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HomeMy WebLinkAboutFMC RESULTS 2013ATG IMPACT VALVE LEAK DETECTOR SPILL BUCKET TEST 11000 N. MoPac Expressway, Suite 500 Austin, Texas 78759 Phone: (512) 451-6334 Fax: (512) 459-1459 Date Printed and Mailed: 1/8/2014 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR ERNIE MEDINA 1501 TRUXTUN AVE. BAKERSFIELD, CA 93301 Test Date: 12/27/2013 Order Number: 3415700 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: 7-ELEVEN #32241, MKT 2368 4101 CALLOWAY DRIVE BAKERSFIELD, CA 93312 Testing performed: Sincerely, Dawn Kohlmeyer Manager, Field Reporting LDT 5000 Field Test Apparatus Line Leak Detector Test Page 1 of 1 Work Order:3415700 Date:12/27/2013 Site Name / ID:7-ELEVEN #32241, MKT 2368 / 32241 Address:4101 CALLOWAY DRIVE City:BAKERSFIELD State:CA Zip:93312 Tank ID Product Product Line Tested From Existing/New Mechanical/Electronic Manufacturer/Model Serial No. Pump Operating Pressure (psi) Calibrated Leak (ml/min) Calibrated Leak (gph) Holding PSI *N/A for Electronic LD's Resiliency (ml) *N/A for Electronic LD's Metering PSI *N/A for Electronic LD's Opening Time (sec) *N/A for Electronic LD's Test Results T4 RUL RUL 1 3 Existing Mechanical Vaporless LD-2000 10061089 29.00 189.0 3.00 29.00 125.00 16 6 Pass T5 PUL PUL 1 3 Existing Mechanical Vaporless LD-2000 070886 28.00 189.0 3.00 28.00 115.00 16 4 Pass Technician Comments: Technician Name:Arturo Gutierrez Certification #:1306 Technician Signature:Expire Date:11/19/2014 Environmental Compliance for Petroleum Systems © 2014 Tanknology Inc., Austin, TX.    All rights reserved.    tanknology.com Impact Valve Inspection Impact Valve Operational Inspection Work Order:3415700 Date:12/27/2013 Site Name/ID:7-ELEVEN #32241, MKT 2368 Address:4101 CALLOWAY DRIVE City:BAKERSFIELD State:CA Zip:93312 Dispenser Number Grade Secure Mount? Valve Lock?Pass/ Fail Comments 1/2 87 Pass Fail Not Tested 1/2 91 Pass Fail Not Tested 3/4 87 Pass Fail Not Tested 3/4 91 Pass Fail Not Tested 5/6 87 Pass Fail Not Tested 5/6 91 Pass Fail Not Tested 7/8 87 Pass Fail Not Tested 7/8 91 Pass Fail Not Tested Technician Comments: Technician Name:Arturo Gutierrez Signature: Environmental Compliance for Petroleum Systems ©2014 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com Appendix VI (Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http://www.swrcb.ca.gov.) MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name:7-ELEVEN #32241, MKT 2368 Bldg. No.: Site Address:4101 CALLOWAY DRIVE City:BAKERSFIELD Zip:93312 Facility Contact Person:Mgr.- Preet- see cell#Contact Phone No.:661-587-8826 Make/Model of Monitoring System:Veeder Root TLS 350 Date of Testing/Servicing:12/27/2013 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID:T4 RUL - RUL In-Tank Gauging Probe.Model:Mag Plus Annular Space or Vault Sensor.Model:VR-303 Piping Sump / Trench Sensor(s).Model:VR-208 Fill Sump Sensor(s).Model:VR-208 Mechanical Line Leak Detector.Model:Vaporless LD-2000 Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model:Probe/ Flapper Other (specify equipment type and model in Section E on Page 2). Tank ID:T5 PUL - PUL In-Tank Gauging Probe.Model:Mag Plus Annular Space or