HomeMy WebLinkAboutFMC RESULTS 2014MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of California
Authority Cited: Chapter 6. 7, 1/ealth 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: TMP Gas & Food Mart# 2 Bldg. No.: ____ _
Site Address: 2140 East Brundage Lane City: Bakersfield Zip: 93307 =.:::..=...:..__ __
Facility Contact Person: ...:T:...:o:..:n~y...:B=al:..__ _____________ Contact Phone No.: (818) 470-4788
Make/Model of Monitoring System: __ v....:e...:.e-"d...:.e.:....r--'-R.:....:o:....:o:...:t_T_L_S"""-...:.3...:.5-"0---------Date ofTesting/Servicing: 2/25/2014
B. Inventory of Equipment Tested/Certified
Check tbe appropriate boxes to indicate specific eouipment inspected/serviced:
Tank 10: 12,000 Gal Regular Tank 10: 12,000 Gal Su~er
18)In-Tank Gauging Probe. Model: 847390-107 18J in-Tank Gauging Probe. Model: 847390-107
I8J Annular Space or Vault Sensor. Model: 749390-407 18J Annular Space or Vault Sensor. Model: 749390-407
I8J Piping Sump I Trench Scnsor(s). Model: 794380-208 I8J Piping Sump I Trench Sensor(s). Model: 794380-208
18J Fill Sump Sensor(s). Model: 794380-208 18J Fill Sump Sensor(s). Model: 794380-208
I8J Mechanical Line Leal.. Detector. Model: FX1V l8l Mechanical Line Leak Detector. Model: FX1V
0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model.
18J Tank Overfill I High-Level Sensor. Model: OPW-61-SO l8l Tank Overfill I lligh-Level Sensor. Model: OPW-61-SO 0 Other (specify equipment type and model in Section E on Page 2). 0 Other (specify equipment type and model in Section Eon Page 2).
Tank 10: Tank ID:
0 In-Tank Gauging Probe. Model: 0 In-Tank Gauging Probe. Model:
0 Annular Space or Vault Sensor. Model: 0 Annular Space or Vault Sensor. Model:
0 Piping Sump I Trench Sensor(s). Model: 0 Piping Sump I Trench Sensor(s). Model:
0 Fill Sump Sensor(s). Model: 0 Fill Sump Sensor(s). Model:
0 Mechanical Line Leak Detector. Model: 0 Mechanical Line Leak Detector. Model:
0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model:
0 Tank Overfill I lligh-Lcvel Sensor. Model: 0 Tank Overfill I lligh-Level Sensor. Model: 0 Other (specify equipment type and model in Section E on Page 2). 0 Other (specif) equipment type and model in Section Eon Page 2).
Dispenser ID: 1&2 Dispenser ID: 3&4
I8J Dispenser Containment Sensor(s). Model: 794380-208 18J Dispenser Containment Sensor(s). Model: 794380-208
18J Shear Valve(s). 18J Shear Valve(s).
0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Conl!linmcnt Float(s) and Chain(s).
Dispenser 10: 5&6 Dispenser ID: 7&8
18J Dispenser Containment Sensor(s). Model: 794380-208 18J Dispenser Containment Sensor(s). Model: 794380-208
I8J Shear Valve(s). 18J Shear Valve(s).
0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s).
Dispenser 10: Dispenser 10:
0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model:
0 Shear Valve(s). 0 Shear Vnlve(s).
0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s). . . •Jfthe facility contains more tanks or d1spensers, copy thts form. Include mformauon for every tank and d1spenser at the fac1ltty.
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 a/It/tat apply): ~ System set-up ~ rm history report
Technician Name (print): -=B.:...ryz..:a:..::n..:....:...:A:...:S~e:::..:l~f _______ _
Certification No.: :B:..:3:..:.7.=:5.=:0...:.1 _____________ _
Testing Company Name: Confidence UST Services, Inc.
