HomeMy WebLinkAbout2011 FMCMONITORING 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 this date.
A. General Information
Facility Name: Mt. Vernon & Columbus Arco AM /PM Bldg. No.:
Site Address: 2698 Mt. Vernon Avenue City: Bakersfield Zip: 93306
Facility Contact Person: Monty Hawatmeh Contact Phone No.: 661 - 703 -7273
Make/Model of Monitoring System: Veeder -Root TLS -350
B. Inventoryy of Equipment Tested /Certified
Check the appropriate boxes to indicate specific equipment Inspected/serviced:
Date of Testing/Servicing: 09/6/2011
Tank ID: 20000 gal. Regular
Tank ID: 12000 gal. Super
[x] In -Tank Gauging Probe. Model: 847390- 107
[x] In -Tank Gauging Probe. Model: 847390 -107
[x] Annular Space or Vault Probe. Model: 794390 -409
L] Annular Space or Vault Sensor. Model: 794390.409
[x] Piping Sump / Trench Sensor(s). Model: 794380- 208
[x] Piping Sump / Trench Sensor(s). Model: 794380 -208
[x] Fill Sump Sensor(s) Model: 794380 -208
L] Fill Sump Sensor(s). Model: 794380 -208
❑ Mechanical Line Leak Detector. Model:
❑ Mechanical Line Leak Detector. Model:
[X] Electronic Line Leak Detector. Model: Red Jacket
Lx] Electronic Line Leak Detector. Model: Red Jacket
[x] Tank Overfill / High Level Sensor. Model: 847390 -107
U Tank Overfill / High Leval Sensor. Model: 847390 -107
❑ Other (specify equip. type and model in Sec. E on Pg. 2)
❑ Other (specify equip. type and model in Sec. E on Pg. 2)
Tank ID:
Tank ID:
❑ In -Tank Gauging Probe. Model:
❑ In -Tank Gauging Probe. Model:
❑ Annular Space or Vault Sensor. Model:
❑ Annular Space or Vault Sensor. Model:
❑ Piping Sump / Trench Sensor(s). Model:
❑ Piping Sump / Trench Sensor(s). Model:
❑ Fill Sump Sensors(s). Model:
❑ Fill Sump Sensor(s). Model:
[_J Mechanical Line Leak Decector. Model:
❑ Mechanical Line Leak Detector. Model:
❑ Electronic Line Leak Detector. Model:
❑ Electronic Line Leak Detector. Model:
❑ Tank Overfill / High Level Sensor. Model:
❑ Tank Overfill / High Level Sensor. Model:
❑ Other (specify equip. type and model in Sec. E on Pg. 2)
❑ Other (specify equip. typs and model in Sec. E on Pg. 2)
Dispenser ID: 1 & 2
Dispenser ID: _3 & 4
❑c Dispenser Containment Sensor(s). Model: 794380 -208
L] Dispenser Containment Sensor(s). Model: 794380 -208
[7 Shear Valve(s).
L] Shear Valve(s).
❑ Dispenser Containment Float(s) and Chain(s).
❑ Dispenser Containment Float(s) and Chain(s)
Dispenser ID: 5 & 6
Dispenser ID: 7 & 8
[x] Dispenser Containment Sensor(s). Model: 794380 -208
[x] Dispenser Containment Sensor(s). Model: 794380 -208
[x] Shear Valve(s).
U Shear Valve(s).
❑ Dispenser Containment Float(s) and Chains(s).
❑ Dispenser Containment Float(s) and Chain(s).
Dispenser ID:
Dispenser ID:
❑ Dispenser Containment Sensor(s). Model:
❑ Dispenser Containment Sensor(s). Model:
❑ Shear Valve(s).
❑ Shear Valve(s).
❑ Dispenser Containment Float(s) and Chain(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 /services in accordance with the
manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that
this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating
such reports, I have attached a copy of the report; (check all that apply) ❑x S et -up [x] Alar hist
Technician Name (print): Bryan A Self Signature:
Certification No: B37501 License No: 804904
Testing Company Name: Confidence UST Services, Inc. Phone No: 800- 339 -9930
Site Address: 2698 Mt. Vernon Avenue, Bakersfield, CA 93306 Date of Testing/Servicing: 091612011
D. Results of Testing /Servicing
Software Version Installed: 328.03
Complete the following checklist:
[x] Yes
❑ No*
Is the audible alarm operational?
x
Yes
No*
Is e Visua a arm operational?
x
Yes
No*
Were all sensors visually inspected, functionally tested, and confinned operational?
Yes
❑ No*
Were all sensors installed at the lowest point of secondary containment and positioned so that other
_jj
equipment will not interfere with their proper operation?
