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16 OIFIED PROGRAM CONSOLIDATED FOR \ ` )TANKS UNDERGROUND UNDERGROUND STORAGE TANKS - TANK PAGE 2 . 7 VI.,PIPING,CONSTRUCTION(CheCkelithat apply) )ERGROUND PIPING ABOVEGROUND PIPING -Y STEM TYPE X 1. PRESSURE F 2. SUCTION r 3. GRAVITY r 1. PRESSURE r 2. SUCTION r 3. GRAVITY 459 CONSTRUCTION r 1. SINGLE WALL r 3. LINED TRENCH r 99. OTHER r 1. SINGLE WALL r 95. UNKNOWN 462 / X 2. DOUBLE WALL r 95. UNKNOWN r 2. DOUBLE WALL r 99. OTHER MANUFACTURE R MANUFACTURER 461 MANUFACTURER 463 I 1.BARE STEEL r 6. FRP COMPATIBLE W/100%METHANOL F 1. BARE STEEL F 6. FRP COMPATIBLE W/100%METHANOL [MATERIALS AND 12. STAINLESS STEEL r 7. GALVANIZED STEEL r 2. STAINLESS STEEL r 7. GALVANIZED STEEL CORROSION r PROTECTION 3. PLASTIC COMPATIBLE WITH CONTENTS r 95. UNKNOWN r 3. PLASTIC COMPATIBLE WITH CONTENTS r 8. FLEXIBLE(HDPE) r 99. OTHER X 4. FIBERGLASS r B. FLEXIBLE(HDPE) IF 99. OTHER r 4. FIBERGLASS r 9. CATHODIC PROTECTION r 5. STEEL W/COATING F 9. CATHODIC PROTECTION 4641 r 5. STEEL W/COATING I 95. UNKNOWN 465 VII.PIPING LEAK DETECTION(Check all that apply)(A dascrtpBon of the monitoring program.ahall be submitted to;the k)qa/agency:) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all that apply): F 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR r 1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH 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 I 2. MONTHLY 0.2 GPH TEST F 2. MONTHLY 0.2 GPH TEST 3+ ANNUAL INTEGRITY TEST(0.1 GPH) I 3. ANNUAL INTEGRITY TEST(0.1 GPH) _.-.,.,... r 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS(Check all that apply): I 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING INTEGRITY I' 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) I r 6. TRIENNIAL INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): F 7. SELF MONITORING r 7. SELF MONITORING GRAVITY FLOW: GRAVITY FLOW(Check all that apply): 9. BIENNIAL INTEGRITY TEST(0.1 GPH) I B. DAILY VISUAL MONITORING I 9. 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 ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(check one) (Check one) X a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS r a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS r b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM r b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION F c. NO AUTO PUMP SHUT OFF r c. NO AUTO PUMP SHUT OFF X 11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT OFF OR I 11, AUTOMATIC LEAK DETECTOR RESTRICTION r 12. ANNUAL INTEGRITY TEST(0.1 GPH) I� 12. ANNUAL INTEGRITY TEST(0.1 GPH) i SUCTION/GRAVITY SYSTEM: SUCTION/GRAVITY SYSTEM: I13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS F 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) r 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND I 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF+AUDIBLE AND VISUAL VISUAL ALARMS ALARMS r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW SHUT OFF OR r 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) RESTRICTION r 16. ANNUAL INTEGRITY TEST(0.1 GPH) r 16. ANNUAL INTEGRITY TEST(0.1 GPH) F 17. DAILY VISU4 CHECK r 17. DAILY VISUAL CHECK VIII.,DISPENSER:CONTAINMENT DISPENSER CONTAINMENT r 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE I' 4. DAILY VISUAL CHECK DATE INSTALLED 468 r 2. CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS r 5. TRENCH LINER/MONITORING i 1998 X 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+AUDIBLE AND VISUAL ALARMS r 6. NONE 469 I certify that tha information provided herein is true and accurate t5tthe best of my knowledge. SIG RE OF OWNE PERATOR DATE 470 4/5/02 IE OF OWNER/OPERATOR(print) 471 TITLE OF OWNER/OPERATOR 472 Bruce T. Marubashi for Shell Oil Producst US H,S&E Analyst 925-766-3498 Permit Number(For local use only) 473 I Permit Approved(For local use only) 474 Permit Expiration Date(For local use only) 475 6