Site Address: 2140 East Brundage Lane Bakersfield, CA 93307 Date ofTesting/Servicing: 2/25/2014
Page 1 of 3
Monitoring System Certification
D. Results of Tes ting/Servicing
Software Version Installed: 329.0 I ~~~---------------------------
c h ~ II h kl" ompJ ete t e o owmg c ec 1St:
181 Yes 0 No* Is the audible alarm operational?
181 Yes D No* Is the visual alarm operational?
181 Yes D No* Were all sensors visually inspected, functionally tested, and confirmed operational?
DYes D No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will
not interfere with their proper operation?
DYes D No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem)
181 N/A operational?
181 Yes D No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment
0 N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate
positive shut-down? (Check all that apply) 181 Sumpffrench Sensors; 181 Dispenser Containment Sensors.
Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 181 Yes; D No.
181 Yes 0 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no
0 N/A 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? 90%
DYes* 181 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.
DYes* 181 No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)
D Product; D Water. If yes, describe causes in Section E, below.
181 Yes D No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable
181 Yes D 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. Comm ents:
Page 2 of 3
Monitoring System Certification
F. In-Tank Gauging I SIR Equipment: 12] Check this box if tank gauging is used only for inventory control.
D 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:
12] Yes D No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults?
12] Yes D No* Were all tank gauging probes visually inspected for damage and residue buildup?
12] Yes D No* Was accuracy of system product level readings tested?
12] Yes D No* Was accuracy of system water level readings tested?
12] Yes D No* Were all probes reinstalled properly?
12] Yes D No* Were all items on the equipment manufacturer's maintenance checklist completed?
* In the Section H, below, descnbe how a nd when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD): D Check this box ifLLDs are not installed.
Complete the followin!!: checklist:
12] Yes 0 No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance?
0 N/A (Check all that apply) Simulated leak rate: 12] 3 g.p.h.; D 0.1 g.p.h ; D 0.2 g.p.h.
12] Yes D No* We're all LLDs confirmed operational and accurate within regulatory requirements?
12] Yes D No* Was the testing apparatus properly calibrated?
12] Yes D No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
0 N/A
DYes D No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
12] N/A
DYes D No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled
12] N/A or disconnected?
DYes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions
12] N/A or fails a test?
DYes D No* For electronic LLDs, have all accessible wiring connections been visually inspected?
12] N/A
12] Yes D 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 3
FREEWAY CAS-LIQUORS 2140 E BRUNDAGE BAJ\ERSFIELD, CA 661-323-0254
FEB 25, 2014 8:42 AM
SYSTEM STATUS P.EPORT
ALL Flll~IOtS tlORr'J\L
ltNEtiTORY REPORT
T 2:91 VOLlt1E • 1649 GALS ULLAGE • 9878 GALS 90% ULLAGEa 8725 GALS TC VOLlt1E • 1634 CAts HEIGfrr • 17.80 lt~HES WATER VOL • 0 CAts WATER • 0. 00 lt~HES TEMP • 72.9 DEG F