Yes
No*
If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem)
Hx
N/A
operational?
x Yes
❑ No*
For pressurized piping systems, does the turbine automatically shut down if the piping secondary
❑ N/A
containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes:
which sensors initate positive shut - down? N Sump/Trench Sensors [x] Dispenser Containment Sensors
Did you confirm positive shut -down due to leaks and sensor failure /disconnected? [x] Yes; ❑ No;
[x] Yes
❑ No*
For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
L] N/A
mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at
the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm
trigger? 90 %
❑ Yes*
U No
Was any momtonng 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?
❑ Product; ❑ Water. If yes, describe causes in Section E, below.
TxTYes
No*
I Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable.
Lxj
yes
No*
I Is all monitoring equipment operational per manufacturer's specifications?
* In Section E below, discribe how and when these deficiencies were or will be corrected.
E. Comments:
F. In -Tank Guaging / SIR Equipment: [X] Check this box if tank guaging is used only for inventory control.
❑ Check this box if tank guaging or SIR equipment is installed.
This section must be completed if in -tank guaging equipment is used to perform leak detection monitoring.
Complete the following checklist:
U
Yes
❑ No*
Has all input wiring been inspected for proper enter and termination,including testing for ground faults?
x
Yes
No*
Were all tank guaging probes visually inspected for damage and residue buildup?
x
T Yes
No*
Was accuracy of system product level readings tested?
x
Yes
No*
Was accuracy of system water level readings tested?
x
Yes
No*
Were all probes reinstalled properly?
[�j
Yes
❑ No*
1 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 LLD's are not.installed.
Complete the following checklist:
[xj Yes
❑ No*
For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance?
(Check all that apply) Simulated leak rate: [X]3 g.p.h.: ❑0.1 g.p.h.; ❑0.2 g.p.h.;
x Yes
No*
Were all LLD's confirmed operational and accurate within regulatory requirments?
x Yes
No
Was the testing apparatus properly ca i rate ?
❑ Yes
No
For mac amca LLD's, does the LLD restrict product ow i it detects a leak?
gesN/A
[x] Yo*
For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak?
❑ N/A
Fx] Yes
No*
For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is
❑ N/A
disabled or disconnected?
[xj Yes
No*
For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system
❑ N/A
malfunction or fails a test?
rx� Yes
No*
For electronic LLD's, have all accessible wiring connections been visually inspected?
❑ N/A
x Yes
No
I 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:
AP( > am. Pm 82703
2698 IIT Ver-nom Ava
dshersfIeId
CA 93306
SEP G. 2011 8:48 AM
SYSTEI °f B:Tr%i I'LIti REPORT
ALL FUNC7'It)NS NORHAL
1 NVEhrrOF-1 REPORT
T 1 : UNI- F;=,DErJ R
VOLUME = 14735 GALS
ULLAGE = 4968 CALS
90% ULLAGE- 2997 GALS
TG VOLUME - 14523 GALS
HEIGHT - 81.47 INCHES
WATER VOL - 0 1jhl -S
WATER e u.(10 INCHES
TEMP = 80.6 DEG F
'T 2 : UL PRE111 Uhl
VOLUME _ 3267 ;ALS
ULLAGE 8582 C4 0 1L5
90A ULLAf;E= 7397 ,�
TC VOLUME z 3213 rALS
HE I I.',HT = 58.06 1 NCH!
WATER VOL 0 GALS
WATER = i i. 00 INCHES
TEMP = 93.'> DEC F
'r } 1, x r. END � A r
SIFTWARG P.EVI-00N LEVEL
VERSION 328.03
SOFTI =1raREa �s4t,3Fe- I rJCr -J:�
CREATED - 08.06.06.17.21
S- MODULES 330160 -004 -a
SYSTEM FEnTURE.S:
PERIODIC I N- TANK TE: n 's
ANNUAL 1 N -TAPQ; TESTS
ISD
SYSTEM SETUP
SEP -6. 2011 8:48" All;-
SYSTEM UNIT'S
U.S.
SYSTEM LANGUAGE
EIVGL I SH
SYSTEM DATE. °TIME FORMAT
MON DD rA'Y HH:MM:SS ::M
I
ARCO amOarn 82703
2698 NIT Varnon Ave �
BakersrIe_Id !
CA 93306
r SHIFT TIME 1 6:00 AM
SHIFT TIME 2 D I S§(BLED
SHIFT TIME 3 DI LEl?
