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UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI.PIPING CONSTRUCTION(Q kas pM!appy) UNDERGROUND RVING ABOVEGROUNDPIPING SYSTEM TYPE 1 PRESSURE ❑ 2. SUCTION ❑ ]. GRAVITY ❑ 1. PRESSURE ❑ 2. SUCTION ❑ ]. GRAVITY CONSTRUCT OW C11. SINGLE WALL ❑ ]. LINED TRENCH ❑99. OTHER ❑ 1. SINGLE WALL ❑95. UNKNOWN MANUFACTURER 2 DOUBLE.WALL .4 P 95 U(N^KNOWN 1( ❑ 2. DOUBLE WALL ❑99. OTHER 4 d lY�! MANUFACTURER /' l r\ MANUFACTURER ❑ 1.BARE STEEL ❑ 0. FRP COMPATIBLE W1 IW%METHANOL ❑ 1. BARE STEEL ❑ a.FRP COMPATIBLE WIIW%METHANOL MATERIALS AND ❑ 2. STAINLESS STEEL ❑ T. GALVANIZED STEEL ❑ 2. STAINLESS STEEL CORROSION ❑ T. GALVANIZED STEEL PROTECTION ❑ ]. PLASTIC COMPATIBLE WITH CONTENTS ❑95. UNKNOWN ❑ 0. PLASTICCOMPATISLEVATH CONTENTS ❑ a FLE%IBLE(HDPE) 099. OTHER 4. FIBERGLASS ❑ a. FLEXIBLE(MOPE) [IN OTHER ❑ 4. FIBERGLASS ❑ 9. CATHODIC PROTECTION ❑ 5. STEELWICOATING ❑ 9. CATHODIC PROTECTION ❑ 5. STEELVOCOATING 13 M. UNKNOWN VIL PIPING LEAK DETECTION(CINCA Nlhaf appy) UNDERGROUND PIPING ABOVEGROUND PIPING - SINGLEWALLPIPING SINGLE WALL PIPING PRESSURIZED PIPING(Clack as that appy): PRESSURIZED PIPING(Chock 0 Mat apply): ❑ 1. ELECTRONIC LINE LEAK DETECTOR].0 GPM TEST WITH AUTO PUMP SHUT OFF FOR ❑ 1. ELECTRONIC UNE 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•AUDIBLE AND VISUAL ALARMS ALARMS ❑ 2. MONTHLY 02 GPM TEST ❑ 2. MONTHLY0.2GPHTEST ❑ ], ANNUAL INTEGRITY TEST(0.1 GPM) ❑ ]. ANNUAL INTEGRITY TEST(p.1 GPX) ❑ 4, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Clack M Maf appy): ❑ S DAILY VISUAL MONITORING OF PUMPING SYSTEM•TRIENNIAL PIPING INTEGRITY ❑ S. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPM) ❑ S. TRIENNIAL INTEGRITY TEST(0 1 GPM) SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): ❑ ] SELF MONITORING ❑ ]. SELF MONITORING GRAVITY FLOW! GRAVITY FLOW(CMG N IMf apply): ❑ 9 BIENNIAL INTEGRITY TEST III I GPM) ❑ a, DAILY VISUAL MONITORING ❑ 9, BIENNIAL INTEGRITY TEST(O.1 GPM) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Clack 0 that appy): PRESSURIZED PIPING(Chock N Mal apply): 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDI8LE AND VISUAL ALARMS AND VIChon aa o) 10.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(mock ono) a AUTO PUMP SHUT OFFWHEN A LEAK OCCURS ❑ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑ 0 AUTO HUSOPUMPBHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM D. O ❑ D AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION ❑ c, NO AUTO PUMP SMUT OFF ❑ o NO AUTO PUMP SHUT OFF It AUTOMATIC LINE 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(D i GPM) SUCTIONIGRAVITY SYSTEM SUCTIOWGRAVITY SYSTEM: ❑ 13. CONTINUOUS SUMP SENSOR•AUDIBLE AND VISUAL ALARMS ❑ 13. CONTINUOUS SUMP SENSOR 4 AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Clack as IMI appy) EMERGENCY GENERATORS ONLY(Chock as Maf aApA ❑ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF-AUDIBLE AND ❑ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF•AUDIBLE AND VISUAL VISUALALARMS ALARMS ❑ 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPM TEST)WITHOUT FLOW SHUT OFF OR ❑ 15. AUTOMATIC LINE LEAK DETECTOR(].0 GPM TEST) RESTRICTION ❑ la. ANNUAL INTEGRITY TEST(0.1 GPH) ❑ 9a. ANNUALINTEGRITYTESTJMIGPM) ❑ t]. DAILY VISUAL CHECK ❑ 1]. DAILY VISUAL CHECK VHL DISPENSER DONTAINMENT DIBPENSERCONTAINMENT 1_FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑ A. DAILYVISLALCHECK VATE INSTALLED _. - -Q-2,CONTINUOUS DISPENSER PAN SENSOR•AUDIBLE AND VISUAL ALARMS ❑ 5. TRENCH LINER/MONITORING ❑ 3'OPNTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER•AUDIBLE AND VISUAL ALARMS ❑ a. NONE IT IX OWNERIOPERATOR SIGNATURE I aDaKRaaalp011P�M4p mn is wa MW afLlrala ta ma bol P!my knoxlaE9a. SIGNAT E OF OWNER(OPER5ZOM DATE NAME OF ON E ERA R(p" TITLE OF OWNEWOPERATOR 1 Pmnn Num",(FarhKM uaa opyi Pamla Apprv,W(Fo/local uaa aroyl Pmtvt Fjpa*W Data(ft k cal Vaa any) CUPAFORM(4199) FOrmelty SWRCS Form 8