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Home My WebLink AboutFMC Results 2013 (North)MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifomia Authority Cited: Chapter 6. 7, llealth 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 tom1 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 Faciliry Name: Downtown Chevron (North) Bldg. No.: ____ _ Site Address: 2317 L Street City: Bakersfield, CA Zip: -'--93"--3_0_1 __ _ Facility Contact Person: Frank Sullivan Contact Phone No.: (661) 327-5008 Make/Model of Monitoring System: Veeder-Root TLS 350 Date ofTesting!Servicing: 11/13/2013 B. Inventory of Equipment Tested/Certified -'''-"'"' ""'-AtJ'I>"• v • """" VV•'"'.,;r o.v '"""'""·'"'"" ~ """'''"-"-"''"'' "'''"'''" '''"'V"'""'"'""I"'"' • '"'"'""' Tank 10: 12,000 gal. Regular Tank 10: 8,000 gal. Plus ~ In-Tank Gauging Probe. Model: 847390-107 ~ In-Tank Gauging Probe. Model: 847390-107 ~ Annular Space or Vault Sensor. Model: 794390-420 ~ Annular Space or Vault Sensor Model: 794390-420 ~ Piping Sump I Trench Sensor(s). Model: 794380-208 ~ Piping Sump I Trench Sensor(s). Model: 794380-208 0 Fill Sump Sensor(s). Model: 0 Fill Sump Sensor(s). Model: ~ Mechanical Line Leak Detector. Model: FX-1V ~ Mechanical Line Leak Detector. Model: FX-1V 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: ~ Tank Overfill I High-Level Sensor. Model: 847390-107 ~Tank Overfill I High-Level Sensor. Model: 847390-107 0 Other (specify equipment type and model in Section Eon Page 2). 0 Other (specify equipment type and model in Section Eon Page 2). Tank 10: 8,000 gal. Su~er Tank 10: 12,000 gal. Diesel ~ In-Tank Gauging Probe. Model: 847390-107 ~ In-Tank Gauging Probe. Model: 847390-107 ~ Annular Space or Vault Sensor. Model: 794390-420 ~ Annular Space or Vault Sensor. Model: 794390-420 ~ Piping Sump I Trench Sensor(s). Model: 794380-208 ~ Piping Sump I Trench Sensor(s). Model: 794380-208 0 Fill Sump Scnsor(s). Model: 0 Fill Sump Sensor(s). Model: ~ Mechanical Line Leak Detector. Model: FX-1V ~ Mechanical Line Leak Detector. Model: FX-1DV 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: ~ Tank Overfill I lligh-Lcvel Sensor. Model: 847390-107 ~ Tank Overfill I High-Level Sensor. Model: 847390-107 0 Other (specify equipment type and model in Section Eon Page 2). 0 Other (specifY equipment type and model in Section Eon Page 2). Dispenser 10: 13 & 14 Dispenser 10: 15 & 16 ~ Dispenser Containment Sensor(s). Model· 794380-208 181 Dispenser Containment Sensor(s). Model: 794380-208 ~ Shear Valve(s). ~ Shear Valve(s). 0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s). Dispenser 10: 17 & 18 Dispenser 10: 19 & 20 ~ Dispenser Containment Sensor(s). Model: 794380-208 ~ Dispenser Containment Sensor(s). Model: 794380-208 181 Shear Valve(s). ~ Shear Valve(s). D 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 Valvc(s). 0 Shear Valve(s). 0 Dispenser Containment Float(s) and Chain(s). 0 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 facilny. C. Certification -1 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 equirlment. 