T 3:87 VOLUME a 6437 GALS ULLAGE • 5090 GALS 90Y. ULLAGE• 3937 GALS TC VOLllt-1E " 6396 GALS HEIGfrr • 48.51 INCHES WATER VOL • 0 GALS WATER • 0.00 INCHES TEMP a 68.9 DEC F
SOFTWARE REVISION LEVEL VERSION 329.01
SOFTWARE~ 346329-100-B CREATED-09.01.29.15.44
S-MODULE~ 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL I ti-TANK TESTS ISO
SYSTEM SETUP
FEB 25. 2014 8:43 AM
SYSTEM UtiiTS u.s. SYSTEM LAtK:lJACE ENGLISH SYSTEM DATE/TINE FORMAT NON DO WYY HH:NM:SS )(N
FREEWAY CAS-LIQUORS 2140 E BRUNDAGE BAKERSFIELD. CA 661-323-0254
SHIFT TINE I SHIFT TINE 2 SHIFT TINE 3 SHIFT TIME 4
11 :00 F-tl DISABLED DISABLED DISABLED
TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED
LlfiE RE-ENABLE METHOD PASS LINE TEST
LINE PER TST NEEDED WRtl DISABLED LINE ANN TST NEEDED WRtl DISABLED
PRINT TC VOLU.'1ES ENABLED
TEMP COMPENSATION VALUE <DEG F >: 60,0 STICK HEIGHT OFFSET DISABLED ULLAGE: 90l'
H-PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVING TINE DISABLED RE-DIRECT LOCAL PRitiTOUT DISABLED
EURO PROTOCOL PREFIX s
SYSTEM SECURITY CODE : 000000
MAl NTENAII>'I! HISTORY DISABLED
TAtiK CHART SECURITY DISABLED
CUSTOM ALARMS DISABLED
SERVICE NOTICE DISABLED
ISO 3166 COUNTRY CODE:
MASS.tDEtiSITY DISABLED
C011MUtHCATIOtS SETUP
PORT SETTINGS:
COMM BOARD : I <EDIM > RS-232 SECURITY CODE : DISABLED
COMM BOARD : 2 <RS-232> BAUD RATE : 9600 PARITY : ODD STOP BIT : I STOP DATA LENGTH: 7 DATA RS-232 SECURITY CODE : DISABLED
COt'r1 BOARD : 3 <FXNOD> BAUD RATE : 2400 PARITY : ODD STOP BIT : I STOP DATA LENGTH: 7 DATA RS-232 SECURITY CODE : DISABLED DIAL TYPE : TOllE ANSWER ON : I Rl NG MODEN SETUP STRI tiC :
DIAL TONE ltiTERVAL: 32
AUTO TRANSMIT SETTINGS:
AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EXTERNAL. I tiPUT OFF DISABLED AUTO SENSOR FUEL. ALARM DISABLED AUTO SENSOR WATER ALAilM DISABLED AUTO SENSOR OUT ALARI1
DISABLED
RECEIVER SETUP:
NONE
AUTO DIAL TIME SETUP:
NONE
RS-232 EtiD OF MESSACE DISABLED
AUTO DIAL ALARM SETUJ>
IN-TAW: SETUP
T 2:91 PRODUCT CODE THERHAL COEFF TANK DIAMETER TANK PROFILE FULL VOL 67. 5 IIICH VOL 45.0 INCH VOL 22.5 INCH VOL
: 2 :.000700 90.00
4 PTS 11527
FLOAT SIZE:
WATER WARNING : HIGH WATER LIMIT:
MAX OR LABEL VOL! OVERFILL LIMIT : -.
HIGH PRODUCT
DELIVERY LIMIT
LOW PRODUCT : LEAK ALARM LIMIT:
9397 5857 2289
4.0 IN.
2.0 3.0
11527 90'/o 10374
95:: 10950
I~ 1383
SUDDEN LOSS LIMIT:
500 99 99 o.oo TANK TILT : PROBE OFFSET : o.oo
SIPHON HAtliFOLDED TAUKS Til: NONE LINE MANIFOLDED TANKS Til: NONE
LEAK MIN PERIODIC: .
LEAK MIN ANNUAL
w. 0
()Y.
0
PERIODIC TEST TYPE STANDARD
AtlNUAL TEST FAIL Al.ARH DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
AllN TEST AVERAGiflC: OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK!OFF
DELIVERY DELAY : 5 MIN PUMP THRESHOLD : I 0. OOY.
T 3:87 PRODUCT CODE THERMAL COEFF TAtiK DIAMETER TA~ PROFILE FULL VOL 67.5 INCH VOL 45,0 INCH VOL 22.5 INCH VOL
FLOAT SIZE:
WATER WARNING : HIGH WATER LIMIT:
MAX OR LABEL VOL: OVERFILL LIMIT :
HIGH PRODUCT ,
DELIVERY LIMIT
LOW PRODtx;T : LEAK ALARM LIMIT:
3 .000700 90.00 4 PTS 11527 9397 5857 2289
4.0 IU.
2.0 3.0
11527 90:~ 10374 95Y. 10950 127. 1383
SUDDEN LOSS LIMIT:
500 99 99 o.oo TANK TILT PROBE OFFSET o.oo
SIPHON MANIFOLDED TANKS Til: NONE LINE HAtllFOLDED TANKS Til! NONE
LEAK HIN PERIODIC:
LEAK Hltl ANNUAL : .
