HomeMy WebLinkAboutFMC 2012MONITORING 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: Lucky 7 #3
Site Address: 726 South Union Avenue
Facility Contact Person: Mohammed
Make /Model of Monitoring System: Gilbarco TLS 350
B. Inventory of Equipment Tested /Certified
Check the appropriate boxes to indicate specific equipment inspected /serviced:
City: Bakersfield
Bldg. No.:
Zip: 93307
Contact Phone No.: 661 - 324 -8516
Date of Testing/Servicing: 04/18/2012
Tank ID: 4,000 gal Diesel
Tank ID: 4,000 gal Diesel
L] In -Tank Gauging Probe. Model: 847390-107
[x]
In -Tank Gauging Probe. Model: 847390 -107
❑ Annular Space or Vault Probe. Model:
❑
Annular Space or Vault Sensor. Model:
L] Piping Sump / Trench Sensor(s). Model: 794380-208
Cx]
Piping Sump / Trench Sensor(s). Model: 794380 -208
❑ Fill Sump Sensor(s) Model:
❑
Fill Sump Sensor(s). Model:
U Mechanical Line Leak Detector. Model: FXIDV
❑
Mechanical Line Leak Detector. Model:
❑ Electronic Line Leak Detector. Model:
❑
Electronic Line Leak Detector. Model:
L] Tank Overfill / High Level Sensor. Model :OPW -61 -SO
U
Tank Overfill / High Leval Sensor. Model: OPW -6I -SO
❑ 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: 8,000 gal. Super
Tank
ID: 10,000 gal Regular
[x] In -Tank Gauging Probe. Model:847390 -107
L]
In -Tank Gauging Probe. Model: 847390 -107
❑ Annular Space or Vault Sensor. Model:
❑
Annular Space or Vault Sensor. Model:
[X] Piping Sump /Trench Sensor(s). Model -794380-208
(�
Piping Sump / Trench Sensor(s). Model: 794380 -208
❑ Fill Sump Sensors(s). Model:
❑
Fill Sump Sensor(s). Model:
[xx Mechanical Line Leak Decector. Model:FXIV
Lx]
Mechanical Line Leak Detector. Model: FXIV
❑ Electronic Line Leak Detector. Model:
❑
Electronic Line Leak Detector. Model:
Lx] Tank Overfill / High Level Sensor. Model:OPW -6I -SO
fix]
Tank Overfill / High Level Sensor. Model: OPW -6I -SO
❑ 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
Fx] Dispenser Containment Sensor(s). Model: 794380 -208
[x]
Dispenser Containment Sensor(s). Model: 794380 -208
Ex] Shear Valve(s).
U
Shear Valve(s).
❑ Dispenser Containment Float(s) and Chain(s).
❑
Dispenser Containment Float(s) and Chain(s)
Dispenser ID: 5 St 6
Dispenser ID: 7&8
[x-] Dispenser Containment Sensor(s). Model: 794380 - 208
[x]
Dispenser Containment Sensor(s). Model: 794380 -208
[xj 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 -1 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 verify that
this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating
such reports, 1 have attached a copy of the report; (check all that apply) x❑ System Set -up U Alarm history report
Technician Name (print): Bryan A Self Signature:
Certification No: B37601 License No: 804904
Testing Company Name: Confidence UST Services, Inc. Phone No: 800- 339 -9930
Site Address: 726 South Union Avenue, Bakersfield, CA 93307 Date of Testing/Servicing: 04/18/2012
A Results of Testing /Servicing
Software Version Installed: 7.03
Complete the following checklist:
[x] Yes
❑ No*
Is the audible alarm operational?
x
Yes
No*
Is the Visual alarm operational?
x
Yes
No*
Were all sensors visually inspected, functionally tested, and confirmed operational?
x I Yes
❑ No*
Were all sensors installed at the lowest point of secondary containment and positioned so that other
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? U Sump /Trench Sensors U Dispenser Containment Sensors
Did you confirm positive shut -down due to leaks and sensor failure /disconnected? U Yes; ❑ No;
UYes
❑ No*
For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
[ -] 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 %
U 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*
Lx] No
Was liquid found inside any secondary containment systems designed as dry systems?
❑ Product; ❑ Water. If yes, describe causes in Section E, below.
Tx
No*
Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable.
[x_1
Yes
0
No*
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' I replaced the drain valve on in the Diesel Salve Spill Bucket. I also replaced the VeederRoot Liquid
Sensor (794389 -208) in the Diesel Slave STP.