Vault Sensor.Model:VR-303 Piping Sump / Trench Sensor(s).Model:VR-303 Fill Sump Sensor(s).Model:VR-208 Mechanical Line Leak Detector.Model:Vaporless LD-2000 Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model:Probe/ Flapper Other (specify equipment type and model in Section E on Page 2). Tank ID: In-Tank Gauging Probe.Model: Annular Space or Vault Sensor.Model: Piping Sump / Trench Sensor(s).Model: Fill Sump Sensor(s).Model: Mechanical Line Leak Detector.Model: Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model: Other (specify equipment type and model in Section E on Page 2). Tank ID: In-Tank Gauging Probe.Model: Annular Space or Vault Sensor.Model: Piping Sump / Trench Sensor(s).Model: Fill Sump Sensor(s).Model: Mechanical Line Leak Detector.Model: Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model: Other (specify equipment type and model in Section E on Page 2). Dispenser ID:1/2 Dispenser Containment Sensor(s).Model:VR-208 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:1/2 Dispenser Containment Sensor(s).Model:VR-208 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:5/6 Dispenser Containment Sensor(s).Model:VR-208 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:7/8 Dispenser Containment Sensor(s).Model:VR-208 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser Containment Sensor(s).Model: Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser Containment Sensor(s).Model: Shear Valve(s). Dispenser Containment Float(s) and Chain(s). *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers’ guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): System set- up Alarm history report Technician Name (print):Arturo Gutierrez Signature: Certification No.:A24526 License. No.:743160 Class 'A' Testing Company Name:Tanknology Phone No.:(800) 800-4633 Testing Company Address:11000 N. MoPac Expressway Suite 500 Date of Testing/Servicing:12/27/2013 Monitoring System Certification Page 1 of 4 12/07 D. Results of Testing/Servicing Software Version Installed:329.02 Complete the following checklist: Yes No*Is the audible alarm operational? Yes No*Is the visual alarm operational? Yes No*Were all sensors visually inspected, functionally tested, and confirmed operational? Yes No*Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No* N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? Yes No* N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; No Yes No* N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % Yes* No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. Yes* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Product; Water. If yes, describe causes in Section E, below. Yes No*Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable Yes No*Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Vent sump sensor -VR-208. Tested all sensors functionality, sensor out, ESO, Failsafe for proper function. Monitoring System Certification Page 2 of 4 12/07 F. In-Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes No*Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes No*Were all tank gauging probes visually inspected for damage and residue buildup? Yes No*Was accuracy of system product level readings