()Y.
0
PERIODIC TEST TYPE STAUDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAGING: OFF PER TEST AVERAG INC: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 5 MIN Pli1P THRESHOLD : IO.OOY.
LEAK TEST METHOD
TEST MONTHLY : ALL TANK WEEK I MOll START TIME : 12:00 AH
TEST RATE :0.20 CAL/HR DURATION : 2 HOURS
TST EARLY STOP!DISABLED
LEAK TEST REPORT FORMAT ENHANCED
LIQUID SENSOR SETUP
L I :87 STP SUMP TRI-STATE <SitiGl.E FLOAT> CATEGORY : SiP SUMP
L 2:91 STP Sll1P TRI-STATE <SINGLE FLOAT> CATEGORY : STP SltiP
L 3:87 FILL TRI-STATE <SINGLE FLOAT> CATEGORY : PIPltiG SltiP
L 4:91 FILL TRI-STATE <SINGLE FLOAT> CATEGORY : PIPING SUMP
L 5:DISP 1-2 TRI -STATE <S Jt.IGLE FLOAT) CATEGORY : DISPENSER PAN
L 6!DISP 3-4 TRI-STATE CSWGLE FLOAT> CATEGORY : DISPENSER PAN
L 7:DISP 5-6 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAtl
L 8!DISP 7-8 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAtl
L 9:87 ANNULAR TRI-STATE <SINGLE FLOAT> CATEGORY : AlltlULAR SPACE
LI0!91 ANNULAR TRI -STATE CSINGLE FLOAT> CATEGORY : ANIIULAR SPACE
OUTPUT RELAY SETUP
R I :DISP RELAY TYPE: STANDARD tlORMALLV CLOSED
TANK 11: 3
LIOUID SENSOR ALMS L I :FUEL ALARM L 2!FUEL ALARH L S!FUEL ALARM
L 6:FUEL ALARM L ?!FUEL ALARM L S:FUEL ALARH L I :SENSOR OUT ALARM L 2:SENSOR OUT ALARM L S:SEIISOR OUT ALARM L 6:SENSOR OUT ALARM L 7:SEIISOR OUT ALARM L S:SEIISOR OUT ALARM
ISO SITE ALAR11S ISO GROSS PRES FAIL ISO DEGRD PRES FAIL ISO VAPOR LEAK FAIL ISO VP PRES FAIL ISO VP STATUS FAIL
ISO HOSE ALARI1S ALL!GROSS COLLECT FAIL ALL !DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL
SMARTSEtiSOR SETUP
s 1:DISP 1-2 CATEGORY AIR FLOt~ HETER
:s 2:DISP 3-4 CATEGORY AIR FLOW METER
:s 3:DISP 5-6 CATEGORY AIR FLOW METER
s 4:DISP 7-8 CATEGORY AIR FLOW METER
:s S:VP SEtlSOR CATEGORY VAPOR PRESSURE
:s 6:CARBON CANISTER CATEGORY VAPOR VALVE
:s e:ATM PRESSURE CATEGORY ATM P SEtlSOR
EVR/ISO SETUP
EVR TYPE: BALAIICE
BALAIICE NOZZLE TYPE
VST
VAPOR PROCESSOR TYPE VEEDER-ROOT POLISHER
ANALYSIS TIMES TIME! 9:00 AM DELAY MINUTES :
ACCEPT HIGH ORVR: DISABLED
ISO HOSE TADLE ID FP FL HL AA RR
01 00 01 02 01 uu 02 01 02 02 01 uu 03 02 03 02 02 uu 04 03 04 02 02 uu 05 04 05 02 03 uu 06 05 06 02 03 uu 07 06 07 02 04 uu 08 07 08 02 04 UU
ISO AIRFLOW METER MAP ID SERIAL NUM LABEL ------------------------I 35011 2 34033 3 35513 4 32000
DISP 1-2 DISP 3-4 DISP 5-6 DISP 7-9
ISO FUEL GRADE HOSE MAP 1 2 3 4 FP HHH MHH HHH HHH AA ------------------------00 401 901 501 U U I 01 402 902 502 U U I 02 403 903 503 u u 2 03 404 904 504 u u 2 04 405 905 505 u u 3 05 406 906 506 u u 3 06 407 907 507 u u 4 07 408 908 508 u u 4