F. In -Tank Guaging / SIR Equipment: E 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:
Lx]
Yes
I ❑ No*
Has all input wiring been inspected for proper enter and term ination,including testing for ground faults?
•
Yes
No*
Were all tank guaging probes visually inspected for damage and residue buildup?
•
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?
Lx]
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.
G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed.
Complete the following checklist:
rx] 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: L13 g.p.h.: 00.1 g.p.h.; 00.2 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 calibrated?
❑ Yes
No
For machanica LLD's, does the LLD restrict product flow if it detects a leak?
N/A
❑ Yes
No*
For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak?
Lx]
N/A
❑ Yes
No*
For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is
[x]
N/A
disabled or disconnected?
❑ Yes
No*
For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system
U
N/A
malfunction or fails a test?
❑ Yes
E
No*
For electronic LLD's, have all accessible wiring connections been visually inspected?
U
N/A
_Lxj Yes
Lj
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:
LUCKY 7 NO.3
RS- '232' END OF MESSAGE
726 SO.UNION
SYSTEM SETUP
DISABLED
BAKERSFIELD CA.93307
- - - - - - - - - - -
SUN VALLEY OIL CO.
APR 18. 2012 7:59 AM
APR 18, 2012
7:59
AM
114 -TANK SETUP
SYSTEM UNITS
U.S.
T 1:G[ESEL 2
SYSTEM S'T'ATUS REPORT
SYSTEM LANGUAGE
PRODUCT CODE
1
- - - - -
- - -
- -
ENGLISH
THERMAL COEFF :.000450
T 1 : DEL. I VERY
NEEDED
TANK DIAMETER
72.00
LUCK`,' 7 NO.3
TANK , PROF I LE
I PT
T 2: DEL. IV ERV
IVEEDED
726 SO .UNION
FULL VOL :
4001
BAK,ERSF I ELD GA . 93307
DE
T : -i : L. I VER4`
NEEDED
SUN VALLEY OIL CO'
FLOAT SIZE: 4.0
INCHES
T 4:DELIVERY
NEEDED
SHIFT TIME 1 10:00 PM
SHIFT TIME 2 DISABLED
WATER WARNING
2.0
SHIFT TIME 3 DISABLED
HIGH WATER LIMIT:
3.0
1 NVENTORY REPORT
PERIODIC' TEST WeLikNIh1GS
MAX OR LABEL 'VOL.:
4001
DISABLED
OVERFILL LIMIT
90%
T I, G I ESEI_ '2
ANNUAL TENT WO RN I NOS
itDO
VOLUME =
670
GALS
DISABLED
HIGH PRODUCT
95-.
ULLAGE =
3331
GAIL
3800
90 %; ULLAGE-
2930
GALS
SYSTEM SECURITY
DELIVERY L I M 1 T
19%
TC VOLUME =
664
GALS
COIIE 0000116
760
HEIGHT -
16.13
INCHES
WATER VUL =
0
GALS
LOW PRODUCT
300
WATER =
0.00
INCHES
LEAK ALARM LIMIT:
99
TEMP =
77.0
DEG F
SUDDEN LOSS LIMIT:
50
TANK TILT
0.00
T ':DIESEL 2
VOLUME _
?53
GALS
MANI FOULED TANKS
ULLAGE =
3248
GALS
T#; NONE
9014 ULLAGE-
2847
GALS
TC VOLUME =
748
GALS
PERIODIC TEST TYPE
HEIGHT =
17.52
INCHES
STANDARD
WATER VOL -
0
GALS
WATER =
0.00
INCHES
COMMUNICATIONS SETUP
PF.k [ OC! I C; TEST FAIL
TEMP =
75.1
DEG F
- - _ - - - - - _ - _ ._
ALARM DISABLED
T 3:SUPER
GROSS TEST FAIL
VOLUME =
105"
GALS
PORT SET TI 1 NGti :
ALARM D I
SABL.ED
ULLAGE =
644`1
GALS
90`o ULLAGE=
5698
GALS
NONE FOUND
PER TEST AVERAGING: OFF
TC VOLUME =
1051
GALS
HEIGHT -
19.00
INCHE::
Rte; 232 SECURITY
TANK TEST NOTIFY:
0114
WATER VOL =
B
GAL 5
CODE 000000
WATER =
0.75
INCHES
TNh: TST SIPHON BREA};
:OFF
TEMP =
73.4
DEC F
DELIVERY DELAY
15 MIN
T 4:REt�UL.AR
VC>LUME _
-.
