BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

IED PROGRAM CONSOLIDATED FO TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 Page VI.PIPING CONSTRUCTION(Check all that apply) ABOVEGROUND PIPING UNDERGROUND PIPINGbeg SYSTEM TYPE 0 1.PRESSURE 0 2.SUCTION 0 3.GRAVITY - 01.PRESSURE ❑2. SUCTION[195.UNKNOWDN3.GRAVITY 462 CONSTRUCTION/ 01.SINGLEWALL 03.LINED TRENCH 099.OTHER 460 0SINGLE WALL WALL 099.OTHER MANUFACTURER 02.DOUBLE WALL 0 95.UNKNOWN 2. 463 MANUFACTURER EnVIFOn 461 MANUFACTURER_ 01.BARE STEEL 0 6.FRP COMPATIBLE w1100% METHANOL Eli.BARE STEEL ❑6.FRP COMPATIBLE WI7110%METHANOL 0 2.STAINLESS STEEL 0 7.GALVANIZED STEEL D 99 NWN [12. STAINLESS ST[13. PLASTIC COMPATIBLE WI CONTENTS 0 8.FLLVANIZED EL FLEXIBLE(HOPE) 99. OTHER 0 3.PLASTIC COMPATIBLE WI CONTENTS OD 4FIBERGLASS ❑9.CATHODIC PROTECTION 0 4.FIBERGLASS ®e .FLEXIBLE(HDPE) ❑95.UNKNOWN 465 [15.STEEL W/COATING ❑9 CATHODIC PROTECTION 464 05 STEEL WICOATING VIL:PIPING'LEAKDETECTION(Check all that apply)(A description of the monitoring prognam shall h ABOVEGROUNbe submitted to tD PIPING he local agency) UNDERGROUND PIPING SINGLE WALL PIPING 467 SINGLE WALL PIPING 466 PRESSURIZED PIPING(Che&WI thatapply): PRESSURIZED PIPING(Check all that apply): SHUT OFF F TEST WITH❑1. ELECTRONIC UNE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR D1. ELECTOSIC LINE LLEAK DETECTOR AND R3.DI DISCONNECTIONAUAUDIBLETO PUMPAND VISUAL OR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS. ALARMS. 02, MONTHLY 0.2 GPH TEST D 2. MONTHLY 0.2 GPH TEST 03. ANNUAL INTEGRITY TEST(O.1GPH) 03. ANNUAL UAL CHECK TEST(O.iGPH) ❑4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all thatappiy) 05. DAILY VISUAL MONITORING OF PUMPING SYSTEM-TRIENNIAL PIPING INTEGRITY D5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) [36. TRIENNIAL INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): 07. SELFMONITOWNG ❑7. SELF MONITORING GRAVITY FLOW GRAVITY FLOW(CMck all that apply): 09. BIENNIAL INTEGRITY TEST(0.1 GPH) 08, DAILY VISUAL MONITORING [19. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all/hat apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CCONNTTI�NUUOUS neTURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Checkoae) D a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [3a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM Ob. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM D DISCONNECTION DISCONNECTION Dc NO AUTO PUMP SHUT OFF Dc. NOAUTO PUMP SHUT OFF ®11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUTOFF OR 011. AUTOMATIC LEAK DETECTOR RESTRICTION 012. ANNUAL INTEGRITY TEST(0.1 GPH) 0 12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTIONIGRAMTY SYSTEM SUCTIONIGRAVITY SYSTEM 013. CONTINUOUS SUMP SENSOR-AUDIBLE ANDVISUAL ALARMS ❑13. CONTINUOUS EMERUMP GENCY GENSOR AUDIBLE ONLY RMS EMERGENCY GENERATORS ONLY(Check all that appy) EMERGENCY GENERATORS ONLY(Check all that apply) D14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND D14' VCONTINUOUS ISUAL ALARMS MP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND VISUALAIARMS 015.AUTOMATIC UNE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR 015. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) RESTRICTION 016. ANNUAL INTEGRITY TEST(0.1 GPH) 016. ANNUAL INTEGRITY TEST(0.1 GPH) El17 ONLY VISUAL CHECK [117. DAILY VISUAL CHECK VI II:DISPENSER CONTAINMENT DISPENSER Eli. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 0 4.DAILY VISUAL CHECK CONTAINMENT DATE INSTALLED 468 ❑2. ONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS ❑5.TRENCH LINER IMON ITORI NG 469 3. ONTINU SPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+ [16.NONE 1998 AUDIB AND VI UAL ALARMS IX..OWNERIOPERATOR SIGNATURE I codify that the informatlo provi d herein is a and urate to the best of my knowledge. DATE J' 470 SIGNATURE OF O RATONAME U� TITLE OF 0 NER/ ERATOR Randy OWNE PRATOR(print) 472 Gasoline & Environmental Com )lance Mana er Rand Martin permit Expiration Date(Far local use only) Permit Number(Far local use only) 473 Perrrit Approved(For local use only) 475 Formerly SWRCB Form B UPCF (1199 revised)