LABEL TABLE ------------------------I : UNASSIGNED 2: BLEND3 3: REGULAR 4: HID GRADE
5: PREMILt1 6: GOLD
7: BRONZE e: SILVER 9: BLEN02 10: BLEIID4
PMC SETUP
PMC VERSION: 01 .02
VAPOR PROCESSOR TYPE VEEDER-ROOT POLISHER
ALARM HISTORY REPORT
-----SVSTEM ALARM -----PAPER OUT DEC 12. 2013 5:27 PH PRitiTER ERROR DEC 12. 2013 5:27 PM
ALARM HISTORY REPORT
IN-TANK ALA21 -----
T 1:
)( loi M * )( EtlD )( )( ioi * )(
Al.AJ1M HISTORY REPORT
----I tl-TANK ALARM -----
T 2!91
LOW PRODUCT ALARM AUG 17. 2012 6!30 PM DEC 19. 2011 1:24PM
INVALID FUEL LEVEL APR 12. 2013 I :52 Pr-1 AUG 17. 2012 8:39 AM DEC 19. 2011 1:16PM
DELIVERY NEEDED FEB 14. 2014 6:02 PM FEB B. 2014 2:40 PM FEB 2. 2014 4:16 PM
K K K K M END K K K K M
ALARM HISTORY REPORT
----IN-TAtlK ALARM -----
T 3:87
OVERFILL A1..ARM JAtl 28. 2014 II :06 PM
JAtl 22. 2014 8:t6 AM JAN 17. 2014 2:13AM
LOW PRODUCT ALARM NOV 27. 2012 10!06 AM NOV 16. 2012 1!42 PM HAY 25. 2012 5:57 PM
HIGH PRODUCT ALARM JUN 17. 2013 11:03 PM MAY 22. 2013 10:31 AM APR 15. 2013 8:05 AM
INVALID FUEL LEVEL JAN 5. 2013 10:07 PM NOV 27. 2012 9:29AM
NOV 16. 2012 1!17 PM
DELIVERY NEEDED FEB 22. 2014 3!02 PM FEB 11. 2014 7:57AM NOV 22. 2013 8:51 PM
MAX PRODUCT ALARM DEC 19. 2011 8!23 AM
ALARM HISTORY REPORT
-----SENSOR ALARM -----L I :87 STP SUMP STP Sll1P FUEL ALARM JUN 4, 2013 2:32 PM
SETUP DATA WARNitlG HAY 15. 2013 6:06 PM
FUEL ALARM MAY 15. 2013 5:59 PM
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 2:91 STP SUMP STPSUMP FUEL ALARM FEB 25. 2013 10!16 AM
SENSOR OUT ALARM MAR 30. 2012 9!41 AM
FUEL ALARM MAR 30. 2012 9:15AM
M M M M M END M K K K M
ALARM HISTORY REPORT
-----SENSOR ALARr-1 -----
L 3:87 FILL PIP100 SUMP FUEL ALARM FEB 25. 2013 10:18 AM
FUEL ALARM
DEC 2. 2012 7:05 PM
SENSOR OUT ALARM MAR 30. 2012 9:41 AM
ALARM HISTORY REPORT
-----SEtiSOR ALARM -----L 4:91 FILL PIPING SUMP
FUEL ALARM
FEB 25. 2013 10!26 AN
FUEL ALARM FEB 25. 2013 10!24 AM
FUEL ALARM
FEB 25. 2013 10!22 AM
M M ~ X M E~D ~ ~ M M X
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 5!DlSP 1-2
DISPENSER PAN
SENSOR OUT ALARM FEB 25. 2013 10!40 AM
FUEL ALARH FEB 25. 2013 10:37 AH
SEtSOR OUT ALARM MAR 30. 2012 9!41 AN
M M M X M END M M M M K
ALARH HISTORY REPORT
-----SENSOR ALARM -----L .;:DISP 3-4 DISPENSER PAN
SENSOR OUT ALARM MAR 30. 2012 9!41 AM
FUEL ALARM MAR 30. 2012 9:39 AN
SEtiSOR OUT ALARM uov e. 2011 11 :12 AM
X K M II )( EtiD II lt ,.; II II
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 7:DtSP 5·6
DISPENSER PAN
FUEL ALARM FEB 25. 2013 10!36 AH