ULLAGE =
9245
GALS
90 ULLA(a'E=
8244
GALS
TC VOLUME =
755
G"LS
HEIGHT -
12.39
INCHES
WATER 'VOL =
0
GALti
WATER. =
0.00
1 NC'HES
TEMP =
71.1
DEG F
e is ** x ENE)
* x*
x x
SOFTWARE REVISION LEVEL
VERSION 7.03
SOFTWARE# 349500 -007 -D
CREATED - 94.08.24.10.26
NO SOFTWARE MODULE
SYSTEM FEATURES:
PERIODIC IN -TANK TESTS
ANNUAL_ IN-TANK TESTS
T 2:DIESEL 2
PRODUC,"T CODE 2
THERMAL COEFF :.000450
TANK DIAMETER 72.00
TANK PROFILE 1 PT
FULL VOL 4ori1
FLOAT S 1 ZE : 4.0 INCHES
WATER WARNING
2.0
Hl(-"H WATER LIMIT:
3.0
P1AX OR LABEL VOL:
4001
OVERFILL LIMIT
90%
3600
HIGH PRODUCT
95`
3900
DELIVERY LIMIT
19x
760
LOW PRODUCT
300
LEAK ALARM LIMIT:
99
SUDDEN LOSS LIMIT:
50
TANK TILT
0.00
MAN I FOLDED TANKS
T#: NONE
PERIODIC TEST TYPE
STANDARD
PER I OD I i' 1'E:�T FAIL
6LAhI1 GISHBLED
GROSS TEST I'IL
ALhRll DIi:;ABLED
PER TEST AVERAG f t*3: OFF
TANK; 'I'ES'T NOTIFY: ON
TNK: TST SIPHON BREAK:OFF
DELIVERY DELAY : 15 MIN
T 3:SUPER
PRODUCT CODE 3
THERMAL 1;OEFF :.000070
TANK DIAMETER 96.00
TANK PROFILE I PT
FULL VOL 7501
FLOAT SIZE: 4.0 INCHES
WATER WARNING 2.0
HIGH WATER LIMIT: 3.0
MAX OR LABEL VOL: 7501
OVERFILL LAMIT 901
6750
HIGH PRODUCT 95%
7126
DELIVER`.' LIMIT 19%
1 ,125
L06J PRODUCT 500
LEAK: ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 50
TANK TILT 0.00
MANIFOLDED TANKS
Tit: NONE
PERIODIC TEST TYPE
STANDARD
PEkIODIi' TEST FAIL
ALARM DISABLED
GROSS TEST FOIL
ALARM DISABLED
PER TEST AVERAGING: OFF
TANK; TEST NO 'T I FY : ON
TNK TST SIPHON BREAK,:OFF
DELIVERY DELAY : 15 MIN
T 4:REGULAR
PRODUCT CODE 4
THERMAL _OEFF :.000070
TANK. DIAMETER 96.00
TANK. PROFILE I FIT
FULL VOL : 10001
FLOAT SIZE: 4.0 1NCHES
WATER WARNING : .o
HIGH WATER LIMIT: 3.0
MA >; OR LABEL VOL: 10001
OVERFILL LIMIT 90
9000
HIGH PRODUCT 951
9501
DELIVERY LIMIT 19%
1 9011
LOW PRODUCT 500
LEAK ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 50
TANK TILT U.00
MAN I FCILDED TANKS
T#: NONE
PERIODIC TEST TYPE
STANDARD
PERIODI(: "'EST FAIL
r;LARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
PFR TFST A'v'F.RAC. I NG : OFF
TANK: TEST NOTIFY: ON
TNK TST SIPHON BREFiK:OFF
DELIVERY DELAY : 15 MIN
LEAK TEST METHOD
'PEST WEEKLY : ALL 'TANK
MON
START TIME : 12:00 AM
TEST RATE :0.20 GAL: HR
DURATION R)URS
LIQUID SENSOR ,SETUP OUTPUT RELAY SETUP ALARM HISTORY REPORT
L I:DIESEL SUMP TANK I
TRI —STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L 2:DIESEL STP TANK 2
TRI —STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L 3:SUPER STP TANK 3
TRI —STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L 4:REGULAR STP TANK 4
TRI —STATE (SINGLE FLOAT.)
