HomeMy WebLinkAbout2014 RESULTSMONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Wit/tin tlte State of California
Awhority Cited: Chapter 6. 7, 1/ealth and Safety Code; Chapter 16, Division 3, Title 23, Cal[fornia Code of Regulations
This fonn must be used to documenl testing and servicing of monitoring equipment. A separate certification or report must be prepared fi)r each
monitoring system control panel by the technician who pcrfonns the work. A copy of this fonn 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: lndieco Bldg. No.: ____ _
Site Address: 1 00 South Oswell Street City: Bakersfield Zip: _93_3_0_7 __ _
Facility Contact Person: Ben Dashitpour Contact Phone No.: {661) 861-9769
Make/Model of Monitoring System: Veeder-Root TLS-350 Date ofTesting/Servicing: 4/24/2014
B. Inventory of Equipment Tested/Certified
-""''-n. t If ... UJIJII VI# I U.ll'-I,VA ... ~ IV Oot •. U ... UI'-' ~ ............ "''-Ulf.'II0'-101 In,:)' 1 .......... ,,,.,'-ol 1' .......... ,,
Tank 10: 10000 9al. Regular (Master) Tank 10: 5000 gal. Re9ular (Slave)
181 In-I ank Gauging Probe. Model: 847390-107 [83 In-Tank Gauging Prohc. \.fodcl: 847390-107
181 Annulnr Space or Vault Sen'>Or. Model: 794380-420 [83 Annular Space or Vault Sensor. Model: 794380-420
181 Piping Sump I 1 rcnch Sen'>Or(s). Model: 794380-208 181 Piping Sump I Trench S~.:~t<.or(s). Model: 794380-208
0 Fill Sump Sensor(s). Model: 0 Fill Sump S~.:n...or(s). Model:
181 Mechanical Line I eak Detector. Model: FX1V 0 Mrehanical I inc Leak Detector. Model:
0 Electronic Line I cak Detector. Model: 0 Electronic Line Leak Dewctor. Model:
181 Tank Overfill I lligh-1 evcl Sen.sor. Model: OPW-61-SO 181 fank Overfill I 1-ligh-Lcvcl Sen'>Or. Model: OPW-61-SO
0 Other (~pecifY equ1pmcnt type and model in Section Eon Page 2). 0 Other (specify equipm<.'llt type and model in Section Eon Page 2).
Tank ID: 5000 gal. Super Tank 10: 10000 gal. Diesel
181 In-fank Gauging l'robt:. Model: 847390-107 [83 In-Tank Gauging Prohc. Model: 847390-107
181 Annular Space or Vault Sensor Model. 794390-420 [83 Annular Space or Vault Sensor. Model: 794390-420
181 Piping Sump I "l rcnch Sensor(s). Model: 794380-208 181 Piping Sump ;·1 rcnch Sell'>Or(s). Model: 794380-208
D Fill Sump Scnsor(s). Modd: 0 Fill Sump Sl!ll.SOr(s). Model:
181 Mechanical Line I eak Detector Model: FX1V 181 Mechanical I inc Leak Detector. Model: FX1 DV
0 Electronic Line Leak Detector. Model: 0 Flectronic I ine Leak Detector. Model:
181 Tank Overfill I I I igh-Lcvel Sensor. Model: OPW-61-SO 181 fank Ovcrlillllligh-Levcl Sensor. Model: OPW-61-SO
0 Otht..T (~pccifY equipment type and model in Section Eon Page 2). 0 Other (specify equipment type and model in Section Eon Page 2) .
. .
Dispenser 10: 1 & 2 Dispenser 10: 3 & 4
181 Dispenser Containment Sensor(s). Model: 794380-208 181 Dispenser Containment Sensor(s). Model: 794380-208
l8l Shear Valve(s). 181 Shear Valvc(s).
0 Dispcns<.T Containm<.'llt Float(s) and Chain(s) 0 Dispetl~ Containment I loat(s) and C'hain(s).
Dispenser 10: 5 & 6 Dispenser 10: 7 & 8
181 Dispct~T Containmc.11t Sensor(s). Model: 794380-208 181 Dispen<;cr Containment Sl!ll.SOr(s). Model: 794380-208
[83 Shear Valve(s). 181 Shear Valvc(s).
0 Dispct\'>(.T Containm<.'llt Float(~) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s).
Dispenser 10: Dispenser 10:
0 Dispct\'>(.T Containment Sensor(s). :vtodcl 0 Dispenser Containment Sc.'ll.SOr(s). Model:
D Shear Valve(s). 0 Shear Valvc(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 facility.