SHIFT TIME 4 DISABLED
TANK PER TST I•EDr WRN
DISABLED
TANK ANN T3T' "NEEDED WRN
DISABLED,
LINE RE- 1ENABLE METHOD
PASS L I �E TEST
LINE PEI TST NEEDED WRN
D I SABLIW
LINE ANN TST NEEDED WRN
DISABLED
PRINT TG VOLUMES
ENABLED
TEMP COMPENSATION
VALUE 63EG F 1: 60.0
ST I CK SHE I CHT OFFSET
DISABLED
ULLAGE: 90%
H- PROTOCOL DATA F0041AT
HEIGHT
DAYLIGHT SAVING TIME
`ENABLED
START DATE
MAR WEEK 2 SUN
START TIME
2:00 AM
END DATE
NOV WEEK I SUN
END TIME
2:00 AM
RE- DIRECT LOCAL PR 114TOUT
DISABLED
EURO PROTOCOL PREFIX
S
SYSTEM SECURITY
CODE : 000000
MAINTENANCE HISTORY
DISABLED
TANK CHART SECURITY
DISABLED
r'US'rOM ALARMS
DISABLED
SERVICE NOTICE
DISABLED
MASS/DENS ITY
DISABLED
�::OhihlUh! i Cr;'1' l Of•IS 5GT11P
- - - - - _ - - - - - -
REC:E I VEP SETUP:
1 N -TmN)t 8ETUF
- - - - - _ - _ -
- - -
PORT :SETT I NGS :
NONE
T 1 : UIILEHDED R
PRODUCT CODE
I
COMM BOARD 1 < EG t IN )
THERMAL COEFF :.000700
PS -232 SECURITY
TANK DIAMETER
117.75
COLE : D1SHNLED
TANK PROFILE
20 PTS
FULL VOL :
19703
COMM BOARD 2 (S-SAT ?
1 1 1 .9 1 NCH VOL
19389
BAUD RATE 96[i0
106.0 I NCH VOL
18791
PARITY NONE
100.1 1NCH VOL :
18010
STOP BIT I STOP
94.2 1 NCH VOL
17091
DATA LENCTFI : 8 DH Cis
88.3 1 NCH VOL
16062
RS -232 SECURITY
AUTO DIAL TIME SETUP:
82.4 1N(;H VOL :
14923
CODE : DISABLED
76.5 INCH VOL
13739
DTP. NOPJ IAL STATE: H I l3H
NONE
70.6 1 NC :H VOL
12507
64.8 1NCH VOL
11269
COMM BOAp.D : 3 R2 _.,3
58.9 1NGH VOL :
9961
BAUD RATE
53.0 INCH VOL
8678
PAR ! ODD
DD
47.1 1NCH VOL
7409
TOP
BATA BET : 1
41.2 1NCH VOL
6170
DATA LENGTH: 7 DATA
DATA
35.3 INCH VOL
4977
RS -232 SECURITY
29.4 INCH VOL
382'4
COLE DISABLED
23.5 1W;H VOL
.2780
17.7 INCH VOL
1878
11.8 ll,rH VOL
1049
AUTO TP.ANSM l T SETT 1►JC;S :
5.9 I NCH VOL
400
AUTO LEEK ALARM L 1111 T
DISABLED
FLOAT SIZE: a . 0 t IV .
AUTO Hit' H WATER LIMIT
DISABLED
RS -232 END OF MES'S;Hr;E
WATER WARMINIis
2.0
AUTO OVERFILL LIMIT
DISABLED
HIGH WATER LIMIT:
1.0
D I SABLED
AUTO LOW PRODUCT
HUTO DIAL a►LHR19 SETUP
- - - - - - - - - - - -
NIA ( OR LABEL VOL:
703
19703
DISABLED
OVERFILL LIMIT
AUTO THEFT LIMIT
17732
D E SABLED
HIGH PRODUCT
9521
AUTO DEL]VE>;Y START
18718
1) 1SABLED
DELIVERY LIMIT
I5»
AUTO DELIVER"` END
2955
DISABLED
AUTO EXTERNAL INPUT ON
LOW PRODUCT
1000
DISABLED
LEAK ALAP.I1 LIMIT:
99
AUTO EYTERIVNL 114PUT OFF
SUDDEN LOSS LIMIT:
99
DISABLED
TANK TILT
1.00
AUTO SEN5t3R FUEL ALt0?1 °1
PROBE OFFSET
-1.00
DISABLED
AUTO SENSOR WATER ALKR19
DISABLED
ri�rIV SIPHON IFULDCG
'Cr;N1;S
AUTO SENSOR OUT ALtiRIH
TO: NONE
DISABLED
LINE I°IAN I FOLDED
T a : NONE
LEAK MIN PER I vD I,; : 29%
5713
LEAAK Nl IN ANNUmL 29%