CATEGORY : STP SUMP
L 5:MPD 1 -2
TRI —STATE cSINGLE FLOAT)
CATEGORY : DISPENSER PAN
L 6:MPLi 3 -4
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
L 7:MPD 5 - -6
TRI -STATE (SINGLE FLOAT:
CATEGOR',` : D 1 SPEN SER PAN
L B:DIESEL. 7 -0
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
R I:DIESEL
TYPE:
STANDARD
NORMALLY CLOSED
LIQUID SENSOR ALMS
L
!:FUEL ALARM
L
2:FUEL ALARM
L
8:FUEL ALARM
L
I:SENSOR OUT ALARM
L
2:SENSOR OUT ALARM
L
B:SENSOR OUT ALARM
L
]:SHORT ALARM
L
2:SHORT ALARM
L
9:SHORT ALARM
R 2: SUPER
TYPE:
STANDARD
NORMALLY CLC 4:3ED
LIQUID SENSOR ALMR
L
3:FUEL ALARM
L
5 : F UEL ALAR11
L
6:FUEL ALARM
L
7:FUEL ALARM
L
3:S'ENSOR OUT Al.,)P 1
L
5:SEN.SOR OUT ALARM
L
6:SENSOR OUT ALARM
L
7:SENSOR OUT ALARM
L
3:SHORT ALARM
L.
5 :SHORT ALARM
L
6:SHORT ALARM
L
7:SHORT ALARM
R 3:REGULAR
TYPE:
STANDARD
NORMALLY CLOSED
LIQUID SENSOR ALMS
L
4:FUEL ALARM
L
5:FUEL ALARM
L
6:FUE1.. ALARM
L
7 : F'UEL ALARM
L
4:SEIJSOR OUT ALARM
L
5:SENSOR OUT ALARH
L
6:SENSOR OUT ALARM
L
7:SENSOR OUT ALARM
L
4:2:HORT ALARM
L
5:SHORT ALARM
L
6:SHORT ALARM
L.
7 : SHOR'P ALARM
ALARM HISTORY REPORT
- - --- SYSTEM ALARM -- - --
PAPER. OUT
FEB 2, 2012 7:57 AM
PRINTER ERROR
FEB 2. 201 7:57 AM
BATTERY IS OFF
JAN 1, 1994 8:00 AM
- - -- IN- -THNIe ALARtl - - --
T I:DIESEL 2
LEAK ALARPI
FED 18, 3863 3:30 A1"1
HIGH WATER ALARM
AFR 21 , 201 0 9: 54 AM
OVERFILL ALARM
MAR 18, 2068 5:13 F'M
SEP 2.- 20174 10:41 AM
AUG 22. 2004 3:35 PI1
LOW PRODUCT ALARM
JAN 3, ^Ol2 4:20 P1"1
MAR 24, 2011 2:20 FH
MAR 11, 2011 9.57 All
SUDDEN LOSS ALARM
APR 30, 2007 12:39 NI
HIGH PRODUCT ALARM
APR 21,
2010
9:54 AH
JAN 10,
2_004
7:07 All
FEB It.
2004
12:29 Pl "I
I NVAI A D
FUEL
LEVEL
JAN ',
2011
6:46 PI "l
MAY 4.
2010
1;08 F'1'1
APR 21,
`010
9:53 AM
PROBE OUT
APR 21. 2010 9:59 Hfl
MAR 2, 2007 '2:10 PM
JUN 10, 2004 2:19 PM
HIGH WATER WARNING
APR 21, 2010 9:54 All
DELIVERY NEEDED
APR 16, 2012 9:07 All
MAR 31, 2012 12:51 I'M
MAR 19, 2012 7:49 AI"1
MAX PRODUCT ALARM
FEB 11, 2004 12:30 PM
N01i 27, _ ^-003 3:35 Atli
GOT 25, 2003 3:03 All
TANK TEST ACTIVE
APR 16, 2012 12 :00 AM
APR 9. 2012 12:00 All
APR 2012 12:00 AM
ALARM HISTORY REPORT ALARM HISTORY REPORT
ALARM HISTORY kEFOkT
- - -- IN -TANK ALARM - - - -- - - -- IN -TANK ALARM -- --
---- IN-TAN}: HLAkI °1 -
T 2:DIESEL 2 T 3:SUPEk
T 4: REGULAR
LEAK. ALARM
APR 30. 2007 1 :00 AM
HIGH WATER ALARM
APR 21. 2010 9:54 AM
OVERFILL ALARM
MAR 13. 2009 1:11 PM
MAR '27. 2008 5:06 PM
JUN 13. 2006 10:39 PM
LOW PRODUCT ALARM
MAY 13. 2011 10:15 AM
APR 26. 2011 2 :39 PH
MAY 4. 2010 12:32 Ptl
SUDDEN LOS ,S ALARM
APR :30. 2007 12:34 All
HIGH PRODUI?T ALARI'I
APR 21 . 20111 9:54 All
SEF S. 2004 1 fl: 37 All
FEB 21. 2004 4:49 AN1
I NVAL I D FUEL. LEVEL.