tested? Yes No*Was accuracy of system water level readings tested? Yes No*Were all probes reinstalled properly? Yes No*Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Check this box if LLDs are not installed. Complete the following checklist: Yes No* N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: 3 g.p.h.; 0.1 g.p.h; 0.2 g.p.h. Yes No*Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No*Was the testing apparatus properly calibrated? Yes No* N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes No* N/A For electronic LLDs, have all accessible wiring connections been visually inspected? Yes No*Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H.Comments: Page 3 of 4 12/07 Monitoring System Certification Form: Addendum for Vacuum/Pressure Interstitial Sensors LG 163-1, Enc. II I.Results of Vacuum/Pressure Monitoring Equipment Testing This page should be used to document testing and servicing of vacuum and pressure interstitial sensors. A copy of this form must be included with the Monitoring System Certification Form, which must be provided to the tank system owner/operator. The owner/operator must submit a copy of the Monitoring System Certification Form to the local agency regulating UST systems within 30 days of test date. Manufacturer: Veeder-Root Model: VPH System Type: Pressure Vacuum Sensor ID S-9 Component(s) Monitored by this Sensor:87 Fill UDC Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail S-10 Component(s) Monitored by this Sensor:87 Product line Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail S-11 Component(s) Monitored by this Sensor:87 STP Sump Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail S-12 Component(s) Monitored by this Sensor:91 Fill Vent Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail S-13 Component(s) Monitored by this Sensor:91 Product Line Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail S-14 Component(s) Monitored by this Sensor:91 STP Sump Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail How was interstitial communication verified? Leak Introduced at Far End of Interstitial Space1 Gauge Visual Inspection Other (Describe in Sec. J, below) Vacuum was restored to operating levels in all interstitial spaces: Yes No (If no, describe in Sec. J, below) J. Comments (500 characters max. use additional sheets if needed): Page 4 of 4 1 If the sensor successfully detects a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the sensor, vacuum/pressure has been demonstrated to be communicating throughout the interstice. WO: 3415700 SWRCB, January 2002 Page 1 of 1 Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: 7-ELEVEN #32241, MKT 2368 Date of Testing: 12/27/2013 Facility Address: 4101 CALLOWAY DRIVE , BAKERSFIELD, CA 93312 Facility Contact: Mgr.