5713
PERIODIC TEST TYPE
STANDARD
HNNUAL TEST FHI L
ALARM DISABLED
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALAF11 D E SHBLED
ANN TEST AVERAGING: OFF
PER TEST AVERNcING: OFF
TANS; TEST ilJOT l FV : OFF
TNK TST SIPHON 8REHI•::OFF
DELIVERY DELAY 5 I'1 I N
PUMP THRESHOLD 10.00'1
T 2 : UL PP.EM I Uhl
LEAK TEST METHOD
OUTPUT RELA',' SUrLIP
PRODLN::T C:ODE
3
- - - - - - - - - - - -
- - - - - - - - - - - -
THERMAL COEFF :.000700
TEST ON DATE : ALL TANK
TANK DIAMETER
117.75
JUN 6. 2008
R 1:87 STP
TANY. PROFILE
20 PTS
START TIME : 1) 1SABLED
TYPE:
FULL VOL
11849
TEST RATE :0.20 GAL /HR
STANDARD
111.9 114CH VOL
11676
DURATION 2 HOURS "
NORMALLY CLOSED
106.0 INCH VOL
11334
100.1 INCH VOL
10963
TST EARLY STOP:DISHBLED
TANK P: 1
94.2 INCH :H VOL
10334
88.3 INCH VOL
9717
LEAF: TEST REPORT FORMAT
82.4 INCH VOL
9027
NORMAL
LIQUID SEr18Ok ALMS-
76.5 INCH VOL
8307
L I :FUEL ALARM
70.6 1NC:H VOL
7554
L 5: FUEL ALARM
6:1.8 INCH VOL
6795
L 6:FUEL ALARM
58.9 INCH VOL
5992
L 7:FUEL ALARM
53.0 1N:H VOL
5204
L 8: FUEL ALARM
47.1 INCH VOL
4426
L I:SEIVSOP. OUT ALARM
41.2 WH VOL
3652
L 5:SENSOR OUT ALARM
35.3 1NCH VOL :
2941
L 6:SENSOR OUT ALARM
29.4 INCH VOL
2243
L 7:SENS0R OUT ALARM
23.5 1 NCH VOL
1616
L 8:SENSOR OUT ALr -;Rhl
17.7 INCH VOL
1 079
1 1 .8 I NCH VOL
594
L I OU I D SENSOR t;ETU•
ISD SITE ALHRPIS
5.9 1NCH VOL
221
- - - - - - - - - - - -
ISD GROSS PRES FAIL.
ISD DEGRD PRES FAIL
L 1:87 STP
VAPOR LEAK FAIL
FLOAT SIZE: 4.0
IN.
TRI -STATE iSI1W;LE FLOAT)
_ISD
ISD VP PRES FAIL
i'A'fE,';ORY . STP SUMP
wATEP. WARNING
2.0
ISD HOSE ALARMS
HIGH WATER LIMIT:
1.0
ALL:GROSS COLLECT FAIL
L 2:87 ANNULAR
ALL:DEGRD COLLE�:T FAIL
MAX OR LABEL VOL:
1.1849
TRI -STATE ( S I PIOLE FLOAT)
ALL : FLOW COLLE(,'T FAIL
OVERFILL LIMIT
901:
CATEGORY : ANNULAR S> 4(:E
10664
R 2:9) STP
HIGH PRODUCT
9511.
TYPE:
11256
STANDARD
DELIVERY LIMIT
15%:
L 3:91 STP
NORMALLY CLOSED
1777
TR I -STATE (S I PA':LE: FLOAT
CwrEWRY : STP F;UMP
TANK P: 2
LOW PROUCT
500
LEAK ALARM LIMIT:
99
SUDDEN LOESS LIMIT:
99
L 4:91 ANNUL14P.
LIQUID SENSOR HLI•iS
TANK TILT
0.00
TRI -STATE c31NGLE FLOAT)
L 3:FUEL mUiRM
PROBE OFFSET
0.00
CATEGORY : AtlNUU;R SPA<:E
L 5:FUEL AU-;RM
L 6:FUEL ALARM
L 7:FUEL ALARM
S1 PHO14 MAN I FOLDED
TANlrS
L 8: FUEL ALARM
TO: NONE
L 5 : D 1 SP 1-2
L 3: SENSOR OUT AI..AR11
L114E MAN1FOLDEEl
TN'.l -STATE (S1IVC;LIE FLOAT)
L S:SENSOR OUT AI.ARL1
Td: N014E
CATEGORY : DISP13N6 :ER PAN
L 6 :SENSOR OUT ALARM
L 7:SENSOR OUT ALARM
L B:SEN50R OUT ALARM
LEAK M I r4 PER I OC, I C•
P 9 %:
3436
L 6:DISF' 3 -4
ISD SITE ALARMS
TRI -STATE <SINGLE FLOAT)
ISD CROSS PRES FAIL.