APR 21. 20111 9:54 AM
APR 13. 21:11:14 6:10 All
PROBE OUT
APR 21 , 2010 9:56 AI'l
MHR 2, 201.17 2:09 Pit
JUN 10, 2004 2:19 PM
HIGH WATER WARNING
APR 21. 2010 9:54 AM
DELIVERY NEEDED
APR
17,
2012
11:13 AM
APR
2.
2012
0:48 All
MAR
2101
2012
8:07 ANI
MH.:
PRODUCT ALARM
APR
21,
2010
9:54 AM
SEF'
6.
2003
3:24 PM
APR
8.
201-10
11::31 PM
TANK. TEST ACTIVE
APR 16, 2012 12:00 04111
APR 9. 2131 2 12:00 f-H
APR 2. 2012 12:01-1 All
HIGH WATER ALARM
APR 211, 2010 9:38 AM
OVERFILL ALARM
APF. 21, 2010 9:38 AM
LOW PRODUCT ALARM
JAN 5, 2012 4 :00 PM
NOV 1. 2011 9:58 AM
SEF' 27, 2011 8:46 AM
HIGH PRODUCT ALARM
APR 21, 2010 9:38 AM
INVALID FUEL LEVEL,
DEC 15, 2010 1:52 PM
NOV 9. 2010 8:31 AM
AP? 21, 2010 9:38 AM
PROBE OUT
APR. 21.. 2010 9:39 HM
APR 21, '2010 9:37 AM
MOR 18, 2008 12:37 PI °I
HIGH WATER WARNING
APR 21. 2010 9:38 AM
DELIVERY NEEDED
APR 12, 2012 12:41 PH
IiAR 10. 2012 2:23 PM
FEB 17, 201 11:42 All
THNK "PEST ACTIVE
APR 16, 2012 12:00 AM
APR 9, 2012 12:00 AI'I
APF: 2, 2012 12:00 AM
HIGH WATER ALARM
APR 21, 2010 9:33 AM
OVERFILL ALARM
Aul" 71 '.011 8:06 FIN
APR 21, 2010 9:34 AM
SEP 22. 2009 10:41 AM
LOW PRODUCT ALARM
NOV 1, 2011 5:06 PH
DEC 31, 2010 11:0E All
DEC 11, 2010 4:44 PM
HIGH PRODUCT ALARM
APR 21. 2010 9:33 AM
FEB 4. 2007 3:39 Phi
JUL 5, 2006 10:07 AI °I
INVALID FUEL LEVEL
NOV 1, 2011 6 :20 PM
DEC 31, 2010 1:12 Phi
DEC 11, 2010 0:44 PH
PROBE OUT
APR 21, 2010 9:34 AM
APR 21, 2010 9:32 All
MAR 18, 2008 12:37 F'M
HIGH WATER WARNING.
APR 21. 2010 9:33 All
DELIVERY
NEEDED
APR 16,
2012
5:03 PI-1
( FPR 13.
2012
4:12 Ph1
APR 10,
2012
11:36 AM
MAX PRODU!
:T ALARM
JUL 5,
200E
10:09 AM
FEB 25,
2004
1:23 All
JUL 31,
2002
3:27 All
TANK TEST ACTIVE
APR 16, 2012 12:00 AM
APR 9. 2012 1 :00 All
APR 2012 1' -:00 All
ALARM H I STOR`r REPORT ALARNI HISTORY REPORT
SENSOR ALARNI - - - -- - - -- SENSOR ALARM - -- --
L I:D1EGEL SUMP TANK 1 L 5:MPD 1 -2
STP SUMP DISPENSER PAN
SENSOR OUT ALARM SEWOR OUT ALARM
APR 25, 2011 11:25 AI 11 APR 25, 2011 11:215 W SENSOR ALARM -----
M FUEL ALARM L 2:DIESEL STP TANY.
