COMPLIANCE INFO_2010-2018 - Laserfiche WebLink

Home Browse Search

vt niplNr. CANSTRUCTIOM /Chegha8tllatamM - UIMERGROUAO PIPING ABOVEGROUND PIPING ' SYSTEM TYPE 1. PRESSURE ❑ Z. SUCTION ❑ 3. GRAVITY 458 ❑ 1. PRESSURE ❑ 2. SUCTION ❑ 3. GRAVITY 459 ❑ 1. SINGLE WALL ❑ 3 LINED TRENCH ❑ 99. OTHER 460 ❑ 1. SINGLE WALL ❑ 95. UNKNOWN 462 CONSTRUCTIOW MANUFACTURER b!f'2. DOUBLE WALL 13U ❑ 2. DOUBLE WALL ❑ 99. OTHER MANUFACTURER " °' / 21 MANUFACTURER 463 ❑ 1. BARE STEEL FRP COMPATIBLE W/ 100% METHANOL (31. BARE STEEL ❑ 6. FRP COMPATIBLE Wt 100% METHANOL MATERIALS AND ❑ 2. STAINLESS STEEL7. GALVANIZED STEEL ❑ 2. STAINLESS STEEL ❑ 7. GALVANIZED STEEL CORROSK)N 133. PLASTIC COMPATIBLE WITH CONTENTS ❑ 95. UNKNOWN ❑ 3. PLASTIC COMPATIBLE WITH CONTENTS 138. FLEXIBLE (HDPE) ❑ 99. OTHER PROTECTION ❑ 4. FIBERGLASS ❑ 6- FLEXIBLE (HOPE) ❑ 99. OTHER ❑ 4. FIBERGLASS ❑ 9. CATHODIC PROTECTION ❑ 5. STEEL Wl COATING ❑ 9 CATHODIC PROTECTION 464 ❑ 5. STEEL VI COATING ❑ 95. UNKNOWN 465 VII. PIPING LEAK DETECTION (Chao aft aw appy/ UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check alf that apply)• PRESSURIZED PIPING (Check all that apply): ❑ UNE LEAK DETECTOR 3.0 GPM TEST WITH AUTO PUMP SHUT OFF FOR ❑ 1. ELECTRONIC UNE :%AK DETECTOR 3.0 GPM TEST WITHAUTO PUMP SHUT OFF FOR LFAK 1. ELECTRONIC LEAK SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL SYSTEM FAILURE AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS ALARMS ❑ 2. MONTHLY 0.2 GPM TEST ❑ 2. MONTHLY 0.2 GPM TEST ❑ 3. ANNUAL INTEGRITY TEST (0.1 GPM) ❑ 3. ANNUAL INTEGRrTY TEST (0.1 GPH) ❑ 4. DAILY VISUAL CHECK CONVEN11ONAL SUCTIOA SYSTEMS (Check ah that apply). CONVENTIONAL SUCTION SYSTEMS: OF PUMPING SYSTEM -TRIENNIAL PIPING INTEGRITY ❑ S. DAILY VISUAL MOTORING OF PIPING AND PUMPING SYSTEM ❑ S. DAILY VISUAL MONITORING ❑ S. TRIENNIAL INTEGRTY TEST (0.1 GPM) TEST (0.1 GPM) SAFE SUCTION SYSTEMS (NII VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (W VALVES IN BELOW GROUND PIPING): ❑ 7. SELFMONITORING G ❑ 7. SELF MONITORING GRAVITY FLOW GRAVITY FLOW (Check at »at apply): 8. 91EW44L INTEGRITY TEST (0.1 GPM) ❑ 8. DAjLYvIsuALmoNIToRiNG ❑ 9. BIENNIAL INTEGRITY TEST (0.1 GPM) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Checkah that apPW- PRESSURIZED PIPING (G.eck a8 that apply): 10. CONTINUOUS?URBIN E SUMP SENSOR AMT+ AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (ct ece (Check aa) ate) ❑ a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑ a. AUTO PUMP SHUT OFF VITEN A LEAK OCCURS AUTO PUMP SMUT OFF FOR LEAKS SYSTEM FAILURE AND SYSTEM DISCONNECTION ❑ b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTCN ❑ C..40 AUTO PUMP SHUT OFF ❑ c. NO AUTO P_ VP SHUT OFF ❑ 11 A ETOMAIAT DUNE LEAK DETECTOR (3.0 GP- 7 EST) WITH FLOW SHUT OFF OR ❑ 11 AUTOMATIC LEA/ 'cTECTOR ❑ 12. ANNUAL INTEGRITY TEST (0.1 GPM) ❑ 12. ANNUAL INfEGRr"v TEST (0.1 GPM) SUCTIONIGRAVITY SYSTEM: ❑ SUMP SENSOR -AUDIBLE ANO VISUAL ALARMS SUCTIONIGRAVITY SYSTELt. 13 CONTINUOUS ❑ 13. CONTINUOUS SLiWP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check as that appy) EMERGENCY GENERATORS ONLY (Check of that apply) ❑ 14. CONTINUOUS SUMP SENSOR WITHOUT AL 0 PUMP SHUT OFF -AUDIBLE AND ❑ 14. CONTINUOUS SUWP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL VISUAL ALARMS ❑ 15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPM -EST) WITHOUT FLOW SHUT OFF OR ALARMS ❑ 15. AUTOMATIC UNE -Z A1C DETECTOR (3.0 GPM TEST) RESTRICTION ❑ 16. ANNUAL INTEGRITY TEST (0.1 GPM) ❑ 16. ANNUAL INTEGRi-' TEST (0.1 GPM) ❑ 17 ONLY VISUAL CHECK ❑ 17. DAILY VISUAL Cl =-'K Vill. DISPENSER CONTAINMENT DISPENSER CONTAINMENT ❑ 1. FLOAT MEEK=.`.!SM THAT SHUTS OFF SHEAR VALVE ❑ 4. DAILY VISUAL CHECK 468 ❑ 2. CONTINUOUS :ISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS ❑ 5. TRENCH LINER; DATE INSTALLED MONITORING �1 y � 3. CONTINUOUS :,SPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +=_:IBIE AND VISUAL ALARMS ❑ fi. NONE 4c9 IX. OWNERIOPERATOR SIGNATURE I certify that the information prwded herein is wa and accurate to the best of my knowledge. SIGNATURE OF OYVNE PERATOR DATE ®/ 470 ®d/ fNA OF OWNER)OPERAT M) k 471 TITLE OF OWNERADP_?ATOR +'2 %'I 1 AA A 1/' Fam r Number IFoN(ical use MY) 473 1 Fe^:i Approved (For local use only) d74 pennrt Ezphaoon Date (For local use only! e'S UPCF (1/98) Formerly SWRCB Fc-- 3