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IL
<br />i -Mar -07-03 12:244 Move -for Loss 7 209 E332 E3078
<br />61 ED -PRO 'RAM CONSOLIDATEUTORM
<br />'I'ANKS
<br />CI NDERGROUND STORAGETANKS -- TANK PAGE 2
<br />...... vi, PIPING f(INSTRUC"FION.(ChcK`
<br />*ND PIPING
<br />k)NDFRGROUND PIPING -ABOV.C. GROU
<br />0 F
<br />41K 0 1 PRESSURE 0 Z. •sucl*ION 1. GRAVITY.
<br />C_Y_STEMTYPE 2, SUCTION L;KAVIIY
<br />[] 95. T.NKNOWN
<br />Sm°IGi_17, WALL 3, LINED TRENCH 0 10. OTHER 46D [3 1. SINGLE:WALL
<br />0 2 DOURI.F. WALL ow).orHER
<br />MANkJFA(7rt)RLK [3 2. DOUBLE WAI I vs. LNKPIIJ 461 MANUFACTURER
<br />MANUrA(,TURLR
<br />13 1. nARI;.HTEI-.L DO. FRPCOMPATI13LE 4,100% MFMAWIL. [11. UAKE SfEEL
<br />[] 1. STAINLESS STEEL [17 GALVANIZED STEEL 0 Unk-i-n 0 2- STAINLESS STEEL
<br />0.1,PLASTIC COMPATIBLE WjC(fNTFNT% ❑ 09 Other 0 3. PLASTIC COMPA fI BLE. W,CON_Tr-.NTS
<br />4. FIBER GLASS n g, I:t.u.v wx-(l IDPL) [j 4. 111JERULASS
<br />❑ 5. STEEL WfCOATINC [3 9, CKI*M.)[C PROTriCTION 464 0 5. ST171iI. WICOATING
<br />Vill PIPING LEAK DFTECI-ION (0kIrk talc A.A qn,lyj JAd*;C1jp,roe ofthe
<br />ABO
<br />SINGLE WALL PIPING 466
<br />PRESSUIUZEI) PIPING
<br />1, LLECTRONIC LIVE I.F.AK nrtTI-.
<br />,TOR 3.0 (jPH TEST WI TIT AUTO PUNIP SHUT
<br />E ---
<br />OFF FOR 1,17AK, SYSTEM FAILUKE, AND SYSTEM DISCONNECTION
<br />AUDIBLE AND VISLIAI. ALARMS.
<br />0 7. MONTI ILY 0.2 UPHTESI'
<br />3' ANNUAL INTEURITY TEST (0 1GPI 1)
<br />CONVENTIONAL SUCTION SYS IEMS
<br />nA1I.Y VISUAL MONITOWNG OF PUNIPINCS-y5"Em I TRIENNIAL PIPING
<br />INTEUKITY TEST (f) I npll)
<br />SAFE. suCuW4 SYS FMS INO VALUES IN BELOW GROUNDPIPING):
<br />❑ 7. SELF MONITORING
<br />GRAVITY FLOW
<br />(3 Y. BIENNIAL INTEGRITY TES 1* (0.1 Ght)
<br />pRESSUR177T) PIPING all thcl UPOYI:
<br />To. c0N'I,1NV.OIJS TL7RRINF SUNIT SENSOR ff_LW AL.'f)lnl.r,. AND VISUAL
<br />ALARMS AND (Check unel
<br />[j,j. AlITOPUMI, 51l OFF WHEN A LEAKOCCURS
<br />0 b. AUTO PI IMP q1 TUT 01'I'VOR LEAKS, SYSTEM FAILURE AND SYSTFNI
<br />DISCONNECTION
<br />Oc. NO AUTO PUMP SHUT OFF
<br />11. AUTOMATIC IJNr J.RAK I)ij,hcrOK J.1-0 GPH TT.1.;Tj wgH FLOW SHUT
<br />Orr OR RL'STKK:1 ION
<br />17. ANNUAL INTEGRITY TEs ril). I GPII)
<br />SUL-.TT11V/r,RAVrTY NYSTEINA
<br />CQNTIN1101A SOMP SENSOR + AL)DIRI,F AND VISUAL ALAFUMS
<br />rMERGENCY (;ENk.%kTORS ONLY Wheck all 111-11 WIP
<br />IC CONTINUOUS SUMP SPNSIOR 3MIT-"
<br />11OUT AUTO PUMP 51113T OF
<br />AUDIBLE AND VI%IJAL ALARMS
<br />Ej 15, AlyromATIc LINE LEAK DETECTOR (3.0 GPI I TEST) WIIHQUT FLOW
<br />SHUT OFF OR RrqTRI(.7rION
<br />❑ 16. ANNLIAT. iNTrt(;RJTY TEs r (m GPH)
<br />❑ 17. DAILY VISUALCBELK
<br />Vill DISPEN
<br />DisPLNSEKCONTAINMFNT
<br />DATE INSTALLED 468
<br />I .-tily ItudAfte 11kibdinoWn
<br />qleiM171
<br />UPCF (12/99 revised)
<br />41
<br />-6v
<br />462
<br />6. FRP COMPATIRI T. MFMANOI.