FUEL ALARM
APR 25, ?Ull 11:17 AM APR 25, 2011 11:'1 All STP SUMP
FUEL AI..HRIh
SENSOR %iI.JT ALARM FUEL ALARM APR 18, 2011 9:10
APR I . 2l.1 11-1 10: U7 HM APR 21. 2010 9:15 AM
ALARM HISTORY
REPORT
ALARM HISTORY REPORT
- -- SENiOk ALARM - -- -
- SENSOR
ALARM
- - -.__
L S:IIESEL 7 -8
HLARM HISTORY REPORT
ALARM HISTOR`i
REPORT
DISPENSER PAN!
FUEL ALARM
- SEIi'OY ALARM - - - --
- - - -- °ENSOR
ALAPIl - - --
APR 16, 2n1' 5:11 All
L 2:DIESEL STP TANK 2
L 6:MPD 3 -4
STP SUMP
FUEL HLARM
STP SUMP
DISPENSER PAN
SENSOR OUT ALARM
FUEL ALARNI
SENSOR OUT ALARM
SENSOR OUT HLARM
F'fl
APR 25. 2011 11:25 All
APR 25, 2011
11:25 HM
FUEL ALARM
FUEL ALARM
APR '25. '2x111
APR 25, 2011 11:16 All
APR 25, 2011
11:21 All
FUEL ALARI)
FUEL ALARM
- - -- -ENsoR ALARH - --
APR 21, 2010 9:26 ANI
APR 21. 2010
9:17 All
L 3::UPER STP TANK 3
APR ':'.1 . 201 D 9:19 AI °I
STP SIJNIP
FUEL ALARM
APR 18. 201:2 9:12' AM
ALARM HISTORY
REPORT
ALARM HISTORY REPORT
- SENSOR
ALARM
- - -.__
- - - -- SENSOR ALARM - - --
SENSOR ALARM - - - --
L 3:SUPER STP
TANK
3
L 7 :MF'P 5 -e
L 4:SEGULAR STP TAN): 4
STP SUMP
DISPENSER PAN
STP SUMP
FUEL HLARM
SENSOR OUT ALARM
FUEL ALARNI
APR 25, 2011
12:12
F'fl
APR '25, 21011 11 :25 AM
APR is, 2,61 .2 9:13 HNI
SENSOR OUT ALARNI
FUEL ALARM
APR '25. '2x111
l I :25
All
APR 25, 2011 11 :22 AM
FUEL ALARM
FIIEL ALARM
APR 25, 2011
1 1 ' 16
AI °I
APR ':'.1 . 201 D 9:19 AI °I
ALARM HISTOR`' REPORT
- - - -- SENSOR ALARM - --
1.. 4:REG1_ILAR STP. TANK 4
STP SUMP
FUEL ALARM
APR 25. 2011 12:25 PM
SENSOR OUT ALARM
APR 25. 2011 11:25 AI
FUEL ALARM
APR 25, 2011 11:19 All
SENSOR ALARM
L 5:MPD I -2
DISPENSER PAN
FUEL ALARI'l
APR 18, 2012 9 :13 AM
ALARM HISTORY REPORT
___ - - - -- SENSOR ALARM - - - --
L 8:DIESEL 7 -6
DISPENSE? PAN
SENSOR OUT ALARM
APR 25, 2011 11:25 AM
FUEL ALARM ALARI,l - -
APR 25, 2 01 1 11:23 HM DISPENSER 6:E 3 -4
DISPENS hISEk PAId
SENSOR OU'F HLARM FUEL ALARNI
APR 21, 2010 10:09 AI °I APR 18. 2012 9:14 HM
- - -- SENSOR ALARM - - - --
L 7:P9PD 5 -6
DIISVIENSER PAN
FUEL ALARM
APR 18, 21012 9:15 At'!