LEAs: M I N ANNUAL
29 %:
CATEGORY : D I SPENSCR PAN
ISD DEGRD PRES FAIL
3436
ISD VAPOR LEHIi FAIL
ISD VP PRES FAIL
PER1OD1L' TEST TYPE
L 7:DISP 5 -6
ISD HOSE ALARI.6
STANDARD
TRI -STATE (S 1 r1r,LE FLOW')
ALL :GROSS COLLECT FA I L
s`ATEi.ORY : DISPENSER PHN
ALL : DEGRD COLLECT FAIL
ANNUAL TEST FAIL
ALL : FLOW C.0LLEC -1' FA 1 L
ALARM DISABLED
PERIODIC TEST FAIL.
L 8:DISP 7 -8
ALARM DISABLED
TRI- STATE- (SINGLE FLOAT)
CATEGORY : D I :SPENSER PAN
GRO SS TEST FAIL
ALARM DISABLE(
ANN TEST AVERAGING: OFF
L 9:87 FILL
PER TEST AVERACt l NG : OFF
TF.1 -STATE ( S I NC;LE FLOAT)
CATEGORY . PIPING ,Ur1P
TANK TEST' 01' 1 F:' :
x1
OFF
TNK TST SIPHON BREAI`.:OFF
LI O: 91 FILL
TRI -STATE LSINGLE FLOAT)
DELIVERY DW41,1
5 MIN
CATEGORY : P I F' I NG SL1hiP
PUMP THRESHOiXi
10.00-.
R C OVEFFILL HLNRM
TYPE:
STANDARD
NORMALLY OPEN
TANK: 9: NONE
1 N -TAN): ALARMS
ALL:OVERFILL ALARM
ALL:HIGH PRODUCT ALARM
ALL:MAX PRODO -7 ALARM
SMARTSENSOR SETUP
s I: D I SP
I-'-, F'S
CATEGORY
VAPOR PP.ESSUPE
s '3:DISF'
1 -2 FM
CATEGORY
H 1 R FLOW METER
s :L�ISF'
3 -4 FM
C'A1')O(>P.`,'
H I R FLOW METER
s 4:GI8P
5 -6 FM
t ATEGOR`f
r; I P. F1.041 DIETER
s 5:1)1SP
7 -8 FM
C:rATEC,0P
HIP PLOW METER
EVR ISD SETUP
DiR, TYPE: VACUUM W� 31ST
VACUUM ASSIST TYPE
HEAL' VAC.
NOZZLE AWL RANGE
MAX: 1.15 MIN: 0.95
VAPOR PROC.ESSON TYPE
NONE
ANALYSIS TIMES
TIME: 10:00 AM
DELHI' MINUTES: 1
ACCEPT HIGH ORVR :
ID
DISABLED
NUM LABEL
BLEND3
1
-
25507
I SI)
HONE TABLE
2
21006
1D
FT'
FL
HL
HA
RR
01
01
01
02
01
UU
02
02
02
02. 01
UU
03
03
03
02
04
UU
04
04
04
02
04'
UU
05
05
05
02
02
UU
06
06
06
02
02
UU
07
07
07
02
03
IJU
08
08
08
02
03
UU
ISD AIRFLOW METER MAP
ID
SERIAL
NUM LABEL
BLEND3
1
-
25507
-- -- -
DISP
1 -2 F
2
21006
D1SP
5-6 F
9
2$432
[lisp
7 -8 F
4
25061
DISP
3 -4 F
ISD FUEL GRADE HONE MAR'
I 2 3 4
FP HHH MHH MHH MHH AA
01 501 901~301 U U 1
02 502 902 30? U U 1
03 503 303 903 U U 4
04 504 904 304 U IJ 4
05 505 905 305 U U 2
06 506 906 306 U U 2
07 507 907 307 U U 3
08 508 908 308 U U 3
LABEL TABLE
1:
UNASSIGNED
2:
BLEND3
3:
REGULAR
4:
MID GRADE
5:
PREMIUM
6:
GOLD
7:
BRONZE
8:
SILVER.