- Preet- see cell#Phone: 661-587-8826 Date Local Agency Was Notified of Testing: 12/23/2013 Name of Local Agency Inspector (if present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY INC. Technician Conducting Test: Arturo Gutierrez Credentials: CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: A-UT License Number: 743160-5258516 Manufacturer Manufacturer Training Component(s)Date Training Expires OPW Phase 1 EVR 1/20/2015 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Spill Box T4 RUL rul fill X Spill Box T5 PUL pul fill X Component Pass Fail Not Tested Repairs Made If hydrostatic testing was performed, describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's Signature:Date:12/27/2013 WO: 3415700 Water was put on 2 five gallon buckets. Labelled hazardous waste and left on site. SWRCB, January 2002 Page 1 of 1 9. SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes Spill/Overfill Containment Boxes are Present, but were Not Tested Test Method Developed By: Spill Bucket Manufacturer Industry Standard Professional Engineer Other (Specify): Test Method Used By: Pressure Vacuum Hydrostatic Other (Specify): Test Equipment Used: LAKE TEST Equipment Resolution: 0.0625 in. Bucket Diameter: Bucket Depth: Wait time between applying pressure/vacuum/water and starting test Test Start Time: Initial Reading (RI): Test End Time: Final Reading (RF): Test Duration: Change in Reading (RF-RI) : Pass/Fail Threshold or Criteria: Test Result: Spill Box # Tank T4 RUL RUL - Fill 1 - Direct - Below Grade in containment sump 12.00 14.00 10 min 09:58:00 12.75 in. 10:58:00 12.75 in. 1 hr 0.00 in. +/- 0.00 Pass Spill Box # Tank T5 PUL PUL - Fill 1 - Direct - Below Grade in containment sump 12.00 14.00 10 min 09:58:00 12.50 in. 10:58:00 12.50 in. 1 hr 0.00 in. +/- 0.00 Pass Spill Box # min +/- Spill Box # min +/- Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) WO: 3415700 Site Diagram (This site diagram is for reference only and is not drawn to scale) Work Order:3415700 Site ID / Name:32241 / 7-ELEVEN #32241, MKT 2368 Address:4101 CALLOWAY DRIVE City:BAKERSFIELD State:CA Zip:93312 W.O.# SC1-3415700 Parts Log W.O.# SC1-3415700 I10100 DEC 27, 2013 1:50 PM 235421 7-11 32241 4101 CALLOWAY DR BAKERSFIELD,CA 93312 SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL I50301 DEC 27, 2013 1:50 PM # 1:235421 7-11 32241 I50302 DEC 27, 2013 1:50 PM # 2:4101 CALLOWAY DR I50303 DEC 27, 2013 1:50 PM # 3:BAKERSFIELD,CA 93312 I50304 DEC 27, 2013 1:50 PM # 4: I51700 DEC 27, 2013 1:50 PM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM I50F00 DEC 27, 2013 1:50 PM MON DD YYYY HH:MM:SS xM I60100 DEC 27, 2013 1:50 PM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 OFF 2 OFF 3 OFF 4 RUL ON 5 PUL ON 6 OFF 7 OFF 8 OFF I60200 DEC 27, 2013 1:50 PM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 2 3 4 RUL 5 PUL 6 7 8 I60300 DEC 27, 2013 1:50 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 1 2 2 3 3 4 RUL 4 5 PUL 5 6 6 7 7 8 8 I60400 DEC 27, 2013 1:50 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 0 2 0 3 0 4 RUL 14544 5 PUL 9695 6 0 7 0 8 0 I60700 DEC 27, 2013 1:50 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 0.00 2 0.00 3 0.00 4 RUL 91.63 5 PUL 91.63 6 0.00 7 0.00 8 0.00 I60900 DEC 27, 2013 1:50 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 0.000000 2 0.000000 3 0.000000 4 RUL 0.000700 5 PUL 0.000700 6 0.000000 7 0.000000 8 0.000000 I61200 DEC 27, 2013 1:50 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 NONE NONE 2 NONE NONE 3 NONE NONE 4 RUL NONE NONE 5 PUL NONE NONE 6 NONE NONE 7 NONE NONE 8 NONE NONE I62100 DEC 27, 2013 1:50 