SENSOR OUT ALARM MAR 30. 2012 9!41 AN
FUEL ALARM MAR 30. 2012 9:35 AM
l( )( M )( l( E~D X )( )( M X
ALARM HISTORY REPORT
-----SENSOR ALARM -----L B:DtSP 7-B DISPENSER PAN FUEL ALARM FEB 25. 2013 10!35 AM
SENSOR OUT ALARM MAR 30. 2012 9!41 AM
FUEL ALARM MAR 30. 2012 9:33 AM
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 9!97 ANNULAR ANNULAR SPACE SENSOR OUT ALARM FEB 25. 2013 10!40 AM
FUEL ALARM
FEB 25. 2013 10:29 AM
SENSOR OUT ALARM MAR 30. 2012 9!41 AN
M M M K M END )( K M M )(
ALARM HISTORY REPORT
-----SENSOR ALARM -----L10 : 91 ANNULAR AIINULAR SPACE FUEl. ALAAI1 DEC JJ , 2013 1:29PM
SENSOR OUT ALARM DEC 9, 2013 11:06 AM
SENSOR OUT ALARM SEP 18, 2013 9:09 AM
-----SENSOR ALARM -----L10:91 AtlllULAR ANNULAR SPACE FUEl. ALARM FEB 25. 2014 9:11 AM
-----SENSOR ALARM -----L 9:87 ANNULAR AtlllULAR SPACE FUEL ALARM FEB 25. 2014 9:13AM
-----SENSOR ALARM -----L 9:87 ANUULAR ANNULAR SPACE FUEL ALARM FEB 25, 2014 9:13AM
FREEWAV GAS-LIQUORS 2140 E BRUNDAGE BAKERSPIEl!D, eA • 661 -323-0254
FEB 25, 2014 9:13AM
S\'STEM STATUS REPORT ------------L 9:FUEL ALARM
----SENSOR AUIRH -----L 2:91 STP SUMP STP SUMP FUEL ALARM FEB 25, 2014 9:20 AM
---SENSOR ALARM -----
1 I :87 STP Sll'IP
STP SUMP FUEl. ALARM FEB 25, 2014 9:22 AM
-----SENSOR ALARM -----L 3:87 FILL PIPING SltiP ' · FUEL ALARM FEB 25, 2014 9:23 AM
-----SENSOR Al.ARM -----1. 4:91 Fll.l. PIPltiG SLtlP FUEl. ALARM FEB 25. 2014 9:24 AM
---SENSOR ALARM -----1.10:91 AlltlUl.AR ANNULAR SPACE FUEl. ALARM FEB 25, 2014 9:25 AM
-----SEflSOR ALARM -----L 9:87 ANNULAR ANIIUI.AR SPACE FUEl. ALARM FEB 25, 2014 9:26 AM
----SENSOR ALARM -----L 9:87 ANNUI.AR ANNUI.AR SPACE FUEL ALARM FEB 25, 2014 9:26 AM
-----SENSOR ALARM -----L S:DISP 7-8 DISPEtiSER PAN FUEL ALARM FEB 25. 2014 9:29 AH
-----SENSOR ALARM -----L 7:DISP 5-6 DISPENSER PAN FUEL ALARM FEB 25. 2014 9:30 AH
-----SENSOR ALARM -----L 6!DISP ::J-4 DISPENSER PAN FUEL ALARM FEB 25. 2014 9:32 AH
-----SEtiSOR ALARM -----L S!DISP 1-2 DISPENSER PAN FUEL ALARM FEB 25. 2014 9:34 AM
-----SENSOR ALARM -----L 9!87 AtltiULAR AtltiULAR SPACE SENSOR Otrr ALARN FEB 25. 2014 9:35 AM
-----SENSOR ALARN -----LI0 :91 ANNULAR ANNULAR SPACE SENSOR OUT ALARM FEB 25. 2014 9:35 AN
-----SENSOR ALARM -----L l :87 STP SI.J1P STP SUMP SEtiSOR OUT ALARI1 FEB 25. 2014 9:36 AN
-----SElSOR ALARM -----L 2:91 STP Sl.t1P STP SUMP SEIISOR OUT ALARM FEB 25. 2014 9:36 AN
-----SENSOR ALARtl -----L 4!91 FILL PIPING Slt1P SEtiSOR OUT ALARM FEB 25. 2014 9:36 AH
-----SElSOR ALARM -----L 5:DISP 1-2 DISPENSER PAN SENSOR OUT ALARM FEB 25. 2014 9:36 AM