9:
BLEND
10:
BLEND4
PPIC SETUP
Pm' VERSION: 01.01
VAPOR PROCESSOR TYPE
NONE
PROCESSOR G'ONTROL LEVEL:
NONE
ALHRN HISTORY REPORT
- - - -- ENSTEII ALARM - - - --
PAPER OUT
AUG 17, 2011 10:03 AM
PRINTER ERROR
AUG 17. 2011 10:03 HM
A k w r- s END r- r. r i
ALARM H l l�r L <iR'; REPORT
- ---
IN-TANK HLr1PM -
T 1 : UNLEADED R
SETUP I-ATr; WHP111IrU',
JUN 6. 2008 8:05 (41
HIGH WATER ALARM
1*14Y 13. 1200'j 8:46 AM
OVEPr I L-L ALHRI'l
HAR 15. 2011 1 :2'5 PM
LOW W)DUCT ALARM
FEB 12. 2010 4:40 PM
HUG I, 2009 2 :23 PM
MA'`i 13. 2009 8:48 AIM
H 1 GH FP.;rLii li :T HLAK''M
MAP, 15. 2011 1:28 Pll
JUN 30. 2009 9 :40 All
JUN 6. 2008 8:05 All
INVALID FUEL LEVEL
FEB 12- 213111 5:03 P11
AUG 1, 2009 2:56 PM
MAY 5. 2009 9:32 PM
PROSE OUT
AUr, '23, 2010 9:38 AM
AUG 23. 2010 9:36 Ahi
DELIVER;' NEEDED
JUL 1- 201 1 7:38 P11
SEP 317. 2010 10:29 PM
AUG 23 • 2010 9 : 36 All
ALARM H I ST,01R" REPORT
- - -- IN-TANK HLArP1 -
T 2:1JL PREMIUM
SETUP DATH WAR141140
JUN 6, 2008 8:05 AM
LOW PRODUCT ALARM
AUG 23, 2010 9::35 Hrl
MAY 13, 2009 F1 :48 Af °I
APR 27. 2009 5:16 11;1
HIGH PRODUCT ALARM
JUN 30. 2009 9:41 Hrl
JUN 6. 2008 8:05 AM
INVALID FUEL LEVEL
AUG 23, 2010 9:39 mm
PROBE OUT
AUG 23� 2010 9:33 Hr1
AUG 23. 2010 9:35 0.0
HIGH WATER IJARNINV
JUN 6. 2009 11146 HM
DELIVERY NEEDED
.JUL 31. 2011 9:11 PM
JUN 2. 2011 8:00 Pm
MAY 10, 2011 5:02 F•1.1
LOW TEMP WAP.IV I PIG
AUG 23. 2010 9:39 All
. k END ,. : n 'r. -
r;LARM H 15TrjR';'
- - - -- SENSOR hLHF,f-I -
L 1 :87 sip
STP SUMP
SENSOR OUT A1-HFil
AUG 2'3. 2010 10:07 HM
FUEL ALARM
HuG 23. 2010 10:06 r;M
FUEL ALARM
AUG 23. 2010 9:521 HM
ri X - - = END x , - -
F1
ALARM HISTORY REPORT
- - - -- SENSOR HL+iRI•'I - - --
L 2:87 ANNULAR
ANNULAP SPACE
FUEL (ALARM
AUG 23. 2010 12:14 PM
FUEL ALARM
AUG 23. 2010 12:13 PM
FUEL HLARl,i
AUG 23, 2010 12:1,2 Prl
A n x x A END x � , '-
ALARM HISTORY N'.L"• PORT
- - - -- SENOR ALARM -
L 3:91 STP
STP SUMP
FUEL ALARM
AUG 23, 2010 :09 PM
FUEL ALARM
Alper 23, 2010 10:06 rill
FUEL ALARM
AUG 2'3. 2010 9:4.1 All
A 1 ri A ': END r t is . R
ALARM HISTORY REPORT r;LARM HISTORY REPORT ALARM H 1:3TOR'r REPORT
- - -- SENSOR ALARM - - --
L 4:91 A NNUL.FiR
ANNULHR SPr• CE
FUEL ALARM
AUG' 23, 2010 12:02 P11
FUEL ALARM
AUG 23. 21310 12,01 PM
FUEL ALARM
AW 23. 2010 11:59 AM
A t- rt, EIV[J 4% t r-
ALARM HISTORY kI F'(*:T
- - -- SEr6*oP - --
L 5:1)ISP 1 -2
D I SPENS'ER Pr:h1
FUEL ALARM
AUG 23. 2110 1 :28 PITT
FUEL ALARM
AUG 23. 2010 10:16 AM
FUEL ALARM
:AUG 23. 2010 10:06 mi'l
- - - -- SEN..;Ok ALARM - - - --
L 6:111ISP 3 -4
DISPENSER PAN
FUEL ALARM
AUG 23. 2010 10: 06 AM
FUEL. ALARM
HLP3 23. 2010 9:54 AM
FUEL ALAPJ9
JUN 30. 2009 9:37 AM
s n +; s r END :0' A
ALARM HISTORY REPORT
- -- -- SENSOR ALARM. -- -,
L 7:DISP 5 -6
DISPENSER PAN
FUEL ALARM
AUG 23. 2010 10:06 AN
FUEL ALARM
