COMPLIANCE INFO_2003-2012 - Laserfiche WebLink

Home Browse Search

UNIFIED PROGRAM CONSOLIDATED FORA? TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI.PIPING CONSTRUCTION(Check au mai apply) Page of Q. UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE iX 1.PRESSURE. ❑2.SUCTION ❑3.GRAVITY 458 ❑1,PRESSURE ❑2.SUCTION ❑3.GRAVITY 459 CONSTRIKTION [11.SINGLE WALL ❑3.LINED TRENCH ❑99.OTHER 46o ❑I.SINGLE WALL ❑95.UNKNOWN 462 MANUFACTURER IN 2.DOUBLEWALL ❑95.UNKNOWN ❑2.DOABLE WALL ❑99.OTHER MANUFACTURER A.O. Smith 461 MANUFACTURER 463 ❑1.BARE STEEL ❑6.FRP COMPATIBLE w/lam% METHANOL ❑1.BARE STEEL. ❑6.FRP COMPATIBLE wnocto/METHANOL.. ❑2.STAINLESSSTEEL ❑7.GALVANIZED STEEL ❑Unknown ❑2. STAINLESS STEEL [17.GALVANIZED STEEL ❑3.PLASTIC COMPATIBLE W/CONTENTS ❑99. Other [13. PLASTIC COMPATIBLE W/CONTENTS El 8.FLEXIBLE(HDPE) ❑99.OTHER IX 4.FIBERGLASS ❑8.FLEXIBLE(HDPE) ❑4. FIBERGLASS ❑9.CATHODIC PROTECTION ❑ S.STEEL W/COATING ❑9.CATHODIC PROTECTION 464 Cl 5. STEEL W/COATING ❑95.UNKNOWN 465 VIL PIPING LEAK DETECTION(Check all thatapply)(A descri tion ofthernorutoring program shall be submitted to the local agency.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING(Check alt that apply): PRESSURIZED PIPING(Check all that apply): ❑1.ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT ❑1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP 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. ❑2.MONTHLY 0.2 GPH TEST ❑2.MONTHLY 0.2 GPH TEST ❑3.ANNUAL INTEGRITY TEST(0.1 GPH) ❑3.ANNUAL INTEGRITY TEST(0.7 GPH) [14. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Check all that apply) ❑5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING S. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST(0.1 GPH) SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): ❑6.TRIENNIAL INTEGRITY TEST(0.1 GPH) El 7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW ❑7. SELF MONITORING ❑9.BIENNIAL INTEGRITY TEST(0.1 GPH) GRAVITY FLOW(Check all that apply): ❑8. DAILY VISUAL MONITORING ❑9.BIENNIAL.INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Check all diet apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10.CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND(Checkone) ALARMS AND(Checkone) ❑a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ❑a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS b.AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM ❑b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION ❑c.NO AUTO PUMP SHUT OFF ❑c NO AUTO PUMP SHUT OFF 1�11. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) rV.ITIi FLOW SHUT Cl 11. AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION ❑12. ANNUAL INTEGRITY TEST(0.1 GPH) ❑12.ANNUAL INTEGRITY TEST(0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM ❑13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS ❑13.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY(Check all that apply) EMERGENCY GENERATORS ONLY(Check all that apply) ❑14.CONTINUOUS SUMP SENSOR WITH AUTO PUMP SHUT OFF" ❑14. CONTINUOUS SUMP SENSOR WITH AUTO FUMP SHUT OFF° AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS ❑15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW 015 AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST) SHUT OFF OR RESTRICTION ❑16.ANNUAL INTEGRITY TEST(0.1 GPH) ❑16.ANNUAL INTEGRITY TEST(0.1 GPH) ❑17.DAILY VISUAL CHECK ❑17.DAILY VISUAL CHECK VIII.DISPENSER CONTAINMENT DISPENSER CONTAINMENT ❑1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑4.DAILY VISUAL CHECK DATE INSTALLED 468 [12.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS [15.TRENCH LINER/MONITORING Dee 1993 ®3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR ❑6.NONE 469 DISPENSER+AUDIBLE AND VISUAL ALARMS DL OWNERIOPERATOR SIGNATURE I certify that the information provided herein is and accurate w the best of m wl SIGNATURE OF OWNER/OPE O 4 DATE �.7 470 1�I/f r NAME OF OWNER/OPRATORffjnintj 471 TITLE OFOWNER/OPERATOR 472 Harvinder Pal Singh Owner Permit Number(For local we only) 473 Permit Approved(For local use only) 474 Permit Expiration Dale(For local use only) 475 UPCF(12/99 revised) 12 Formerly SWRCB Form B