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15 <br />16. <br />17 <br />0 01 <br />Model Number: 17 <br />L___ ___ _________________- <br />Sensor Type: ____ Vapor- Liquid ____ Both. <br />Sensor Brand: __________ Sensor Model: ___________ <br />Loc tions) for sensors [Indicate location of sensor(s) with check m rkl• <br />_ _Tank: Sensor Brand: U-_tZ Sensor Model:__ __ O�- <br />__ _Piping: Sensor Brand: V, ZOEI <br />Sensor Model: -11J41-3-5 <br />C Dispenser: Sensor Brand:E_" __ Sensor Model:_,q�t �T <br />Other(specify):--- Sensor Brand: ------------ Sensor <br />Model: --- <br />C. ____ Monitoring and response plan submitted [Section 2632 (d) (1) & (2)]. <br />Any special accessories, fittings, coatings, or linings not inherent within the initial design of the 1 ° tank or double- <br />wall UST. [Section 2631 (b)] <br />A Approved by a nationally recognized independent testing organization. <br />B. Demonstration of integrity with the primary and/or secondary containment. <br />Tanks subject to floatation. [Section 2635 (a) (7)] <br />_J A Anchored by deadman o sla <br />_ B. Anchors to be installed as specified by manufacturer. <br />_ C. Installation details provided on plans. <br />D. Calculations provided. <br />SPILL AND OVERFILL PREVENTION <br />Underground storage tank equipped with spill container and an overfill prevention system. (detail drawing of spill <br />container(s)/piping sump(s) required, including tank fill and all openings). <br />A Spill container [Section 2635 (b) (1)]. <br />--__ If made of metal, exterior wall protected from galvanic corrosion. <br />Capacity: (minimum o five gallons _____________________________________________- <br />--L., Equipped with a drain valve which allows drainage of spill into primary container. <br />---- Manufacturer: -O, ----------------------------------------------------- <br />B. Overfill prevention system does not allow for manual override and meets one of the following <br />requirements: <br />(1) Alert transfer operator at 90% full by restricting the flow into the tank or triggering an audible and <br />visual alarm [Section 2635(b)(2)(A)] . rt <br />Manufacturer: ____________________ Model:__ <br />V r✓1 L <br />(2) Restrict delivery flow to the tank 30 minutes before overfill when ank is filled at no more than <br />95% capacity and activates an audible alarm at least five minutes before overfill [Section <br />2635(b)(2)(B)]• <br />Manufacturer:----------------------- Model: ----------------------_. <br />(3) Provide positive shut off at no more than 95% capacity [Section 2635 (b) (2) (C)]. <br />Manufacturer:_ _____________ <br />____ (4) Provide positive shut-off of flow to the tank so that the fittings on top of the tank are not exposed to <br />