AUG 23. 2010 9:54 All
FUEL ALARM
JUN 30, 2009 9:38 rill
.,
x R ENE, ► A A + END k r A Z
- - - -- SENSOR ALARM - - - --
L B:UISP 7 -8
DISPENSER PAN
FUEL ALARM
AUG 23. 2010 10:06 AM
FUEL ALARM
AUG 23, 2010 9:55 W
FUEL ALARM
JUN 30. 2005 9:37 HN
r 1 R . ENP % m -, t
ALARM HI::Ti>PY REI,,wr
- - - -- SENSOR al-ARM - - - --
1. 9:87 FILL
PIPING SUMP
SETUP DATA WARN I Nr;
MAR 24. 2011 9:06 AM
SETUP DATA WiYW I Nr;
MAR 23. 2011 3:31 FM
FUEL ALARM
MAR ". 2011 :J: 15 PM
.,.r.END R ��
ALARM H I STOR•'r REPOIOT
---
1_10:91 FILL
P I I• I W, SUMP
FUEL. ALARM
AUG 23. 2010
9:56 iim
FUEL ALARM
JUN 3U • 2009
5.44 riM
FUEL +iLARH
JUN 30. 2005
x:'23 a1r9
X...'• END A., t ft -
- - -- SDCOR #ALARM - - - --
L 1 :87 STP
STP SUMP
FUEL. HLAPM
SEP 6. 2•U 1 1 9: 17 AN
- --- SENSOR, rit.s-01 - - ---
L 3:91 STP
STP SUMP
FUEL ALARM
SEP 6. 2u11 9:17 Hti
- - - -- SLNSOR ViLAkil - - --
L 5:DISP 1 -2
U' I SPEN DER PAN
FUEL HLARr1
SEP 6. 2011 9:20 k1l
-•- - 2EIVGOR - --
I_ o:GI:P 3 -4
Ul5PEN-'EP. PAN
FUEL ALARM
SEP 6. 22011 9:21 HI "I
-- - -- SENSO){ Hl.r {kI7 - - - --
1
[. 1:U1:9P 7 -8
DISPEKSER PAN
FUEL i LAK1.1
SEP 6. :,oil 9 : 2,4 #41
SEPISOR ;IL.iRM
L 7:DISP 5 -e
DISPENSER PApi
FUEL ALARM
SEP 6. 2011 9:24 KPI
- - --- SEWSOP. ALARM - - --
1,10:91 FILL
P 1 P I PIG SUPIP
FUEL ALARM
SEP 6. 2011 9:25 kM
- - -- SENSOR wL.HRM - - - --
L. 9:87 FILL
P 1 P I NG SU1P
FUEL mLARM
SEP 6. 2011 9:25 41
AK*O am,r -qn V703
2698 MT Varncn Kva
S ®I =er 3f fi e l d
04 93306
SEP E . 201 1 9: 27 ;-ir'1
S.'sTEM :TATIJ'3 P.EPowr
ALL FUNCTIONS PK)Ri`IAL
- - - --
SENSOR ALARM - - --
1. 2:87 ANNUL4.,
ANNULAR SPACE
FUEL ALAP11
SEP 6. 2011 9:29 41
- - - -- SENSOR 14.HRM --
L 2:87 ANNULAR
NNNULAR SPi•CE
FUEL AUiRM
SEP 6. 2011 9:29 9 W1
AK'0 aimpin 8'2703
ARCO Wl.,pm 82,703" 2698 MT Vor-r.osi Ave
:2698 PIT Vernon Ave Balror5f i el d
Bab Q"3f iv I d 0A 93306
C'A 9=6
SEP 6. 201 1 9:30 iM SEP 6. 2011 9:35 Art
SYPITEH ST�MG REI,(.,P'f SYSTEM ST�j`1'1_1:� REPOPT
- - - - - - - - - - -
L 2:FUEL ALARM - - - - - - - - - - - - L 4: FUEL mLi-iRM
SENSOR mlmP(,]
SENSOR ALARN L 4'91 ANNULAR
L 2:87 AlqlqUbAR ANNULmP SPw E
e4 1 ('10LAP SPAt-E FUEL ALARM
FUEL ALAPM SEP •, 2011 9:36 W
SEP 6. 2011 9:31 Am
ARCO arow pm 82703
SENSOR ALAR1,1 2698 MI, Vel-non Ave
L 4:1?1 ANNULAR Bale;-r sf i E? I d
ANNULAR SPACE CA 93306
FUEL ALAPH
SEP 6, 2011 9:34 H11 SER 6. 2011 9:39 HM
SENSOIR
L 4:91 ANNUL�P
ANNULHIR SPACE
FUEL HIJ-01
SEP 6. 21011 9:34 AM
slp.3,Tul RL:Powv
- - - - - - - - - - - -
ALL FUtc-rIONS NORMAL
AW_;HIVE kii-ir,
S c
hVE SETUP DhTm:
s*rt4RT T I mE:
SEP 6. 2011 9:48;3) 41
ARCHIVE UTILiTV
SAVE SETUP rtP,Th:
END TIME:
SEP 6. 2,Oil 9:50:30 OM
B'sqES : 1502
----- SENSOR t4LmRH
L 5:1)ISP 1-2
DISPENSEP PAN
FUEL ALARM
SEP, iL. 2011 -9:53
SENSOR ALARM
L 1:87 STP
STP SUMP
FUEL ALARM