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): Bradley Seykora Signature:~.L-~~::::::::...-__,.-;¥-""';;:2,!P..---====------- Certification No.: B40738 License. N~---=.80=-4..:..:9:..:0:....4:.._ ____________ _ Testing Company Name: Confidence UST Services, Inc. Phone No.: ~C8:..:0:..:0:.L)_.:3:..:3:.:9:._-9::..:9:..:3:.:0:.__ ____ _ Site Address: 2317 L Street, Bakersfield, CA 93301 Date ofTesting!Servicing: 11/13/2013 Page 1 of 3 I Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: .....::.3::.29::..:·~0:::.0 _____________ _ c -~ ~--he foil heckr '~'"· 181 Yes 0 No* Is the audible alarm operational? 181 Yes D No* Is the visual alarm operational? 181 Yes 0 No* Were all sensors visually inspected, functionally tested, and confirmed operational? 181 Yes 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 0 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 D 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 Sump/Trench Sensors; 181 Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 1:81 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. 181 Yes* D No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) D Product; 181 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. Comments: small amounts of water and debris were removed from all STP sumps. Page 2 of 3 Monitoring System Certification F. In-Tank Gauging I SIR Equipment: 181 Check this box if tank gauging is used only for inventory control. 0 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: 181 Yes 0 No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? 181 Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? 181 Yes 0 No* Was accuracy of system product level readings tested? 181 Yes 0 No* Was accuracy of system water level readings tested? 181 Yes 0 No* Were all probes reinstalled properly? 181 Yes 0 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): 0 Check this box if LLDs are not installed. c Jete the foil heckl· 181 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: 181 3 g.p.h.; 0 0.1 g.p.h ; 0 0.2 g.p.h. 181 Yes 0 No* Were all LLDs confirmed operational and accurate within regulatory requirements? 181 Yes 0 No* Was the testing apparatus properly calibrated? 181 Yes 0 No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 0 N/A 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut offifthe LLD detects a leak? 181 N/A 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled 181 N/A or disconnected? 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions 181 N/A or fails a test? 0 Yes 0 No* For electronic LLDs, have all accessible wiring connections been visually inspected? 