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01/08/2004 08:23 2094683 FIFTH FLOOR PAGE 21 SNOW UNIFED-FiROGRAM CONSOLIDATED FORM TANKS -UNDERGROUND STORAGE TANKS-TANK.PAGE 2 UNDEROROUND PIPING ABOVEGROLTND PIPING SYSTEM TYPE �IPRFtiSIJRE El 2.SUCTION 3.GRAVITY 458. 1.PRESSURE C32.SUCTION 0;_0-P-_1k'vT7y- CONSTRUCTION/ El 1,SINGLE WALL L3 3.LINED TRENCH OTHER 460. 0I.SINGLEWALL r-1.95-UNKNOWN MAN'UFACTURER M.DOUBLE WALL Q 95,UNKNOWN M 2.DOUBLE WALL [j99,.OT]-IfiFt MANU ER 461, MANUFACTURER 0 1.RARE STEEL ar&M?COMPATIBLE W/1000%METHANOL 0 L BARE STEEL E3 6,FRP COMPATIBLE [J 2.STAINLESS$TEEL El 7.GALVANIZED STEEL 2.STAINLESS STEEL [17.GALVANIZED STEEL [13,PLASTIC COMPATIBLE WITH CONTENTS C1 95.UNKNOWN 3.PLASTIC COMPATIBLE W1 CONTENTq [18,FLE)(IBLE(HC PE) 919.OTHER. E3 4.PIBERQLASS 8.FLEX113LE(HDPE) E)09.OTHER 4.FIBERGLASS El 9.CATHODIC PROTECTION [3 5.STEEL W/COATINO 9,CATHODIC PROTECTION 464. 5.sTEn COATING [1.95,UNKNOWN UNDERUROUND PIPING ABOVEGROUND PIP SINGLE WALL FFP`TNG 4". S114GLE WALL PIPING PRESSURIZED PJKNG(Check all that apply); PRESSURIZED PIPING(Check in that apply): 0 1, ELECTRONIC LINE LEAK DETECTOR �,O GPH TEST-VnT]-[ AUTO PUMP [I I. ELECTRONIC LINE LEAK DETECTOR 3.0 CPR TF-ST WIT14 AUTO PIJAIP SNUT-OFF FOR LEAK4 SYSTEM FAILURE,AND SYSTEM DI�CONNECTION S14UT OFF FOP,LEAY�SYSTEM FAILUR.11,AND SYSTEM 019CONNECTION +AUDIBLE AND VISUAL ALARMS. +AUDIBLE AND VISUAL ALARMS, [12, MONTHLY 0.2 OPH TEST [j 2. MONTHLY 0.2 OPH TEST [13, ANNUAL INTEGRITY TEST%I GPH) Ej 3. ANNUAL INTEGRITY TUT(0,1 GPH) L3 4, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVEN17ONAL SUCTION SYSTEMS(Check allthult apply) 5, DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PfPIN0 LJ5. DAILY VISUAL MONITORING OF?MC AND PUVIPING SYSTEM SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING); 06. TRIENNIAL INTEGRIT Y TEST(0.1 UPH) L3 7. SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW ORCUND PIPING): GRAVITY FLOW [3 7, SELF MONITORINO E19. BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Chock all that apply)! [18. DAILY VISUAL MONITORING [39. BM-NNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PINNG SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check all that vpp�ft PRESSURIZED)PIPING(Check 411 thntapply); 10. CONTINUOUS TURBINE SUMP SENSOR YM AUDIBLE AND VISUAL 10, CONTINUOUS TURBINE SUMP SENSOR WIT14 AUDIBLE AND VIS*-rAL ALARMS AND(Chock one) ALARMS AND(Check one) 8.AUTO PUMP SHUT OFF WHEN A LEAK OCCURS C3 a.AUTO PUMP SHUT OFF WHEN A LEAK OCCURS -;W AUTO PUMP SHUT OFF POP LEAKS,SYSTEM FAILURE AND SYSTEM b,AuTo Pump SHUT OFF FOR LEAKS,SYSTEM FAILURE ANDsys-.rishi DISCONNECTION DISCONNECTION Cc, NO AUTO.PUMP SJ,IUT OFF [jc, No AUTO Pump siiuT OFF J. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEM MM FLOW SHUT OFF OR RESTRICTION 11.AUTOMATIC LEAK D17TECTOR [312, ANNUAL INTEGRITY TEST(0.1 OPH) 12.ANNUAL INTEGRITY TEST(0.1 GPH) CI 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 0 13.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALkRMS EMERGENCY GENERATORS ONLY(Check all That apply) EMERGENCY GENERATORS ONLY(Cheek all that apply) [114. CONTINUOUS SUMP SENSOR WITH AUTO PUMP n=OFF 0 14,CONTINUOUS SUMP SENSOR WITHO AUTO PjMP SHUT OFF AUDEBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS 0 15. AUTOMATIC LINE LEA'K DETECTOR (3.0 17.PR TES7) WT114ou FLOW SHUT OFF OR RESTRICTION Ej 15.AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) 0 16, ANNUAL INTEORITY TEST(0,1 GPM) El 16.ANNUAL INTEGRITY TEST(0.1 GPH) 37. DAILYVISUAL CHECK Q 17.DAILY VISUAL CHECK DISPENSER CONTAINMENT 46s' VI. FLOAT MECHANISM THAT S97JTS OFF SHEAR VALVE [3 4. DAILY VISUAL CHECK 46". DATE INSTALLED n2 CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARM$ 05. TRI;NCHtLJNER1V,:ONITOJWG CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR 0 6- NONE DISPENSER+AIMIBLE AND VISUAL ALARMS j OPERATOR -1 T75 7QA*weaA� 0-1 1 1101L NAME OF O%VNER/OFERATOR(print)! Ponnit Numbcr(Agency use only) 471. 1 ftnutit Approved By(Agency use ottly) 474permit Expiration Date(Agency we only) 47!7 1 1 owk-ft--i opCph**r^-b(1/99)^3/4 mm`von61m