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0 • <br />?5_ PTPTHC INFORMATION <br />PIPING INFORMATION <br />TANK# <br />TANK# <br />TANK# TANK# <br />DISTANCE from <br />DISPENSER to TANK <br />11 <br />(J" <br />` / <br />MANUFACTURER <br />14, 1-2, 75/71 / 72t D / % <br />SYSTEM TYPE <br />p <br />CONSTRUCTION <br />MATERIAL <br />LEAK DETECTION SYSTEM <br />100% METHANOL COMPATIBILITY with <br />FRP <br />CORROSION PROTECTION <br />* System Type; suction, pressure, and gravity <br />** Construction: single -walled, double -walled, lined -trench, etc. <br />*** Material Type; steel -iron, stainless-steel, fiberglass, etc. <br />26. Piping (cross-sectional diagram, including connections to tank and dispensers). <br />Double wall piping or _ Secondary containment (Trench liner, etc.) <br />(1) Product line (leak detector or automatic shut-off on <br />pressurized piping). <br />(2) Vent and vapor recovery lines if not designed to <br />prevent the entrance of standing fluids. (Ball float valve) <br />(3) Manways and other single walled pipe fittings on a <br />double -walled tank, if not designed to prevent the <br />entrance of standing fluid. <br />27. 1� State Water Resources Control Board "Facility (A)" and "Tank Permit (B)" application forms submitted. <br />28. !t Plan review and operating permit fees paid. <br />29. X Monitoring and Response Plans submitted. <br />30.X( Proof of financial responsibility on file. ,,}} <br />31. X What is the approximate depth to ground water: <br />(include source of information - borehole logs, monitoring well data, water <br />studies, etc.) <br />32. <br />33. <br />OW <br />Total number of tanks an site after installation: _ <br />Any existing tanks to be removed or abandoned? <br />Control Board "Facility Permit (B)" application form. <br />YES ( ) NO E ) If yes, submit State Water Resources <br />34. Responsible party(ies) shall submit a *Letter of Commitment• prior to the <br />installation of new tanks. (Applies to sites with documented soil and/or groundwater contamination) <br />35. X County/City Fire District and Building Department notified. <br />36. REMARKS <br />