181 N/A 181 Yes 0 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 ~fiD~+, 0 (' ~usr ~C£5,~ •ccw.ch.JAMOC w""' ~nooK~ Leak Detector Test Results Sheet Customer Address: Work Order: 31588B Site Address: Sully's Food Store LLC 1000 Truxtun Avenue Bakersfield, CA 93301 Test Date: 11/13/2013 Downtown Chevron (North) 2317 L Street Bakersfield, CA 93301 Site Contact: Frank Sullivan Phone: 661-327-5008 Technician: Bradley Seykora Phone: 800-339-9930 ICC No.: 8111231 Product Type LLD Type Model Serial No. Check Bleed Leak Valve Off ML. Rate Holding Tested: Pressure Regular UNL Mechanical FX1V N/A 14 PSI 50ml 3gph@ 10 psi Plus UNL Mechanical FX1V N/A 16 PSI 75 ml 3gph@ 10 psi Premium UNL Mechanical FX1V N/A 12 PSI 35 ml 3gph@ 10 psi Diesel Mechanical FX1DV N/A 16 PSI 110ml 3gph@ 10 psi 3gph@ 10 psi 3gph@ 10 psi 3gph@ 10 psi 3 gph@ 10 psi Technician Name: B~ Technician No.: Signature: Date: / 8111231 11/13/2013 Pass/Fail Pass Pass Pass Pass i I I DOWIITOWI{ C~·~ROII flO. 2317 L ST. BAKERSFIELD.CA t~V 13. 2013 12:43 PH SYSTEM STATUS REPOP.T ALL FUNCTIONS NORI1AL INVENTORY REPORT T I :PLUS VOLUME " 3273 Gfo\LS ULLAGE • 4756 GALS 90l: ULLAGE• 3953 GALS TC VOLUHE • 3240 GALS HEIGHT • 51.26 IIICHES WATER VOL • 0 GALS WATER • 0.00 ltlCHES TEMP • 74.1 DEC F T 2:UNLEADED VOLLt1E .. 69?6 .:Ofo\1.:.; ULLACE • 5118 GHLS 9DY. ULLAGE• .:1913 GALS " TC VOLUME • 6860 GALS HEIGHT • 67.09 INCHES WATER VOl. • 0 GALS WATER • 0.00 INCHES TEl1P • 73.6 DEC F T 3:SUPREME VOLl.t1E D 4251 GALS ULLAGE • 3778 GALS 9!r.: UllAGE• 2975 GALS TC VOLUME • 41 99 GALS HEIGHT • 62.79 ltiCHES WATER VOL • 0 GALS WATER • 0.00 INCHES TEMP • 77.4 DEG F T t~:DIESEL VOLI..t1E " 4073 GALS UllAGE • 7971 GALS 90l: ULLAGE• 6766 GALS TC VOLUME " 4039 GALS HEIGHT • 44.57 INCHES WATER VOL • 0 GALS WATER • 0.00 INCHES TEMP • 78.0 DEC F X X X ~ X EIID ~ ~ X M M . .... "' . -. SOF1WARE REVISIOtl LEVEL VERSION 329.00 SOFTWAREP 346329-100·A CREATED -08.10.09.17.08 S-MODULEP 330160-004-a S'ISTEM FEATURES: PERIODIC 111-TA!ll\ TESTS ANNUAL IN-TANK TESTS ISO SYSTEH SETUP NOV 13. 2013 12:44 PM SYSTEI'I Utll iS u.s. SYSTEr1 LANGUAGE ENGLISH SYSTEM DATE/l"IME FO~T MON DD WY't HH:MH:SS >-H Dourrrowu CHEVROU uo. 2317 L ST. BAl\ERSFIELO.CA SHIFT TINE I DISABI.EO SHIFT TIME 2 DISABLED SHIFT TIHE 3 DISABI.ED SHIFT TIME 4 DISHBI.ED TAW.: PER TST NEEDED WRN DISABLED TAtll: ANN TST NEEDED ~JRN DISABLED LINE RE·ENABLE METHOD PASS LINE TEST LINE PER TST IIEEDED WP.II DISABLED LitlE ANN TS'r NEEDEJ'\ WRN DISABLED PRIUT TC VOLUMES ENABLED TEMP COI1PEUSATION VALUE <DEC F ): 60,0 STICK HEIGHT OFFSET DISABLED ULLAGE: 90:~ H-PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVI tlo:: TIME ENABLED ... ...-grfiRT· DATt; -• MAR WEE!: 2 SUtl START TIME 2:00 1'.11 EtiD DATE NOV WEEJ: 1 SUtl END TIME 2:00 AM RE-DIRECT L<X·I\L PRitn"OUT DISABLED EURO PRO"COCOL f'P.EFIX s SYSTEtl SECURITY CODE : 000000 11Altll'EI~t¥;E HISTORY DISABLED TAN~ CHART SECURITY DISABLED CUSTOM ALARMS DISABLED SERVICE tiOTICE DISABLED ISO 3166 COUIITRY CODE: HASS/DEtlSITV £1ISABLED 1 ~~~N~C~T~Ofl~ :~u~ __ POIIT SETTWGS: COHM BOARD : I <£DIM ) RS-232 SECURITY CODE : DISABI.ED COMM BOARD : 2 <RS-232> BAUD RATE : 9600 PARITY : NONE STOP BIT : I STOP DATA LEN~H: 8 DATA RS-232 SECURITY CODE : DISABLED CCMM BOARD : 0 <FXMOD> BAUD RATE : 2<100 PARITY : ODD STOP BIT : I STOP DATA LE~-rH: 7 DATA RS-232 SECURITY CODE : DISABLED DIAL TYPE : TONE AIISWER ON : I Rl tlG MODEM SETUP STRING : DIAL TOllE INTERVAL: 32 AUTO TRANSMIT SETTIIK:S: AUTO LEAl{ ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELI\IEP.Y START DISABLED AUTO DELIVER'/ EtlO DISABLED AUTO EXTERNAL INPUT Otl DISABLED AUTO EXTERllAL I tiP liT OFI-' DISABLED AUTO SENSOR FUEL ALARM DISMBLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARrl DISABLED RECEIVER SETUP: NONE AUTO DIAL TINE SI:."TUP: tiOtlE RS-232 EUO OF MESSAGE DISABLED AUTO DIAL ALAPJI SETUP IN-TAN.: SETUP T 1 :PLUS PRODUCT CODE THERMAL COEFF TAll.: DIAMETER TAllY. PROFILE FULL VOL : I :.000700 120.00 I PT 8029 FLOAT SIZE: 4.0 IN. WATER WARNING : HIGH WATER LIMIT: MAX OR LABEL VOL: OVERFILL LIMIT : HIGH PRODUCT DELIVERY LIMIT LOW PRODUCT : LEAY. ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT PROBE OFFSET 2.0 3.0 13029 9W. 7226 95% 7627 IW. 802 500 99 50 0.60 o.oo SIPHON MANIFOLDED TAtn:S Til: NONE LitlE HAIHFOLDED TAN.:S Til: NOliE LEAK MIN PERIODIC: LEAl! HIN AtiiiUAL : PERIODIC TEST TYPE ANtlUAL TEST FAIL 10% 802 10~ 802 QUICK ALAPJ1 DISABI.ED PERIODIC TEST FAIL ALARM DISABLED CROSS TEST FAIL ALARM DISABLED AtiN TEST AVERAGIIIC: OFF PER TEST AVERAGING: OFF TAflK TEST NOT! FY: OFF TNl: TST SIPHON fiRI:AK:OFF DELIVERY DELAY : I Mill PUMP THRESHOLD : IO.OOY. T 2:UJlLEADED PRODUCT CODE THERMAL COEFF TAtn: DIAMETER TAtll: PROFILE FULL VOL FLOAT SIZE: WATER WARIU tlG : HIGH WATER LIMIT: 2 .000700 120.00 I PT 12044 4.0 IN. 2.0 3.0 MAX OR LABEL VOL 120.:14 OVERFILL LIMIT 90Y. 10839 IIIGH PRODUCT 95!~ 11441 DELIVERY LlHIT lOY. 1204 LOW PRODUCT : 500 LEAl: ALARM LIMIT: 99 • SUDDEN LOSS LIHIT: 50 TAll~ TILT : 0.00 PROBE OFFSET : 0.00 SIPHON MANIFOLDED TAtlKS Til: !lONE LINE MANIFOLDED TAIIKS Til: NONE LEAK MIN PERIODIC: LEAl~ HI tl ANUUAL : PERIODIC TEST TYPE ANNUAL TEST FAIL JW. 1204 10'4 1204 QUICK ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED CROSS TEST FAlL ALARM DISI\BLEO AWl TEST AVERACltlG: OFF PER TEST AVERAGltlG: OFF TANI~ TEST NOTIFY: OFF TNK TST SIPHON BREAI::OFF DELIVERY DELAY : I t-IW PlJ1P THRESHOLD : lO.OOY. T 3:SUPREME PROOlJ\.."1' CODE THEP.MAL COEFF TANK DIAMETER TANK PROFILE FULL VOL FLOAT SIZE: WATER WARUING : HIGH WATER LIMIT: HAX OR LABEL VOL: OVERFILL LIMIJ : HIGH PRODUCT DELIVEP.Y LIMIT LOW PRODUCT : LEAY. ALARM LIMIT: 3 .000?00 120.00 I PT 8029 4.0 ltl. 2.0 3.0 8029 go:~ 7226 9~: 7627 lOY. 802 500 SUDDEN LOSS LIMIT: 99 99 0.96 0.00 TAtiK TILT : PROBE OFFSET SIPHON NAtUFOLDED TAtiY.S Til: NONE LINE MANIFOLDED TANKS Til: NONE ~ MW PERIODIC: 10:~ : 802 LEAK MIN AtHWAL : 10:~ 802 PERIODIC TEST TYPE STAtiDnRD ANNUAL TEST FAIL ALARM DISH9te0 PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISnBLED ANti TEST AVERAGING: OFF PER TEST AVERAGitlG: OFF TAtlK TEST IK>TI FV: OFF TNI: TST SIPHON BREAl::OFF DELIVERY DELAY : I MIN PUI1P THRESHOLD : 10.0~: T 4:DIESEL PRODUCT CODE THERMAL COEFF TANK DIAMETER TANI: PROFILE FULL VOL FLOAT SIZE: WATER WARNING : IIIGH lJATER LIHlT: MA~ OR LABEL VOL: OVEP.FILL LIMIT : HICH PRODUCT DELIVERY LIMIT LOW PRODUCT : LEAK ALARM LIMIT: 4 ,000ol50 120.00 I PT 12044 4.0 IN. 2.0 3.0 12044 9W. 10839 95Y. 11441 lOY. 1204 1200 99 SUDDEt~ LOSS LIMIT: 99 1.60 o.oo TANK TILT PROBE OFFSET SIPHON MANIFOLDED TAN}:S Til: NONE Ll NE MANIFOLDED TAt~l:S Til: IIOtiE ~ MIN PERIODIC: 10:: : 1204 LEAl~ Mlfl AtHHJAL : IW. 1204 PERIODIC TEST ~/PE STAtlDARD AWWAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED CROSS TEST-FAIL ALARM DISABLED ANti TEST AVERAGING: OFF PER TEST AVERAC II~: OFF TAIIK TEST NOTIFY: OFF Tt~K TST SIPHOII BREAK:OFF DELIVERY DELAY : I MIN PUMP THRESHOLD : IO.OOY. LEAK TEST METHOD ------------TEST ON DATE : ALL TAtll: OCT 9. 