BILLING - Laserfiche WebLink

Home Browse Search

UNIFIED PROGRAM CONSOLIDATED FO 7/jU 1D� TANKS ` l UNDERGROUND STORAGE TANKS -TANK PAGE 2 Pae of VI.PIPINGCONSTRUCTION Oh ck.11 thm I UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE O 1.PRESSURE .SUCTION ❑3.GRAVITY 458. 0 1,PRESSURE 0 2.SUCTION 0 3,GRAVITY 459, CONSTRUCTION/ JiH.SINGLE WALL 0 3.LINED TRENCH 0 99.OTHER 460, 0'1.SINGLE WALL ,q 0 95.UNKNOWN 462, MANUFACTURER 0 2 DOUBLE WALL 0 95.UNKNOWN 0 2.DOUBLE WALL N-/ ❑99.OTHER MANUFACTURER 461. MANUFACTURER 463. BARE STEEL 0 6.FRP COMPATIBLE W/100%METHANOL 0 1.BARE STEEL �//I/l 0 6,FRP COMPATIBLE W/100%METHANOL ❑2.STAINLESS STEEL 0 ,A.1.7.GALVANIZED STEEL 0 2.STAINLESS STEEL " / 1f 0 7.GALVANIZED STEEL 0 3.PLASTIC COMPATIBLE WITH CONTENTS 0 95.UNKNOWN 0 3,PLASTIC COMPATIBLE W/CONTENTS 0 8.FLEXIBLE(HDPE) 0 99.OTHER [14.FIBERGLASS [18.FLEXIBLE(HDPE) [199.OTHER 0 4.FIBERGLASS 0 9.CATHODIC PROTECTION ❑ S.STEEL W/COATING 0 9.CATHODIC PROTECTION 464, 0 5.STEEL W/COATING 0 95.UNKNOWN 465. VILPIPING LEAK DETECTION(Check all lhataeftA.eeuti ionofihe+mnitoi mshM[be,mbm Hedtothakwleenc. UNDERGROUND PIPING 1O re ABOVEGROUND PIPING SINGLE WALL PIPING 5,qe 7/0-J 466. SINGLE WALL PIPING 461- PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): 01. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP 01, ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT-OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS. +AUDIBLE AND VISUAL ALARMS. [12. MONTHLY 0.2 GPH TEST [12. MONTHLY 0.2 GPH TEST 03. ANNUAL INTEGRITY TEST(0.1 GPH) 0 3. ANNUAL INTEGRITY TEST(0.1 GPH) 0 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all that apply) 0 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING 05. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): [16. TRIENNIAL INTEGRITY TEST(0.1 GPH) [37. SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW / 0 7. SELF MONITORING F19. BIENNIAL INTEGRITY TEST(0.1 GPH) d I /1 GRAVITY FLOW(Check all that apply): /O� if•// 0 8. DAILY VISUAL MONITORING 09. 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 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(Check one) ALARMS AND(Check one) 0 a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0 a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0 b.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM 0 b.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION Ee. NO AUTO PUMP SHUT OFF On. NO AUTO PUMP SHUT OFF 011. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT 011 AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION 0 12. ANNUAL INTEGRITY TEST(0.1 GPH) ❑12. ANNUAL INTEGRITY TEST(0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS 013,CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) 014. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF 014. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS 0 0. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW 0 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICTION 016. ANNUAL INTEGRITY TEST(0.l GPH) 0 16. ANNUAL INTEGRITY TEST(0.1 GPH) 017. DAILY VISUAL CHECK 0 17. DAILY VISUAL CHECK VIII.DISPENSER COL`JTA3Nt �' T DISPENSER CONTAINMENT 468. 31. FLOAT MECHANISM THAT SI TUTS OFF SHEAR VALVE 04. DAILY VISUAL CHECK 469. DATE �I9N1STAjL�LED ❑2. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 0 S. TRENCH/LMER MONITORING G/fO ` �•'- I` 03 SPENSER+AUDIBLEAND PAN ALAR SENSOR AUTO SHUT OFF FOR 06. NONE D IX.OWNER/OPERATOR SIGNATURE I certify that the infortnation provide a ein is true arW Ocuraj6lt)athe best of y knowledge. SIGNATURE OF O WNI R L)PERATO DATE: 470. NAME OF OWNER/OPERATOR(print' (t L/ �� TITLE OF OWNER/OPERATOR: ,a_/J 471 L�l Permit Number(Agency use only) 473. Permit Approved By(Agency use only) 474. Permit Expiration Date(Agency use only) 475. UPCF hwfwrc-b(1/99)-3/4 http://"w.unidoes.org Rev.02/16/00