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IIFIED PROGRAM CONSOLIDATED F TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 2 Cl >. VF PIP(Nfa QNSTR�JG'T E((�( �ftec�`att tlra annt UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE X 1. PRESSURE r 2. SUCTION r 3. GRAVITY r 1. PRESSURE r 2. SUCTION r 3. GRAVITY 459 CONSTRUCTION IF 1. SINGLE WALL IF 3. LINED TRENCH r 99. OTHER r 1. SINGLE WALL r 95. UNKNOWN 462 / X 2. DOUBLE WALL r95. UNKNOWN r 2. DOUBLE WALL r 99. OTHER MANUFACTURE R MANUFACTURER kw'64�90l) 461 MANUFACTURER 463 F 1.BARE STEEL r 6. FRP COMPATIBLE W/100%METHANOL r 1. BARE STEEL r 6. FRP COMPATIBLE W/100%METHANOL MATERIALS AND r 2. STAINLESS STEEL r 7. GALVANIZED STEEL r 2. STAINLESS STEEL r 7. GALVANIZED STEEL CORROSION r PROTECTION 3. PLASTIC COMPATIBLE WITH CONTENTS r 95. UNKNOWN r 3. PLASTIC COMPATIBLE WITH CONTENTS r 8. FLEXIBLE(HDPE) r 99. OTHER X 4. FIBERGLASS r 8. FLEXIBLE(HDPE) IF 99. OTHER r 4. FIBERGLASS r 9. CATHODIC PROTECTION r 5. STEEL W/COATING r 9. CATHODIC PROTECTION 464 r 5. STEEL W/COATING 11-95. UNKNOWN 465 77 7777,77 7,77,71 ' VII P1P��VGkE ( "17TGTIONTGizeraHs#h EapP�yfA 'P �#aflh mdrntorrngp`rvgrmpat#Zbe #ri7t/er #cataenc}� UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): r 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR r 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 r 2. MONTHLY 0.2 GPH TEST r 2. MONTHLY 0.2 GPH TEST r 3. ANNUAL INTEGRITY TEST(0.1 GPH) r 3. ANNUAL INTEGRITY TEST(0.1 GPH) r 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Check all that apply): r 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING INTEGRITY r 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) r 6. 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 IF 7. SELF MONITORING GRAVITY FLOW: GRAVITY FLOW(Check all that apply). IF 9. BIENNIAL INTEGRITY TEST(0.1 GPH) r 8. 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(Check all 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 one) F 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 r 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 r 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 j EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) r 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND r 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND VISUAL VISUAL ALARMS ALARMS r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) RESTRICTION r 16. ANNUAL INTEGRITY TEST(0.1 GPH) r 16. ANNUAL INTEGRITY TEST(0.1 GPH) r 17. DAILY VISUAL CHECK r 17. DAILY VISUAL CHECK i Vtll OIS(E SERO N,;, Me DISPENSER CONTAINMENT r 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE r 4. DAILY VISUAL CHECK DATE INSTALLED 468 r 2. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS r 5. TRENCH LINER/MONITORING 2002 X 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+AUDIBLE AND VISUAL ALARMS r 6. NONE 469 IX OWNERLOPERATOR SIrNAT1 IRF I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNAT E,QF O ER/ ERATOR DATE 1/15/02 470 ee��)) 9 NAME OF OWNER/OPERAT R(print) 471 TITLE OF OWNERIOPERATOR 472 Bruce T. Marubashi for Equilon Enterprises LLC PERMIT ANALYST 925-766-3498 Permit Number(For local use only) 473 I Permit Approved(For local use only) 474 I Permit Expiration Date(For local use only) 475 6