SEP 6. 2011 9:53 "1
- - - -- SEWSOP AI-4a Vl
1, 9:87 FILL
PINNG SUMP
C-EIIISOR OUT HLfAR111
SEP 6. 2011 95:3 W
-- -- S'Eur-X)P
1.10:91 FILL
Pi PING SUMP
SE11:3OR OUT ALARM
I-')'EF
6. 201 1 9:53 #41'1
SEI't';op AIj.-,K11
L G:DISP 7-8
DISPENSER PAN
FUEL ALARPI
,'E�
.D - 6. 2CI 1 1 9:54 ikl-1
SENSOR i4ljiRll
L 1,:67 HNNUUIR
i-01NULHR SPAf;F
FUEL ALAPH
S. E P 6. '21:111 9:54 AM
SEM�OR ALARM
L -1:91 ANNULHR
ANNULAR SPACE
FUEL ALARM
SEP 6. 2011 9:54 r:dl
ALARM
L STP
IM SUMP
SE14SOR OUT ALARM
SEP 6. 2011 9:54 AN
ARCO an. pin 82703
2698 MT VQrnoro Fives
sal. Ql,sf I e I d
CA 93306
SEP 6. 2011 9:54 A11
SYSTEM MORT
- - - - - - - - - - - -
ALL FUN OTI GPI NORMAL
SEtqSOR ALARM
L G*ISP 3-4
DISPENSER NAN
FUEL ALARM
SEP 6. 201I 9:57 All
rl
HR'Q0 am, pno G!"103
2698 MT Ve•nor, Ave
Besl,er st I * I d
CA 9:J306
SEP 6. 2011 9:57 AN
civalis w-Wr
- - - - - - - - - - - -
L 6: FUEL t4IHp%m
SWRCB, January 2006
Spill Bucket Testing Report Form
This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form 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: Mt Vernon & Columbus Arco AM /PM
Date of Testing: 9/6/2011
Facility Address: 2698 Mt. Vernon Avenue Bakersfield, CA 93306
Facility Contact: Monty Hawatmeh
I Phone: 661 - 703 -7273
Date Local Agency Was Notified of Testing: Ester Duran
Name of Local Agency Inspector (f present during testing): 8/23/2011
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A Self
Credentials: Z CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester ❑ Other (Spec)
License Number(s): CSLB# 804904 ICC# 8022804 -UT Tank Tester 11 -1756
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: El Hydrostatic ❑ Vacuum ❑ Other
Test Equipment Used: Lake Test
Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank
Number, Stored Product, etc.
1 Regular
2 Super
3
4
Bucket Installation Type:
❑ Direct Bury
X Contained in Sump
❑ Direct Bury
X Contained in Sump
❑ Direct Bury
❑ Contained in Sump
❑ Direct Bury
❑ Contained in Sum
Bucket Diameter:
12.00"
12.00"
Bucket Depth:
13.50"
13.75"
Wait time between applying
vacuum /water and start of test:
5 Min
5 Min
Test Start Time (Ti):
9:00 am
9:00 am
Initial Reading (Rj):
9.75"
10.00"
Test End Time (TF):
10:00 am
10:00 am
Final Reading (RF):
9.75"
10.00"
Test Duration (TF — Ti):
1 Hour
1 Hour
Change in Reading (RF - Rj):
0.00"
0.00"
Pass /Fail Threshold or
Criteria:
0.0625"
0.0625"
Test Result:
X Pass ❑ Fail
X Pass ❑ Fail
❑ Pass ❑ Fail
❑ Pass ❑ Fail
Comments — (include information on repairs made prior to testing, and recommended follow -up for failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements.
Technician's Signature:, !4�:! Date: 09/6/2011
State laws and regulations do not cufntly require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.