Laserfiche WebLink
U 14rllcu rnvaanr4mt x.vt�av uvAit cu rvntn <br /> TANK <br /> UNDERL'�t. OUND STORAGE TANKS -49aNK PAGE 2 b <br /> / <br /> VI. PIPING CONSTRUCTION(Check an that apply) Page _ of <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SYSTEM TYPE 0 1.PRESSURE 0 2.SUCTION ❑3.GRAVITY 458 0 1.PRESSURE 0 2. SUCTION [13.GRAVITY 459 <br /> CONSTRUCTION/ 01.SINGLEWALL 03.LINED TRENCH 099.OTHER 460 01.SINGLE WALL 095.UNKNOWN 462 <br /> MANUFACTURER 02.DOUBLE WALL 0 95.UNKNOWN [12.DOUBLE WALL [199.OTHER <br /> MANUFACTURER AO Smith 461 MANUFACTURER_ 463 <br /> 01.BARE STEEL 06.FRP COMPATIBLE w/100% METHANOL 01.BARE STEEL 06.FRP COMPATIBLE Will METHANOL <br /> 0 2.STAINLESS STEEL [17.GALVANIZED STEEL 0 UKNOWN D 2. STAINLESS STEEL [17.GALVANIZED STEEL <br /> 03.PLASTIC COMPATIBLE W/CONTENTS 099. OTHER 03. PLASTIC COMPATIBLE W/CONTENTS 08.FLEXIBLE(HOPE) 099. OTHER <br /> 04.FIBERGLASS 08.FLEXIBLE(HDPE) D4. FIBERGLASS D 9.CATHODIC PROTECTION <br /> 05.STEEL W/COATING 09.CATHODIC PROTECTION 464 05. STEELW/COATING 095,UNKNOWN 465 <br /> 'Vil PIPING.LEAK DETECTION Check all that apl )(A bescrlotion of the monitoring program shall be submitted to the local agency.) <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 <br /> PRESSURIZED PIPING(Checkall lhxtapplift PRESSURIZED PIPING(Checkall thatapply): <br /> ❑1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR 01. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR <br /> LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ AUDIBLE AND VISUAL <br /> ALARMS. ALARMS. <br /> 02. MONTHLY 0.2 GPH TEST 02. MONTHLY 0.2 GPH TEST <br /> D3. ANNUAL INTEGRITY TEST(O.IGPH) 03. ANNUAL INTEGRITY TEST(OAGPH) <br /> 04. DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Checkolthat apply) <br /> 05. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING INTEGRITY 05, DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br /> TEST(0.1 GPH) <br /> SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): 06. TRIENNIAL INTEGRITY TEST(0.1 GPH) <br /> 0 7. SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): <br /> GRAVITY FLOW 07. SELF MONITORING <br /> 09. BIENNIAL INTEGRITY TEST IDA GPH) GRAVITY FLOW(Chack all that apply): <br /> 08. DAILY VISUAL MONITORING <br /> 09.- BIENNIAL INTEGRITY TEST(0.1 GPH) <br /> SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING <br /> PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): <br /> 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND <br /> (Check one) (Check ane) <br /> 0 a. AUTO PUMP SHUTOFF WHEN A LEAK OCCURS Oa AUTO PUMP SHUTOFF WHEN A LEAK OCCURS <br /> Ob. AUTO PUMP SHUTOFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM Ob <br /> DISCONNECTION <br /> AUTO PUMP <br /> SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM <br /> DISCONNECTION <br /> Uc. NOAUTO PUMP SHUTOFF Uc NO AUTO PUMP SHUT OFF <br /> 011. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUTOFF OR [111, AUTOMATIC LEAK DETECTOR <br /> RESTRICTION <br /> 012. ANNUAL INTEGRITY TEST(0.1 GPH) 012. ANNUAL INTEGRITY TEST(0,1 GPH) <br /> SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM <br /> 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) <br /> 014. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND 014. CONTINUOUS SUMP SENSORITW HOUT AUTO PUMP SHUT OFF+AUDIBLE AND <br /> VISUAL ALARMS VISUAL ALARMS <br /> 015, AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR 015. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) <br /> RESTRICTION <br /> E:116, ANNUAL INTEGRITY TEST(0.1 GPH) 016, ANNUAL INTEGRITY TEST(OH GPH) <br /> D17, DAILY VISUAL CHECK 017. DAILY VISUAL CHECK <br /> VIIL DISPENSER CONTAINMENT <br /> DISPENSER Ell. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 04.DAILY VISUAL CHECK <br /> CONTAINMENT <br /> DATE INSTALLED 46B 02. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 05.TRENCH LINER/MONITORING <br /> 1998 03. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+ D6.NONE 468 <br /> AUDIBLE AND VISUAL ALARMS <br /> IX,OWNER/OPERATOR SIGNATURE <br /> I certify that the information provided hereinA true and accurate to the best of my knowledge. <br /> SIGNATURE OF OVINER/OPILAT DATE 470 <br /> 5/� 07 <br /> NAME OF OWNER/OPRATOR(print) TITLE OF OWNER/OPERATOR 472 <br /> Sandy Huff Operations & Environmental Secialist <br /> Permit Number(For local use only) 473 Permit Approved(For local use only) Permit Expiration Date(For local use only) <br /> 475 <br /> UPCF(1/99 revised) Formerly SWRCB Form B <br />