PM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 0 2 0 3 0 4 RUL 800 5 PUL 800 6 0 7 0 8 0 I62200 DEC 27, 2013 1:50 PM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 0 2 0 3 0 4 RUL 13816 5 PUL 9210 6 0 7 0 8 0 I62300 DEC 27, 2013 1:50 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 0 2 0 3 0 4 RUL 13089 5 PUL 8725 6 0 7 0 8 0 I62400 DEC 27, 2013 1:50 PM 4 RUL 1.5 5 PUL 1.5 I62800 DEC 27, 2013 1:50 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 0 2 0 3 0 4 RUL 14544 5 PUL 9695 6 0 7 0 8 0 I62900 DEC 27, 2013 1:50 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 0 2 0 3 0 4 RUL 2181 5 PUL 1454 6 0 7 0 8 0 I70300 DEC 27, 2013 1:51 PM LIQUID TYPE SENSOR LOCATION TYPE 1 DISP 1-2 PAN TRI-STATE (SINGLE FLOAT) 2 DISP 3-4 PAN TRI-STATE (SINGLE FLOAT) 3 DISP 5-6 PAN TRI-STATE (SINGLE FLOAT) 4 DISP PAN 7-8 TRI-STATE (SINGLE FLOAT) 5 87 ANNULAR DUAL POINT HYDROSTATIC 6 87 FILL SUMP TRI-STATE (SINGLE FLOAT) 7 87 STP SUMP TRI-STATE (SINGLE FLOAT) 8 91-ANNULAR DUAL POINT HYDROSTATIC 9 91 FILL SUMP TRI-STATE (SINGLE FLOAT) 10 91 STP SUMP TRI-STATE (SINGLE FLOAT) 11 VAPOR PIPING PAN TRI-STATE (SINGLE FLOAT) 12 TRI-STATE (SINGLE FLOAT) 13 TRI-STATE (SINGLE FLOAT) 14 TRI-STATE (SINGLE FLOAT) 15 TRI-STATE (SINGLE FLOAT) 16 TRI-STATE (SINGLE FLOAT) I72900 DEC 27, 2013 1:51 PM VACUUM SENSOR PUMP NUMBER DEVICE LABEL PUMP NUMBER 9 87 FILL VRL UDC VAC R 5:87 STP 10 87 PRODUCT LINE VAC R 6:PREMIUM STP 11 87 STPSUMP-FILLCNCT R 5:87 STP 12 91FILL-VENT-CONTSUMP R 6:PREMIUM STP 13 91 PRODUCT LINE VAC R 6:PREMIUM STP 14 91 STPSUMP-FILLCNCT R 6:PREMIUM STP I72A00 DEC 27, 2013 1:51 PM VACUUM SENSOR VOLUME DEVICE LABEL VOLUME 9 87 FILL VRL UDC VAC 36.0 GALLONS 10 87 PRODUCT LINE VAC 36.0 GALLONS 11 87 STPSUMP-FILLCNCT 36.0 GALLONS 12 91FILL-VENT-CONTSUMP 36.0 GALLONS 13 91 PRODUCT LINE VAC 36.0 GALLONS 14 91 STPSUMP-FILLCNCT 36.0 GALLONS I72B00 DEC 27, 2013 1:51 PM VACUUM SENSOR RELIEF VALVE PRESENT DEVICE LABEL RELIEF VALVE 9 87 FILL VRL UDC VAC NO 10 87 PRODUCT LINE VAC NO 11 87 STPSUMP-FILLCNCT NO 12 91FILL-VENT-CONTSUMP NO 13 91 PRODUCT LINE VAC NO 14 91 STPSUMP-FILLCNCT NO I72C00 DEC 27, 2013 1:51 PM VACUUM SENSOR RELIEF VALVE PRESSURE DEVICE LABEL RELIEF VALVE PRESSURE 9 87 FILL VRL UDC VAC -9.0 PSI 10 87 PRODUCT LINE VAC -9.0 PSI 11 87 STPSUMP-FILLCNCT -9.0 PSI 12 91FILL-VENT-CONTSUMP -9.0 PSI 13 91 PRODUCT LINE VAC -9.0 PSI 14 91 STPSUMP-FILLCNCT -9.0 PSI I90200 DEC 27, 2013 1:51 PM SOFTWARE REVISION LEVEL VERSION 329.02 SOFTWARE# 346329-100-C CREATED - 09.07.01.16.29 S-MODULE# 330160-104-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS BIR ISD I20600 DEC 27, 2013 1:51 PM 235421 7-11 32241 4101 CALLOWAY DR BAKERSFIELD,CA 93312 TANK ALARM HISTORY TANK 4 RUL HIGH WATER ALARM DEC 27, 2013 1:13 PM DEC 12, 2012 11:02 AM OVERFILL ALARM DEC 27, 2013 1:04 PM DEC 3, 2013 5:33 AM JUL 20, 2013 10:41 PM LOW PRODUCT ALARM SEP 13, 2013 5:45 AM AUG 31, 2013 7:48 PM APR 2, 2013 7:34 AM SUDDEN LOSS ALARM DEC 12, 2012 10:52 AM HIGH PRODUCT ALARM DEC 27, 2013 1:06 PM JAN 25, 2013 2:53 AM JAN 18, 2013 6:34 PM INVALID FUEL LEVEL DEC 27, 2013 1:17 PM PROBE OUT DEC 27, 2013 1:17 PM DEC 27, 2013 1:01 PM DEC 12, 2012 12:24 PM HIGH WATER WARNING DEC 27, 2013 1:13 PM DEC 