2008 STAP.T TINE : DISABLED TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT NORMAL LIQUID SENSOR SETUP L I :89 STP TRI-STATE <SI tlCLE FLOAT> CATEGORY : STP SU!1P L 2!89-87 Alltl TRI-STATE <SINGLE FLOAT> CATECORV : ANilULAR SPACE L 3!87 STP TRI-STATE <SINGLE FLOAT> CATEGORY : STP SUMP L 4:91 STP TRI-STATE <SWGLE FLOAT> CATEGORY : STP SIJ'1P 1. s:DsL STP TRI-STATE <SINGLE FLOAT> CATEGORY : STP SUMP L 6!91 DSL ANII TRI-STATE <SIIIGLE 1-'LOHT> CATEGORY : ANNULAP. SPACE L 7:PArl 13-14 TRI-STATE <SIIIGLE FLOAT> CATEGORY : DISPENSER PAU 1. S:PAtl 17-18 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAt~ L '3 !PAll 19·20 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAN LIO!PAU 13-14 NORMALLY CLOSED CATEGOP.'l' : DISPEtiSER PAN OUTPUT RELAY SETUP R 1 :POS SHUTOFF TYPE: STANDARD NORMALLY CLOSED TANK 11: LIQUID SENSOR ALMS L I :FUEL ALARM L 3:FUEL ALARM L 4:FUEL ALARM L 5:FUE!. ALARH L 7:FUEL ALARM L 8:FUEL ALARM I. 9:FUEL ALARM LIO:FUEL ALARH L 1 :SEtlSOR OUT ALARM L 3:SEtiSOR OUT Al.f\RM L 4 :SENSOR OUT ALARM L 5 :SENSOR OUT ALARM L 7 :SENSOR OUT ALARM L 8:SEtlSOR OUT ALARH L 9:SENSOR OUT ALARH LIO:SENSOR OUT ALARM L I :SHORT ALARM L 3:SHORT ALARr1 L 4 :SHORT ALARt-1 L 5:SHORT ALARM L 7 :SHORT ALARM L 8 :SHORT ALARM L 9:SHORT ALARM Ll O:SHORT ALARM lSD SITE ALARMS ISO GP.OSS PRES FAIL ISO DEGRO PRES FAIL lSD VAPOR LEAK FAIL ISO VP PRES FAIL lSD VP STATUS FAIL ISO HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL R 2:0VERFILL ALARM TYPE: STANDARD tlORHALLY OPEN TANK 11: NONE I N~Ti\Nl: ALARMS ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM ALL:HAX PRODUCT ALARM SMARTSENSOR SETUP :s 1 :rn 13-14 CATEGORV AIR FLOW METER :s 2:FH 15-16 CATEGORV AlP. FLOW METER s 3:FM 17-18 CATEGORY AIR FLOW 11ETER ~ 4:FI'1 19-20 CATEGORY AIR FLOW t1ETER s e:ps 19-20 CATEGORV VAPOR ~RESSURE EVR/ISD SETUP EVR TYPE: VACUil'1 ASSIST VACUUM ASSIST TYPE HEALV WV:; NOZZLE A/L RANGE MAX: 1.15Mltl: 0.95 VAPOR PROCESSOR TYPE NONE AtlALVSIS TIMES Tl~1E: 10:00 AM DELAY MINUTES: ACCEPT HIGH ORVP.: DISABLED lSD HOSE TABLE ID FP FL HL AA RR ------------------------01 00 13 02 01 uu 02 01 14 02 01 uu 03 02 15 02 02 uu 04 32 16 02 02 uu 05 17 17 02 03 uu 06 18 18 02 03 uu 07 19 19 02 04 uu 08 20 20 02 04 uu ISO AIRFLOW HETER HAP ID SERIAL Nlt1 LABEL. I 23386 2 57567 3 22219 4 22221 FH 13-14 FM 15-16 FH 17-18 FH 19-20 ISO FUEL GRADE HOSE HAP I 2 3 4 FP NH~ MHH HHH MHH AA ------------------------00 001 101 201 3 U I 01 002 102 202 3 u 1 02 003 103 203 3 u 2 03 0 u 2 u 1 u u u 0 04 2 U 0 U I U U U 0 05 0 u 2 u 1 u u u 0 06 2 U I U 0 U U U 0 .07 2 U I U 0 U U U 0 08 2 u 0 u 1 u u u 0 09 2 u 0 u 1 u u u 0 10 2 U I U 0 