-----SEIISOR ALARM -----L 3!87 FILL PIPING SltlP SENSOR Olii' ALARM • FEB 25. 2014 9!3b ~1
-----SEtiSOR ALARM -----L 6!DISP 3-4 DISPErSER PAN SENSOR OUT ALARM FEB 25. 2014 9!36 AN
-----SElSOR ALARM -----L 7!DISP 5-6 DISPEtlSER PAN SENSOR OUT ALARM FEB 25. 2014 9:36 A11
-----SENSOR ALARM -----L 8!DISP 7-8 DISPEtlSER PAN SENSOR OUT ALARM FEB 25. 2014 9:36 AN
-----SENSOR ALARM -----LI0!9l ANNULAR ANNULAR SPACE FUEL ALARM FEB 25. 2014 10:19 AM
-----SENSOR ALARM -----L 9:87 ANNULAR • AtiNULAR SPACE FUEL ALARM FEB 25. 2014 10:21 AM
FREEWA'.' CAS-LIQUORS
2140 E BRUNDAGE BAKERSFIELD. CA 661 -323-0254
FEB 25. 2014 10:26 ~1
SYSTEM STATUS REPORT ------------ALL FUNCTIOIS NORMAL
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 regulato1y agency.
1. FACILITY INFORMATION
Facil ity Name: TMP Gas & Food Mart# 2 j Date ofTesting: 2/25/2014
Facility Address: 2140 East Brundage Lane Bakersfield, CA 93307
Facility Contact: Tony Bal I Phone: 818-470-4788
Date Local Agency Was Notified of Testing: 1/17/2014
Name of Local Agency Inspector (if present during testing): Ester Duran
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A Self
Credentials 1: [8] CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester 0 Other (Specify)
License Number(s): CSLB# 804904 ICC# 8022804-UT TT# 11-1756
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: [8] Hydrostatic 0 Vacuum 0 Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank 1 Regular 2 Super 3 4
Number, Stored Product, etc.)
Bucket Installation Type: 0 Direct Bury 0 Direct Bury 0 Direct Bury 0 Direct Bury
X Contained in Sump X Contained in Sump 0 Contained in Sump 0 Contained in Sump
Bucket Diameter: 12.00" 12.00"
Bucket Depth: 14.00" 14.00"
Wait time between applying 5 Min 5 Min vacuum/water and start of test:
Test Start Time (T1): 9:45am 9:45am
Initial Reading (R1): 8.50" 9.00"
Test End Time (TF): 10:45 am 10:45 am
Final Reading (RF): 8.50" 9.00"
Test Duration (T F-T1): I Hour I Hour
Change in Reading (RF-R1): 0.00" 0.00"
Pass/Fail Threshold or 0.0625" 0.0625" Criteria:
Test Result: X Pass 0 Fail X Pass O Fail 0 Pass O Fail 0 Pass D Fail
Comments-(include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFIC ATION OF T ECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING .
I hereby certify that a// the information contained in this report is tr14e, accurate, and in full compliance with legal requirem ents.
1 State laws and regulations do not curr ly require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
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