BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

NIFIED PROGRAM CONSOLIDATED FO m A TANKS J UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI.PIPING CONSTRUCTION(Oheak sdlfalappW UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE (Y 1 PRESSURE ❑ 2. SUCTION ❑ ]. GRAVITY ❑ i. PRESSURE ❑ 2. SUCTION ❑ ]. GRAVITY CONSTRUCTION/ ❑ T SINGLE WALL ❑ ]. UNEOTRENCH ❑99 OTHER ❑ 1. SINGLE WALL ❑95.UNKNOWN MANUFACTURER 1j2. DOUBLE WALL ❑95. UNKNOWN ❑ 1 DOUBLEMALL -❑99.OTHER MANUFACTURER MANUFACTURER ❑ 1.BARESTEEL ❑ 8. FRP COMPATIBLE W/WO%METHANOL ❑ 1. BARE STEEL ❑ S. FRPCOMPATIBLEWI 10%METHANOL MATERIALS AND ❑ 2.STAINLESSSTEEL ❑ 7. GALVANIZEDSTEEL ❑ 2.STAINLESS STEEL ❑ 7.GALVANIZED STEEL CORROSION PROTECTION F❑b]. PLASTIC COMPATIBLE WITH CONTENTS ❑95. UNKNOWN ❑ ].PLASTIC COMPATIBLE WITH CONTENTS ❑ B. FLEXIBLE(HOPE) 110. OTHER CX4. FIBERGLASS ❑ S. FLEXISLE(HOPE) ❑90. OTHER. ❑ 4.FIBERGLASS - ❑ 9. CATHODIC PROTECTION ❑ 5. STEELWICOATING ❑ S. CATHODIC PROTECTION ❑ 5. STEELWICOATING 1195. UNKNOWN VII.PIPING LEAK DETECTION(Chock a6 Net appy) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING SINGLE WALL PIPING PRESSURIZED PIPING(Crack ad that appy): PRESSURIZED PIPING(Check ad that appy): 111. ELECTRONIC LINE LEAK DETECTOR IO GPM TEST WITH AUTO PUMP SHUT OFF FOR ❑ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPM TEST WITH AUTO PUMP SHUT OFF FOR LEAK, LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION.AUDIBLE AND VISUAL SYSTEM FAILURE,AND SYSTEM DISCONNECTION.AUOIBLE AND VISUAL ALARMS ALARMS Cl 2. MONTHLY 0.2 GPM TEST ❑ 2. MONTHLY 02 GPM TEST ❑ ].ANNUAL INTEGRITY TEST(0.1 GRH) ❑ ]. ANNUAL INTEGRITY TEST(01 GPM) ❑ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Check all that appy): ❑ 5 DAILY VISUAL MONITORINCOF PUMPING SYSTEM•TRIENNIAL PIPING INTEGRITY ❑ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(01 GPM) ❑ 6.TRIENNIAL INTEGRITY TEST(0.1 GPM) SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING) SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING)'. ❑ 7. SELF MONITORING ❑ T. SELF MONITORING GRAVITY FLOW GRAVITY FLOW(Check ad Mat apply).' ❑ 9 BIENNIAL INTEGRITY TEST(0.1 GPH) - - Cl 6. DAILY VISUAL MONITORING ❑ 9 BIENNIAL INTEGRITY TEST(O.1 GPM) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check ah that apply): PRESSURIZED PIPING(Check ep that appy): 10 CONTINUOUS TURBINE BUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (crack NTI one) 'OL CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(cha.k ane) �T�}a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑ ..AUTO PUMP SHUT OFF WHEN A LEAK OCCURS LjL6 AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM ❑ 6, AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION - ❑ c. NO AUTO PUMP SHUT OFF ❑ e. NO AUTO PUMP SHUT OFF Q[I1 AUTOMATIC LINC LEAK DETECTOR(3.0 GPM TEST)WITH FLOW SHUT OFF OR ❑ 11.AUTOMATIC LEAK DETECTOR RESTRICTION ❑ 12 ANNUAL INTEGRITY TEST(01 GPM) ❑ 12.ANNUAL INTEGRITY TEST(0.1 GPM) SUCTION-GRAVITY SYSTEM' SUCTIDNIGRAVITY SYSTEM: ❑ t] CONTINUOUS SUMP SENSOR.AUDIBLE AND VISUAL ALARMS ❑ 13 CONTINUOUS SUMP SENSOR•AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Clack a0 that apply/ EMERGENCY GENERATORS ONLY(Chock as that app ) ❑ 14 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SMUT OFF.AUDIBLE AND ❑ A. CONTINUOUS SUMP SENSOR WITHOUTAUTO PUMP SHUT OFF.AUDIBLE AND VISUAL VISUALALARMS ALARMS ❑ 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPM TEST)WITHOUT FLOW SMUT OFF OR ❑ 1S AUTOMATIC UNE LEAK DETECTOR(3.o GPM TEST). RESTRICTION IX10. ANNVALINTEGRITY TEST(0.1 GPM) ❑ id.ANNUAL INTEGRITY TEST(0.1 GPM) ❑ 17. DAILYMSUALCHECK ❑ I7. DAILY VISVALCMECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT IF❑y 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 134. DAILY VISUAL CHECK yL DATEINSTALLED 2. CONTINUOUS DISPENSER PAN SENSOR.AUDIBLE AND VISUAL ALARMS ❑ 5. TRENCH LINER I MONITORING 111 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER.AUDIBLE AND VISUAL ALARMS ❑ e. NONE IX OWNERIOPERATOR SIGNATURE 1 Famy Nat Ne into..firm provided haain Is We and apparels Is Ne bast of my Mead.fg.. SIGNATURE PRA ft DATE / � S " 0 Z NAME OPE R Mdntl TITLE OF EPAPERATOR �� S5 Remit Number(Forlacal me at*) Permit Appmvad(Forlocat we only) Permit Expiration Data(Forbin use any) CUPAFORM(4199) Formerly SWRCB Form B