- - -- SENSOR ALARM - - - --
L 4:REGULAR STP TANK 4
STP SUMP
:SENSOR OUT ALARM
APR 18, 2012 5:17 AM
- - - -- SENSOR ALARM - - --
L S:MPG 1 -2
DISPENSER PAN
SENSOR OUT ALARM
APR 18. 2012 9 :17 AM
- SENOR ALARM - - - --
L 6:MPD 3 -4
DISPENSER PAN
SENSOR OUT ALARM
APR 18, 2012 9:1? Al °1
- - -- SENSOR ALARM 7:I'9PD 5 -6
DISPENSER PAN
SENSOR OUT ALARM
APR 18, 201'2 9:17 All
_..._ -- SENSOR ALARM - - - --
L O :DIESEL 7 -8
DISPENSER PAN
SENSOR OUT ALARIM
APR 18, 2012 9:17 Al "I
- - - -- SENS'O'R ALARM
L. 1 :DIESEL SUIMP TAN}: I
S7'P SUMP
SENSOR OUT ALARM
APR 18. '201: 9:17 AIM
- - - -- SENSOR ALARI°I
EBFL :S'I'P TANK 2
;STP SUI,1P
SENSOR UU "1' ALARM
APR 18. 201 = 9: 1 7 Al'l
SENSOR ALARM
L 3:SuPER STP TAN. 3
STP SUMP
SENOR OUT ALARM
APR 18, 2012 9:17 AM
-- SENSOR ALARM - - --
L I:GIESEL SUMP ThNK 1
STP SUMP
SENSOR OUT ALARM
APR 18. 2012 9 :26 AM
-- SENSOR, ALARM - --
L l : E! I £SEI_ SUMP TANK 1
STP SUMP
FUEL ALARM
APR 18, 201 9:322 AM
SENSOR ALARM - -- --
L 1- DIESEL SUMP TANK t
STP SUMP
FUEL ALFiRM
APR 10, 2012 9:32 Al'I
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: Lucky 7 #3
Date of Testing: 4/18/2012
Facility Address: 726 South Union Avenue, Bakersfield , CA 93307
Facility Contact: Mohammed
I Phone: 661- 324 -8516
Date Local Agency Was Notified of Testing : 3/20/2012
Name of Local Agency Inspector (if present during testing): Ernie Madenia
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A Self
Credentials: 0 CSLB Contractor M ICC Service Tech. X SWRCB Tank Tester ❑ Other (Specify)
License Number(s): CSLB# 804904 ICC# 8022804 -UT Tank Tester 1 1 -1756
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: ❑x Hydrostatic ❑ Vacuum ❑ Other
Test Equipment Used: Lake Test
Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank
Number, Stored Product, etc.
1 Diesel Slave
2 Diesel Master
3 Super
4 Regular
Bucket Installation Type:
❑ Direct Bury
❑ Contained in Sum
M Direct Bury
❑ Contained in Sump
Z Direct Bury
❑ Contained in Sump
❑ Direct Bury
❑ Contained in Sum
Bucket Diameter:
12.00"
12.00"
12.00"
12.00"
Bucket Depth:
14.00"
14.00"
14.00"
14.00"
Wait time between applying
vacuum /water and start of test:
5 Min
5 Min
5 Min
5 Min
Test Start Time (Tj):
9:10 am
9:10 am
9:10 am
10:10 am
Initial Reading (Rj):
10.00"
10.00"
10.50"
9.50"
Test End Time (TF):
10:10 am
10:10 am
10:10 am
10:10 pm
Final Reading (RF):
10.00"
10.00"
10.50"
9.50"
Test Duration (TF - Ti):
I Hour
I Hour
1 Hour
I Hour
Change in Reading (RF - Rj):
0.00"
0.00"
0.00"
0.00"
Pass /Fail Threshold or
Criteria:
0.0625"
0.0625"
0.0625"
0.0625"
Test Result:
X Pass ❑ Fail
I X Pass ❑ Fail
I X Pass ❑ Fail
X 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:
ti Cd, -
Date: 04/18/2012
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
Senser Key
1) TLS 350
2) VeederRoot Liquid Senser
3) VeederRoot ATG Probe
4) OPW -61 -SO OverFill Prevention
5) Red Jacket LLD
O
\V j
T 5 2
3
Lucky 7
726 South Union Avenue
Bakersfield, CA 93307
'V �
T 5 2
3
O
D
ME
O
2 2
5 5
` Ces,
'GGNKIAMU WIT+POLFIQC w
Invoice No: 28972
Repair Lo L.,
I replaced the drain valve in the diesel slave spill bucket. I also replaced the veederroot liquied senser in the
diesel slave STP sump.
"7 -dg " Required Repairs: .
Comments:
Updated 04 /19/06 TATT Team