.CATHODIC PROTECTION 0011 ❑5. STEEL WICOATING E)95.UNKNOWN 465 Vll.PIPING LEAK))ETECTION ICI%mk all that I A JadeA don-(the manilorin roa7am shill be d.bmhced to the loonl agency) . UNDERGROUND PIPING ABOVL•GROUND PIPING SINGLE WALL PIPING 4" SINGLE WALL PIPING 467 r0OrFIFOR PIPING(Checks t that applr): PRESSVRIZEO PIPING IChcrk alt that-PPlr)I ONIC LINE LEAK DETECTOR 3.0 GPH TEST WIT�I AUTO PUMP SHUT ❑1. ELECTRONIC LME LEAK DETECTOR 3.0 GPH TEST M=9 AUTO PUMP LEAK,SYSTEM FAILURE.AND SYSTEM DISCONNECTION+ AS14UT OFF FOR LEAK,SYSTEM UDIBLE AND VISUAL ALARMS AILURE,AND SYSTEM DISCONNECTION+ AUDIBLE AND VISUAL ALARMS. ❑2.MONTHLY 0,2 GPH TSST ❑2. MONTWLY 0.2 GPH TEST ❑3.ANNUAL INTEGRITY TEST(0.1 GPH) ❑1.ANNUAL rNTEGRITY TEST(0.IGPH) ❑4, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all tha 000) ❑5.DAILY VISUAL MONITORING OF PUMPING SYSTEM.-TRIENNIAL PIPING ❑S, DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITYTEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): ❑6. TRIENNIAL INTEGRITY TEST(0.1 GPH) (]7.SELF MONITORING 't SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW ❑7. SELF MONITORING ❑9.B 1 ENNI AAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW ICN«k all th-t applyk ❑8. DAILY VISUAL MONITOI ING ❑9. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Ckak all hm apply) PRE9SUFUZED PIPING ICheckall th01 opply): 10. CONTINZ:OUSTURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL AL A S AND(Chrck 0-) ALARMS AND IChect one) AUTO PUMP SHUT OFF WHEN A LEAK OCCURS {❑��y��UTO PLNIP SHUT OFF WHEN A LEAK OCCURS (J b. ALTO PIMP SHUT OFF FOR LEAKS.SYSTEM FAILURE AND SYSTEM D SCONNEICTI}ON OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION �02 NO AUTO PUMP SHUTOFF NO AUTO PUMP SHUT OFF INTI. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT 0-Il"' 1AUTOMATIC LEAK DETECTOR OFF Oa RESTRICTION EI/I 2.ANNUAL IN TEST(0.1 GPH) E)12, ANNUAL INTEGRITY TEST(D'.I GPH) LJ SUCTSON/GRAVITY SYSTEM SUCTIONIGIL\VITY SYSTEM 4`4 33, CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ❑13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ENILRCENCY GENERATORS ONLY(Cheek all Ihatapvly) EMERGENCY GENERATORS ONLY(Chcrk ll thatavply) 014. CONTCNOUS SUMP SENSOR Jyl Q AUTO PUMP SFIUT OFF• O 14• nO CONTINUOUS IBLE AND VISUAL SO ALARMS AUTO PUMP SkNT OFF AUDIBLE AND VISUAL ALARMS (315. AUTONIATIC LINE LEAK DETECTOR(3.0 GP1,1 TEST) ITHQY.[FLOW ❑15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICTION ❑ ❑ 16,ANNUAL 16 A),.NVAL INTEGRITY TEST(0.1 GPH) ATEGRITY TEST(0.1 GPH) ❑17. DAILY VISUAL CHECK ❑17. DAILY VISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT 1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑4.DAILY VISUAL CHECK DATE INSTALLED 4018 ❑1.CONTINUOUS DISPENSER PAN SE SOR AUDIBLE AND VISUAL ALAILMS ❑5 TRENCH LINER/MONITORING ❑3.CONTINUOUS DISPENSER P ENSOR WITH AUTO SHUT OFF FOR ❑6,NONE 467 DISPENSER-AUDIBLE OVISUAL ALARMS IX.OWNLRIOPERATOR SIGNATURE 1 ccniry wt the i it p ide e J OCV of mr knorledg SIGNATU DATE �� NA OP T R(p nt) dl TIT IF OWNER/ RAT R 472 Pertrtil NttmEer lFa loeal ttae only) d3 Permit Approval(Fvr 104-1 Yre only) X474 rermt EaPkra60a pate(Por local ate only) 41S UPCF(12/99 revised) 12 Formerly SWP CB Folin B