12, 2012 11:02 AM DELIVERY NEEDED DEC 27, 2013 1:18 PM DEC 27, 2013 1:01 PM DEC 13, 2013 6:30 PM MAX PRODUCT ALARM DEC 27, 2013 1:06 PM DEC 12, 2012 10:55 AM LOW TEMP WARNING DEC 12, 2012 12:25 PM TANK 5 PUL HIGH WATER ALARM DEC 27, 2013 1:13 PM DEC 12, 2012 11:04 AM OVERFILL ALARM DEC 27, 2013 1:04 PM DEC 12, 2012 10:57 AM LOW PRODUCT ALARM DEC 27, 2013 1:18 PM DEC 27, 2013 1:02 PM SEP 15, 2013 7:15 AM SUDDEN LOSS ALARM DEC 12, 2012 10:53 AM HIGH PRODUCT ALARM DEC 27, 2013 1:06 PM DEC 12, 2012 10:57 AM INVALID FUEL LEVEL DEC 27, 2013 1:18 PM PROBE OUT DEC 27, 2013 1:17 PM DEC 27, 2013 1:02 PM DEC 12, 2012 10:53 AM HIGH WATER WARNING DEC 27, 2013 1:13 PM DEC 12, 2012 11:04 AM DELIVERY NEEDED DEC 27, 2013 1:18 PM DEC 27, 2013 1:02 PM SEP 14, 2013 7:02 AM MAX PRODUCT ALARM DEC 27, 2013 1:06 PM DEC 12, 2012 10:57 AM I30200 DEC 27, 2013 1:51 PM 235421 7-11 32241 4101 CALLOWAY DR BAKERSFIELD,CA 93312 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 DISP 1-2 PAN DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:39 AM FUEL ALARM DEC 12, 2012 11:43 AM SENSOR OUT ALARM 2 DISP 3-4 PAN DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:40 AM FUEL ALARM DEC 12, 2012 10:27 AM SENSOR OUT ALARM 3 DISP 5-6 PAN DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:38 AM FUEL ALARM DEC 12, 2012 10:28 AM SENSOR OUT ALARM 4 DISP PAN 7-8 DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:39 AM FUEL ALARM DEC 12, 2012 10:28 AM SENSOR OUT ALARM 5 87 ANNULAR DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:24 AM LOW LIQUID ALARM DEC 27, 2013 10:16 AM LOW LIQUID ALARM 6 87 FILL SUMP DEC 27, 2013 1:10 PM FUEL ALARM DEC 27, 2013 12:51 PM FUEL ALARM DEC 27, 2013 10:47 AM SENSOR OUT ALARM 7 87 STP SUMP DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:04 AM FUEL ALARM DEC 12, 2012 10:28 AM SENSOR OUT ALARM 8 91-ANNULAR DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:32 AM LOW LIQUID ALARM DEC 27, 2013 10:31 AM LOW LIQUID ALARM 9 91 FILL SUMP DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:33 AM FUEL ALARM DEC 12, 2012 11:43 AM SENSOR OUT ALARM 10 91 STP SUMP DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:34 AM FUEL ALARM DEC 12, 2012 10:27 AM SENSOR OUT ALARM 11 VAPOR PIPING PAN DEC 27, 2013 10:47 AM SENSOR OUT ALARM DEC 27, 2013 10:41 AM FUEL ALARM DEC 12, 2012 10:27 AM SENSOR OUT ALARM IB3800 DEC 27, 2013 1:52 PM s 9:87 FILL VRL UDC VAC VAC SENSOR SERIAL NUMBER 15754 COMPENSATED PRESSURE: -6.067 PSI UNCOMPENSATED PRESSURE: -6.180 PSI EVACUATION STATE: VACUUM OK FLUID STATUS: NORMAL VCV: CLOSED 12-27-13 1:51PM LEAK RATE: 0.066 GPH TIME TO NO VAC: 100:00 HHHH:MM 12-26-13 1:03PM EVAC RATIO:0.8 @ -6.6PSI SENSOR FAULTS: NONE s10:87 PRODUCT LINE VAC VAC SENSOR SERIAL NUMBER 15757 COMPENSATED PRESSURE: -7.494 PSI UNCOMPENSATED PRESSURE: -7.607 PSI EVACUATION STATE: VACUUM OK FLUID STATUS: NORMAL VCV: FAULT 12-27-13 11:51AM LEAK RATE: -27.800 GPH TIME TO NO VAC: 100:00 HHHH:MM 6-07-13 2:56PM EVAC RATIO:7.9 @ -6.5PSI SENSOR FAULTS: VCV FAULT s11:87 STPSUMP-FILLCNCT VAC SENSOR SERIAL NUMBER 15756 COMPENSATED PRESSURE: -7.754 PSI UNCOMPENSATED PRESSURE: -7.867 PSI EVACUATION STATE: VACUUM OK FLUID STATUS: NORMAL VCV: CLOSED 12-27-13 