<br />0 7. GALV&N17ED STEFL
<br />CJTf,FLEXI1JLEfHr)PFJ []99 OTVIER
<br />0 9. CATHODIC: PROTFCTI(N
<br />[] 95. UNKNOWN 44q
<br />lle�l Ta the kcal agency.)
<br />SINGLE WAIJ, PIPTNr lot
<br />PRESRUCZ17D PIPtN'G jcwk all That 2pPNV*
<br />Of FEr.X-TRONIC LINE LEAK i)ETECTOR 31)CP)ITr_1;T WITS AUTO PUMP
<br />Slitj ()vV Vok LEAK, 1,VATKM FAILURE, AND SYS�I'InNt bIS(0%NFt.Tj()N +
<br />Al Dinf.Y AND VISUAL ALARMS.
<br />❑ I MO,,4,1 HI.Y 0 ) OPH TEST
<br />3. ANNUAL rNTF(' R ITY TFIST (0. 1 GPI 1)
<br />[14. 0A1fYVI',WALCIIf7CK
<br />CONVENTIONAL. SUCTION SYSTr.MS (chew al; that *00
<br />Q S. DAILY VINUALMONITORIN(i OF PIPING AND PUMPINU SYSTEM
<br />[36 'rRIF-,!-NIAF,TNTr,(-,RITYTES'T-(.C.1(3PH)
<br />SAFE stX71 ION'SYSTF.MS (NO VALVES IN 13ELO* GROUND PIPIN(j)-
<br />E17. SELF MON11OWNG,
<br />GRAVITY FLOW (check allftlapplyl,
<br />❑ S. DAILY VISUAL munror ING
<br />9. 11117NNIAL INTEGRITY 11' �y (0.1 GPII)
<br />SFe,,l,)Nj)A -TAINF
<br />RTI.V r.ON -D PIPING
<br />PRLSSUKIZLD PIPING (Check oil 11-1apT11y)
<br />10. CONTINUOUS TURBINE SUMP SENSOR WITT] ATIDII)LE AND VISUAL
<br />ALARMS AND
<br />, AU 10 rUMe SHUT OFF WIfr'.N A LEAK OCCUICS
<br />b AUTO POMP SHUT OFF FOR J,RAKS, SYSTEM I-AII.I.Rl: AND SYSTEM
<br />L)TSCS�iNNFMON
<br />O,z NO AUTO PUMP SI TUT Orr
<br />0 11. AUTOMATICLTIAK DE.TI.CTOR
<br />0 12. A.NNUAL INTEGRITY TEST (TT. I GPII)
<br />suL-noNJ(JKAVI'I Y SYSTEM
<br />0 13. CON-yI.NUOUSSL;mP SENSOR - AUDIIII.E. AND VISUAL ALARMS
<br />EMEKGE14CV GENrIZATORS ONLY (t:fteck all that apply)
<br />o 14. cownNuoi is surorswsuK W11 ROUT AUTO PT;MP SHUT OFF
<br />AUDIBLE AND VISUAL ALARMS
<br />0 15. AUTUMA TIC LINE LEAK nr.TrCTOR (3,0 (;Pl I TEST)
<br />C1 16. ANNUAL IN FEGIU1 Y TEST (f) I GPI1)
<br />M 17. DAILY VISUAL CHECK
<br />SEII CONTAINNIFNT
<br />F1 1. FLOAT' MECHANISM TIIAT snurs OFF'SHEAR VALVE ®4. DAILY VISUAL CHECK
<br />p 2 CONTINUOUS 1_)ISPFNSFR PAN SENSOR R AUVWLF ANI) VISI IAL ALARMS 9(5. TRENCH LINLK; MONITORING
<br />0 3 C.0,
<br />NTlN7U0US VISpbNSER PAN Sr-14SOR W[TII ALTO sHur OFF FOR
<br />El 6, NONE
<br />AUDIBLE ANL) %11SL'AL _AI.ARM-q---.
<br />-
<br />IX. OWNF-RIOPERATOR SIGNAXURF,
<br />DATE
<br />471
<br />u;w -rawly ) 474
<br />470
<br />Formerly SWRCB Form B
<br />
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