U U U 0 11 2 U 0 U I U U U 0 17 005 105 205 3 u 3 18 006 106 206 3 u 3 19 007 107 207 3 u 4 20 008 108 208 3 u 4 32 004 104 204 3 u 2 33 2 u 1 u 0 u u u 0 34 2 u 1 u 0 u u u 0 35 2 u 0 u 1 u u u 0 LABEL TABLE 1 UNASSIGNED 2 BLEN03 3 REGULAR 4 MID GRADE 5 PREM!lti 6 GOLD 7 EROtiZE 8 SILVER 9 BLEtiD2 10 BLEN04 · PMC SETUP PMC VERSION: 01.02 VAPOR PROCESSOR TYPE NONE PROCESSOR COttrROL LEVEL: NONE ALARM HISTORY REPORT -----SENSOR ALARM -----L I :89 STP STP SUMP * x * * l< END )( l< l< l< l<i ALARM HISTORY REPORT -----SENSOR ALARM -----L 2:89-87 ANtl AtltiUtAR SPACE l< M jo( M M END M M l< * M AlARI'I HISTORY REPORT -----SEtiSOR ALARM ----- 1. 3:87 STP STP SLt1P · * * M l< * END l<i l<i l< * M ALAP~ HISTORY REPORT -----SENSOR ALARM -----L 4:91 STP STP Sll1P * * M * M END * M M * * ALARM HISTORY REPORT -----SENSOR ALARM -----L S:DSL STP STP SUMP * * l< * l< END l< * M l<i l< AlARM HISTORY REPORT -----SENSOR ALARM -----L 6:91 DSL ANN AlltlUtAR SPACE )( ~ M )( l<i END A l< l< l< M AlARM HISTORY REPORT -----SENSOR ALARM ----- L ?:PAN 13-14 DISPENSER PM M )( )( jo( )( END )( )( )( jo( )( ALARM HISTORY REPORT -----SENSOR ALARM -----L S:PAN 17-18 DISPENSER PAU l< M l< l< l<i END A l< jo( l< )( ALARM HISTORY REPORT -----SENSOR ALARM L 9:PAN 19-20 DISPENSER PAN ~ ~ M ~ ~ END M M X M ~ ALA'RH HISTORY REPORT -----SENSOR ALARM -----LIO:PAtl 13-14 DISPEflSER PAN JoE JoE M * I( EflD ~ ;..: J( :.~ * ARCIIIVE UTILITY SAVE SETUP DATA: START TIME: NOV 13. 2013 12:53!58 PM \. ARCHIVE UTILITY SI\VE SETUP DATI\: END TIME: NOV 13. 2013 12:55!45 PM BYTES : 13695 ~ .1:\ • . ... .. ,. ..... ~,. -----SEtiSOR ALARM ----..: L 4!91 STP STP SUMP .,;." FUEl. ALARM "· NOV 13. 2013 1:10 ~1 •' -----SEflSOR ALARM -----L 1:89 STP STP Slt1P FUEL ALARM NOV 13. 2013 1:14PM OOWtlTOWN CHEVROtl NO. 2317 L ST. BAKERSFIELD. CA NOV 13. 2013 1!15 PH sYSTEM ~ATUS .~Ef-ORT i: I :f.~~iAPJ1-.----- T .t:PLUS I II\IEIITOR'/ IIICREASE !!\'CREASE START tlq;.' 13. 2013 t:I31'H ~OLUNE HEIGHT WATER :TEMP " 6921 GALS M 96.52 INCHES M o.oo WCHES M 80.9 DEC F ·Jt.CREAsE EIID fiOV 13. 2013 I !16 Pt1 VOl.IJ1E HEIGHT WATER TEMP M 7003 CAl.S • 97.74 INCHES M o.oo INCHES • 81.5 DEC F GROSS lt.CREA.c;E- 1'C llET n.CREASEa ~ 82 78 -----SErSOR ALARM -----L .I :99 STP STP SUMP FUEL ALARM NOV 13. 2013 1:17 PH ----SEfiSOR ALARM -----L.3:87 STP STPSUNP FUEL ALARM NOV 13. 2013 1:20PM ~ ; -~---SENSOR AI.ARM -----.L ·s:ost. STP· 6TP SI.I1P • FUEL AI.ARM . ~V I_?; 2013 _ 1.:23 PN .. .l ---ltl-TAUI~ ALARM ----- '1' 4:DIESE1. HIGH PRODUCT ALARM NOV 13. 2013 1:25 PN I U-TAtlK ALARM ----- T 4:DIESEt OVEP.F ILL ALARM rrov 13. 2013 1:26PM ·'· ----.SENSOR ALARM ----- t 8:PAN 17-18 DISPENSER PAll FUEL ALARM ~NOV 13 •. 2013 ., 1 :26 Pt1 • ,P, ;)\ '. ~~~ . ~.. . . ,, ~ · . . I 1-<l:DIESEt . l INEtffORV I r..-;REASE ~;~~~R~E START -NOV :13 •. 2013 I :25 PM ~vox.lk • 9289 GALS ;HEIGHT. • 86.45 WCHES '.WATER ·.. • 0.00 ltlCHES :TEt1P • 83,0 DEt:; F . ' i. IHCREAS!; EIID }:NoV 13.~ 2013 I :27 PN ~~~LU1E. • 11495 GALS 'HEIGHT • cJ09.05 INCHES (.,WATER • • 0.00 INCHES 'TEMP " 82 • B DEC F l ; J, CRQSS I UCREASE• 2207 :·TC NET INCREASE• 2186 t. t' ~j ~ ·, ~ -· ;~--~IN-TANK ALARM : T 2: UNLEADED OVERFILL ALARM I NOV 13.