1:51PM LEAK RATE: 0.081 GPH TIME TO NO VAC: 100:00 HHHH:MM 4-29-13 3:40PM EVAC RATIO:2.0 @ -8.0PSI SENSOR FAULTS: NONE s12:91FILL-VENT-CONTSUMP VAC SENSOR SERIAL NUMBER 15760 COMPENSATED PRESSURE: -7.423 PSI UNCOMPENSATED PRESSURE: -7.536 PSI EVACUATION STATE: VACUUM OK FLUID STATUS: NORMAL VCV: CLOSED 12-27-13 1:51PM LEAK RATE: 0.109 GPH TIME TO NO VAC: 100:00 HHHH:MM 12-27-13 11:32AM EVAC RATIO: -0 @ -7.8PSI SENSOR FAULTS: NONE s13:91 PRODUCT LINE VAC VAC SENSOR SERIAL NUMBER 15759 COMPENSATED PRESSURE: -7.168 PSI UNCOMPENSATED PRESSURE: -7.281 PSI EVACUATION STATE: VACUUM OK FLUID STATUS: NORMAL VCV: CLOSED 12-27-13 1:51PM LEAK RATE: -0.000 GPH TIME TO NO VAC: 100:00 HHHH:MM 7-20-13 4:22PM EVAC RATIO:0.2 @ -7.8PSI SENSOR FAULTS: NONE s14:91 STPSUMP-FILLCNCT VAC SENSOR SERIAL NUMBER 15758 COMPENSATED PRESSURE: -3.986 PSI UNCOMPENSATED PRESSURE: -4.098 PSI EVACUATION STATE: VACUUM OK FLUID STATUS: NORMAL VCV: CLOSED 12-27-13 1:51PM LEAK RATE: 0.024 GPH TIME TO NO VAC: 100:00 HHHH:MM 12-03-13 3:04PM EVAC RATIO:0.7 @ -4.0PSI SENSOR FAULTS: NONE IB3900 DEC 27, 2013 1:52 PM s 9:87 FILL VRL UDC VAC DURATION START DATE/TIME HH:MM:SS 13-12-06 04:04:44 1:00:56 13-12-10 20:46:16 1:16:24 13-12-16 04:25:46 0:54:02 13-12-21 00:22:56 1:03:31 13-12-26 11:24:49 1:02:09 13-12-26 11:24:49 1:02:11 13-12-26 11:24:49 1:02:11 13-12-26 11:24:49 1:02:11 13-12-26 11:24:49 1:02:11 s10:87 PRODUCT LINE VAC DURATION START DATE/TIME HH:MM:SS 12-12-12 10:35:07 0:35:19 13-02-19 14:46:47 0:23:23 13-03-24 16:09:56 0:10:35 13-06-07 14:06:41 264:11:10 13-06-07 14:06:41 1824:57:57 13-06-07 14:06:41 1824:57:57 13-06-07 14:06:41 1824:57:57 13-06-07 14:06:41 1824:57:57 13-06-07 14:06:41 1824:57:57 s11:87 STPSUMP-FILLCNCT DURATION START DATE/TIME HH:MM:SS 13-04-29 14:38:58 0:40:59 13-04-29 14:38:58 0:41:01 13-04-29 14:38:58 0:41:01 13-04-29 14:38:58 0:41:01 13-04-29 14:38:58 0:41:01 13-04-29 14:38:58 0:41:01 13-04-29 14:38:58 0:41:01 s12:91FILL-VENT-CONTSUMP DURATION START DATE/TIME HH:MM:SS 13-02-04 16:30:33 0:11:26 13-03-03 16:34:53 0:34:08 13-04-30 16:08:56 1:37:42 13-04-30 16:08:56 1:37:44 13-04-30 16:08:56 1:37:44 13-04-30 16:08:56 1:37:44 13-04-30 16:08:56 1:37:44 13-12-27 11:23:29 0:02:19 13-12-27 11:28:21 0:03:39 s13:91 PRODUCT LINE VAC DURATION START DATE/TIME HH:MM:SS 12-12-04 15:51:51 0:13:31 12-12-04 15:51:51 0:13:35 13-03-21 17:46:13 0:19:04 13-05-04 14:28:04 0:11:54 13-07-20 15:18:40 0:18:58 13-07-20 15:18:40 0:19:01 13-07-20 15:18:40 0:19:01 s14:91 STPSUMP-FILLCNCT DURATION START DATE/TIME HH:MM:SS 13-03-25 16:44:51 1:18:33 13-04-28 15:25:45 0:45:31 13-06-02 10:47:00 0:37:53 13-07-05 03:22:49 0:32:39 13-08-27 14:58:00 0:26:24 13-12-03 14:52:32 0:06:13 13-12-03 14:52:32 0:06:16 13-12-03 14:52:32 0:06:16 13-12-03 14:52:32 0:06:16 I31600 DEC 27, 2013 1:52 PM 235421 7-11 32241 4101 CALLOWAY DR BAKERSFIELD,CA 93312 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 1-2 FLOW METER DEC 4, 2012 3:48 PM COMMUNICATION ALARM 2 3-4 FLOW METER DEC 4, 2012 3:48 PM COMMUNICATION ALARM 3 5-6 FLOW METER DEC 4, 2012 3:48 PM COMMUNICATION ALARM 4 7-8 FLOW METER DEC 4, 2012 3:48 PM COMMUNICATION ALARM 8 PRESSURE SENSOR DEC 4, 2012 3:49 PM COMMUNICATION ALARM 9 87 FILL VRL UDC VAC DEC 27, 2013 