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TANK: TA0108107 UNIFIED PROGRAM CONSOLIDATED FORM PR#. PRO231084 FAC#.- FA006447 UNDERGROUND STORAGE TANKS-TANK PAGE 2 Page 7 of7 VI.PIPING CONSTRUCTION(check all that apply) IPING ABOVEGROUND PIPINU 459 SYSTEM TYPE 1.PRESSURE 0 2.SUCTION 0 3.GPAVITY 458 0 1.PRESSURE 0 2.SUCTION 0 3.GRAVITY - - 0 LSINGLEWALL n 95.UNKNOWN 462 CONSTRUCTION 0 1.SINGLE WALL 03.LINED TRENCH 0 99.OTHER 0 2.DOUBLE WALL 0 WOTHER 02.DOUBLEWALL 095.UNKNOWN 461 MANUFACTURER 463 MANUFACTURER n 1.BARE STEEL 0 6.FRP COMPATIBLE w;100%METHANOL 0 1.BARE STEEL 0 6.FPP COMPATIBLE wi 100%METHANOL 0 2.STAINLESS STEEL 0 7.GALVANIZED STEEL 0 2.STAINLESS STEEL 0 7.GALVANIZED STEEL 0 95.UNKNOWN 0 PLASTIC COMPATIBLE W/CONTENTS 0 95.UNKNOWN 0 PLASTIC COMPATIBLE W/CONTFNTS g4.FIBERGLASS 0 8.FLEXIBLE(HDPE) 0 99.OTHER 0 4,FIBERGLASS 0 8.FLEXIBLE(HDPE) 0 99.OTHER 0 5.STEEL W/COATING 0 9.CATHODIC PROTECTION 464 1 0 5.STEEL W/COATING 0 9.CATHODIC PROTECTION 465 VIL PIPING LEAK DETECTION(Check all that apply)(A dmaiption ofthe monitoringpixtIparn shall be submktcd UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): 0 1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF 0 1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK.SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS. VISUAL ALARMS. n 2.MONTHLY(12 GPH TEST R 2.MONTHLY 0.2 GPH TEST C] 3.ANNUAL INTEGRITY TEST(0.1 GPH) 3.ANNUAL INTEGRITY TEST(0.1 GPH) 0 4.DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS(Check all that apply) CONVENTIONAL SUCTION SYSTEMS E] 5.DAILY VISUAL MON ITORING OF PIPING AND PUMPING SYSTEM 5.DAILY VISUAL MONITORING OFPUMPFNG SYSTEM+TRIENNIEAL PIPING INTEGRITY TEST(0.1 GPH) n 6.TRIENNIAL INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): 0 7.SELF MONITORING n 7.SELF MONITORING GRAVITY FLOW GRAVITY FLOW(Check all that apply): 0 9.BIENNIAL rNTFGRITY TEST(0.1)GPH n 8.DAILY VISUAL MONITORING n 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): to.CONTINUOUS TURBINE SUMP SENSOR�KITH AUDIBLE AND VISUAL 10.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(Check mac) ALARMS AND(check a-) 0 a,AUTO PUMP SHUT OFF WHEN A LEAK OCCURS �'a.AUTO PUMP SHUT OFF WHEN A LEAK OCCURS n It.AUTO PUMP SHUT OFF FOR LEAKS.SYSTEM FAILPRE AND SYSTEM It.AUTO PUMP SHUT OFF FOR LEAKS.SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION n c.NO AUTO PUMP SHUT OFF c.NO AUTO PUMP SHUT OFF IF11.AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT OFF OR n 11.AUTOMATIC LEAK DETECTOR RESTRICTION C] 12.AN'NUAL INTEGRITY TEST(0.1 GPH) I12.ANNUAL INTEGRITY TEST(0.1 GPff) SUCTION/GRAVITY SYSTEM CTION/GRAVITY SYSTEM n 13.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS n 13.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that aPPIO EMERGENCY GENERATORS ONLY(Check all that applY) HOUT AUTO PUMP SHUT OFF n 14.CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF n 14.CONTINUOUS SUMP SENSOR WIT AUDIBLE AND VISUAL ALARMS GPH TEST)AEU AUDIBLE AND VISUAL ALARMS R(3.0 GPH TEST)WITHOUT FLOW o 15.AUTOMATIC LINE LEAK DETECTOR(3.0 QUT FLOW 0 15.AUTOMATIC LINE LEAK DETECTO SHUT OFF OR RESTRICTION SHUT OFF OR RESTRICTION n 16.ANNUAL INTEGRITY TEST(03 GPH) n 16.ANNUAL INTEGRiTY TEST(0.1 GPH) C] 17.DAILY VISUAL CHECK n 17.DAILY VISUAL CHECK DISPENSER CONTAINMENT P5 1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [-] 4.DAILY VISUAL CHECK DATEINSTALLED 468 n 2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 0 5.TRENCH LINER MONITORING n 3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO S14UT OFF FOR E] 6.NONE 469 DISPENSER+AUDIBLE AND VISUAL ALARMS NATURE I cenify that the infmmtiw pmvided hcrein is tnw mat accuiate to the best ofmY knowle* 470 DATE OFO m4mf TOR S GNA h Z' TITLE 0 W ERA 472 N F OF OWNERJO RXf) 1"1AjJL.a'r -,,. _V .7-- 0 pmt fKpirat.Data(F.,local We-01Y) W 11%,C a- C-11-La-6c's. L,,L-- > 1".. 475 PennitNurnber(F"locall..Iy) 473 Pemift Appmcd(I'm IwA use eady) 474 12/31/1993 PT0004797 EE0003804 - - UPCF(12/99 revised)