· 2013 I :27 PM :\ 1" J· . .:: ' ~- ·~ "1 ..:---.I U-TAIIY. ALARM ----tr 2: Ut«:EADED ·HIGH PRODUCT ALARM ~v 13. 2013 1:29PM ... .. ~- ;_ . i t , ~ .\ . . '& ,,! ,.:j.:.:--I N-THNI~ ALARM -----Vt> 2:lll1L'EADED ~OBE:OUT ~ov. 1~. 2013 t:3o PM . . .. 1' .: . .. ...... !-' . -/. ~ \ -1 • : -i·---J'ti· TANK ALARM -----.'·T· 4:DIESEL .~ROBE;otir 7~V 13.12012 t:31 PH ~ t~ ,J :::· .! ! . '-! :-. (> I • '£,( •· -~--. ~-~----SElSOR ALARt1 ~l! 9:PAN 19-20 ~DISPENSeR PAtl ~.FUEL (iLARH )';.tiqV 1:_} •. 2013 1 :31 PH ·.-.; :': ... : , __ • t ~ t ,, t·~ I, z • . :. . "" I .,. . I t i . oT 2:UNLEADED ~ I t~EtffORV INCREASE ~{ . ,,·E 5TART j'l ·'·!f.$:. 2013 I :27 PM. . . 'u1E • 8926 GALS ~.~ fff.· • 03.33 INCHES . ' ~ . • 0 .llll ttlCHES - ; ' • 83.9 DEC F :f\&isE END ~~iJ~: 2013 1 !32 PM V.Ql_~E-· " 11505 GALS }.~f:·JGW.:" •109.17 INCHES j WATER~-· • 0.00 HlCHES ~:·1~P ~\ • 83.7 DEC F i: t ~ ··. ·~ ~/.tGROsSiltiCREASE• 2579 fi1Q NETf-1 NCREASE.. 2538 ;: J !J :· • ~ ·,. ..... l-:-.•• ~ ll• .•:.: 'I ~·. 1, • ~ IF . ''f .. . ·\ . ·' ll ,, · lr .! --~ f~-TAfll~ ALARM -----~~:P.CU3 {.. ~H·PP.ODUCT ALARM ·'· ... J;l, 2013 1:33 PH ~-.:,· \ ·ir f).:~ ~ 1,'· •f, ~ !f: ·' \:• '•": ~ .:: • "'·;t:("' " . . ·:-... r-.• '( ; • •:•. ~, ~-!. •. :., .... .,,._} . • -~~~t~-TANK ALAPJI -----'F St:: [ltUS 1.-0VERfi'JLL ALARM ~NOV. ·1~-. 2013 I :33 PH .. . ... ., . f1~ ~f ;':~ lt' ~r ~l· ~·;·\~ t-TANh ALJ\RI1 --··-- .3:SIJPREME ' GH 'RROOUCT ALARM v_ 1!3.~ 2013 1 ::1<1 PH ·;. • ''!!!' ' 't~ f\: ~~ ·." !f.i ~(.i ... :j. :-~ '"'J I .. ·i!~·~·, . x.l• ~,:~-.:. ENSOR ALARM ~::4.:P. II 13-14 @'lf;jPE ER PAN gUEL'A (~~[ •. , ~ 2013 I :35 PH [~· ... \~ . ~·\ .. ·1'~.:.'; __ SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors petforming annual testing ofUSTspi/1 containment structures. The completedform and printouts from tests (if applicable), should he provided 10 the.faci/ity owner/opera/Or .for submittal to the local regulat01y agency. 1. FACILITY INFORMATION Facility Name: Downtown Chevron (North) I Date ofTesting: 11/13/2013 Facility Address: 2317 L Street, Bakersfield, CA 9330 I Facility Contact: Frank Sullivan I Phone: 661-327-5008 Date Local Agency Was Notified ofTesting: I 0/31/2013 Name of Local Agency Inspector (ifpresent during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Bradley Seykora Credentials 1: I8J CSLB Contractor I8J ICC Service Tech. 0 SWRCB Tank Tester 0 Other (Specify) License Number(s): CS LB# 804904 ICC# 8111231-UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: I8J Hydrostatic 0 Vacuum 0 Other ! Test Equipment Used: Lake Test Equipment Resolution: 0.0625" ... Identify Spill Bucket (By Tank 1 Regular 2 Plus 3 Super 4 Diesel ! Number, Stored Product, etc.) Bucket Installation Type: 0 Direct Bury ~ Direct Bury r Direct Bury 0 Direct Bury I8J Contained in Sump I8J Contained in Sump 18JContained in Sump 18JContained in Sump Bucket Diameter: 12.00" 12.00" 12.00" 12.00" Bucket Depth: 11.75" 12.25" 12.00" 12.25" Wait time