12:23 PM NO VACUUM ALARM DEC 27, 2013 12:10 PM HIGH LIQUID ALARM DEC 27, 2013 12:09 PM NO VACUUM ALARM 10 87 PRODUCT LINE VAC DEC 27, 2013 12:08 PM NO VACUUM ALARM DEC 27, 2013 11:57 AM HIGH LIQUID ALARM DEC 27, 2013 11:57 AM NO VACUUM ALARM 11 87 STPSUMP-FILLCNCT DEC 27, 2013 12:23 PM NO VACUUM ALARM DEC 27, 2013 11:56 AM NO VACUUM ALARM DEC 27, 2013 11:52 AM NO VACUUM ALARM 12 91FILL-VENT-CONTSUMP DEC 27, 2013 11:15 AM NO VACUUM ALARM DEC 27, 2013 11:13 AM HIGH LIQUID ALARM DEC 27, 2013 11:13 AM NO VACUUM ALARM 13 91 PRODUCT LINE VAC DEC 27, 2013 11:11 AM NO VACUUM ALARM DEC 27, 2013 11:08 AM HIGH LIQUID ALARM DEC 27, 2013 11:07 AM NO VACUUM ALARM 14 91 STPSUMP-FILLCNCT DEC 27, 2013 10:59 AM NO VACUUM ALARM DEC 27, 2013 10:57 AM HIGH LIQUID ALARM DEC 27, 2013 10:56 AM NO VACUUM ALARM 16 ATM P SENSOR 5-6 I10100 DEC 27, 2013 1:54 PM 235421 7-11 32241 4101 CALLOWAY DR BAKERSFIELD,CA 93312 SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL FD2095 (Rev 03/08)  ENHANCED LEAK DETECTION  LINE TESTING  SB-989 SECONDARY CONTAINMENT  TANK TIGHTNESS  FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY NAME & PHONE # OF CONTACT PERSON ADDRESS OWNER NAME OPERATOR NAME PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED?  YES  NO TANK # VOLUME CONTENTS TANK TESTING COMPANY TESTING COMPANY NAME & PHONE # OF CONTACT PERSON MAILING ADDRESS NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR CERTIFICATION # DATE & TIME TEST TO BE CONDUCTED ICC # TEST METHOD APPLICANT SIGNATURE DATE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 ● Fax: 661-852-2171 Page 1 of 1 APPLICATION TO PERFORM ELD/LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION (Please note that these are separate individual tests and will be charged per separate type test accordingly.) PERMIT # UNDERGROUND STORAGE TANK PERMIT APPLICATION TO OPERATE AN UST BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 ● Fax: 661-852-2171 TYPE OF APPLICATION (CHECK)  OPERATE NEW FACILITY  TRANSFER OF OWNERSHIP  OPERATE AN EXISTING FACILITY PREVIOUS TANK OWNER (if applicable) .NAME PHONE # ADDRESS CITY ZIP CODE NEW TANK OWNER NAME PHONE # ADDRESS CITY ZIP CODE BILLING ADDRESS CITY ZIP CODE TANK OPERATOR (if different from owner) NAME PHONE # ADDRESS CITY ZIP CODE APPLICANT’S NAME (if different from owner) NAME PHONE # ADDRESS CITY ZIP CODE TANK LOCATION FACILITY NAME OPPERATOR NAME PHONE # ADDRESS CITY ZIP CODE EMERGENCY CONTACT NAME PHONE # ADDRESS CITY ZIP CODE TANK INFORMATION TANK # VOLUME DATE INSTALLED SUBSTANCE STORED PREVIOUS SUBSTANCE Do you have a HAZARDOUS MATERIAL RESPONSE PLAN?  YES  NO Do you have an OWNER – OPERATOR AGREEMENT?  YES  NO Have you filled out a HAZARDOUS MATERIAL BUSINESS PLAN?  YES  NO FOR OFFICIAL USE ONLY The applicant has received, understands, and will comply with the attached conditions of the permit and any other state, local and federal regulations. This form has been completed under penalty of perjury, and to the best of my knowledge, is true and correct. PERMIT # APPLICANT SIGNATURE APPLICANT NAME (PRINT) APPROVED BY THIS APPLICATION BECOMES A PERMIT WHEN APPROVED S: Forms-Web\Fire\UST\FD2087 UST Permit Application to Operate an UST.doc (Rev 06/10)