between applying 5 min. 5 min. 5 min. 5 min. vacuum/water and start of test: Test Start Time (T1): 1:00pm 1:00pm 1:00pm 1:00pm Initial Reading (R1): 6.50" 7.00" 7.50" 8.75" Test End Time (T F): 2:00pm 2:00pm 2:00pm 2:00pm Final Reading (RF): 6.50" 3.50" 7.50" 8.75" Test Duration (TF-T1): I hour I hour I hour I hour Change in Reading (RF-R1): 0.00" 3.50" 0.00" 0.00" Pass/Fail Threshold or 0.0625" 0.0625" 0.0625" 0.0625" Criteria: Test Result: IBI Pass OFail 0 Pass IBI Fail I8J Pass 0 Fail I8J Pass 0 Fail --------·- Comments-(include information on repairs made prior to testing. and recommended[ollow-upforfaile_cjtests) The 89 Grade OPW fi I I so ill bucket failed during testing and needs to be reo laced. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING 1 hereby certify that all the information contained in this report is true, accurate, am/ in full compliance with legal requirements. Technician's Signature: ~S~==========----~ Date: II /13/20 13 ____ _ 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. Do w n t o w n Ch e v r o n (N o r t h } 23 1 7 L St r e e t Ba k e r s f i e l d . CA 93 3 0 1 0 @ 0 o e Q 1 = Ve e d e r Ro o t ti S - 35 0 2= Ex t e m a l Ov e r f i l l Al a r m 3= Em e r g e n c y Sh u t Of f Sw i t c h 4= Ve e d e r Ro o t A T G Pr o b e 5= Ve e d e r Ro o t 20 8 Su m p Se n s o r 6= Ve e d e r Ro o t 42 0 An n u l a r Se n s o r 7= Re d Ja c k e t FX 1 V Le a k De t e c t o r 8= Re d Ja c k e t FX 1 DV Le a k De t e c t o r 9= 12 0 0 0 Ga l l o n Re g u l a r ST P Su m p 10 = 80 0 0 Ga l l o n Pl u s ST P Su m p 11 = 80 0 0 Ga l l o n Su p e r ST P Su m p 12 = 12 0 0 0 Ga l l o n Di e s e l ST P Su m p 13 = Re g u l a r OP W DB Sp i l l Bu c k e t 14 = Pl u s OP W DB Sp i l l Bu c k e t 15 = Su p e r OP W DB Sp i l l Bu c k e t 16 = Di e s e l OP W DB Sp i l l Bu c k e t ~f\D~+. CJo (I~ \UST¥ \S' ~-"liuc1\0 ~f\D~+. CJo ~ ~UST(J. '+,CES•~ Job Order /Invoice #: :315&8~ Date Called nme To Whom "8UILO WITH CONFIDENCE" "C()W'I.IANCE WITH COHAOENCE" Lic.970703 Lic.804904 Toll Free #: 1-800-339-9930 Name: Confidence UST Site Name: S. }fy ~ cL,vro~ ( N{)rJL) I Street: 16250 Meacham Road Street: 2 3 I 7 L S'~l"p City: Bakersfield CA 93314 City:-~c-lt.,rs...C'c frJ State: I' ,4-Zip: ?S'3o I I Terms: Store No: Description of work performed: I ! "t>uri~r ne, u,...r, -~,.~r r,rJr·:t;.;...J..;, ... 1 ·~ .k 9 .A-,..-r~ h aPt.J ! /",'// ~,~/ rBt.;-~J--Ft;,"k~ ~<J,./ A -k f~Ci>k. -.Pl. t:7 v I 1? .......... v-..P .Jr~L /-A. _/ ~ /.r,s J).,."',_ < // ~JP S,Atv.~S --,- I I TRAVEL and LABOR (0.5 Hour Minimum Labor Charge) OVERTIME (5:00 PM -7:00AM) Date I Techniclan(s) Name Start End Total OTStart OTEnd OTTotal fJ, J'3 .. J' I \br-~-lt~v ~ Wu n, Travel , Labor L.S"T.r Travel Date I Technlcian(s) Name J:: .. i-:£. .. :<:. Start End Total OT Start OTEnd OTTotal I Travel Labor Travel Date J Techniclan(s) Name Start End Total OT Start OTEnd OTTotal I Travel Labor Travel SUPPLIES-MATERIALS-RENTALS Check One oty. I UST Parts Site Parts ---··-·- COMMENTS Store Employee Print Name: St0«1 Employee Signature; )ICF ·WHITE