C. Certification -I certify that the equipment identified in this document was inspected/serviced in accordance with the
manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this
information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such
reports, I have also attached a copy of the report; (check all that apply): [8} System set-up [8} Alarm history report
Certification No.: =8:.::3....:4..:.1.=..06::._ ___ _
Signature: ~-~
License. No.: 804904 ~~~--------------------------
Technician Name Kristo~her Karns
Testing Company Name: Confidence UST Services, Inc. Phone No.: {800) 339-9930
Site Address: 100 South Oswell Street, Bakersfield, CA 93307 Date ofTesting/Servicing: 4/24/2014
Page 1 of 3
Monitoring System Certification
D. Results of Testing/Servicing
Software Version Installed: -=.3.::.33:::.;·:..:0...:.4 _____________ _
c he foil --~~ -------------heckr -----------
181 Yes 0 No* Is the audible alarm operational?
181 Yes 0 No* Is the visual alarm operational?
181 Yes 0 No* Were all sensors visually inspected, functionally tested, and con finned operational? i
181 Yes 0 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment
will not interfere with their proper operation?
0 Yes 0 No* If alarms arc relayed to a remote monitoring station. is all communications equipment (e.g .. modem)
181 N/A operational?
181 Yes 0 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 Sumprrrench Sensors; 181 Dispenser Containment Sensors.
Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 181 Yes; 0 No.
0 Yes 0 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no
181 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%
0 Yes* 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.
0 Yes* 181 No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)
0 Product: 0 Water. If yes. describe causes in Section E. below.
181 Yes 0 No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable
!
181 Yes 0 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:
Page 2 of 3
Monitoring System Certification
F. In-Tank Gauging I SIR Equipment: t8l 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:
t8l Yes 0 No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults?
t8l Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup?
t8l Yes 0 No* Was accuracy of system product level readings tested?
t8l Yes 0 No* Was accuracy of system water level readings tested?
t8l Yes 0 No* Were all probes reinstalled properly?
t8l 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 ifLLDs arc not installed.
c he foil kf -"' ...
t8l 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 appM Simulated leak rate: t8l 3 g.p.h.; 0 0.1 g.p.h : 0 0.2 g.p.h.
t8l Yes 0 No* Were all LLDs confirmed operational and accurate within regulatory requirements?
t8l Yes 0 No* Was the testing apparatus properly calibrated?
t8l Yes 0 No* For mechanical LLDs. docs 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 off if the LLD detects a leak?
t8l N/A
0 Yes D No* For electronic LLDs, docs the turbine automatically shut off if any portion of the monitoring system is disabled
t8l N/A or disconnected?
0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system
t8l N/A malfunctions or fails a test?
0 Yes 0 No* For electronic LLDs, have all accessible wiring connections been visually inspected?
t8l N/A
t8l 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
....
I OSWELL LIQUOR 100 S. OSWELL BAKERSFIELD CA 1
661-861-9769
APR 24. 2014 9:11 AM
'
S'ISTEH STATUS REPORT ------------T 1 :SUDDEN LOSS ALARM
T 4:DELIVERY tiEEDED
JINEIITORY REPORT
T 1:87 UNLEADED VOLUME • 3066 GALS ULLAGE a 7086 GALS
SOY. ULLAGE• 6070 GALS TC VOLUME a 3026 GALS HEIGHT a 32,64 INCHES WATER VOL • 0 GALS WATER • 0.00 INCHES TEMP a 78.5 DEG F
T 2:87 UNLEADED 2 VOLUME • 162D GALS ULLAGE • 3444 GALS
90l'. ULLAGE• 2937 GALS TC VOLUME a 160D GALS HEIGHT • 34.05 INCHES WATER VOL • 0 GALS WATER " D. 00 I ~HES TEMP • 77.5 DEG F
T 3:91 PREHIUH VOLtl1E • 1382 GALS ULLAGE .. 3692 GALS
9()l( ULLAGE• 3175 GALS TC VOLUME • 1364 GALS HEIGHT • 30.32 INCHES
WATER VOL • 19 GALS WATER • 1 • 64 1 NCHES TEMP • 78.5 DEG F
T 4:DIESEL VOLUME • 2052 GALS ULLAGE " 8100 GALS 90:; ULLAGE• 7084 CAts
TC VOLUME " 2D31 GALS HEIGHT .. 24.44 INCHES UATER VOL • .. • 0 GALS WATER " O.OD ltiCHES TEMP " 81 .4 DEC F
~ M M * * END * W w w *
SOFTWARE REVISION LEVEL VERSION 333.04 SOFTWAREP 346333-100-E CREATED-13.06.07.08.25
S-HODULE~ 330160-004-a SVST01 FEATURES: PERIOtiC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APH
SVSTEH SETUP
APR 24. 2014 9:11 AH
SVSTEH UNITS u.s. SVSTEH LANGUAGE EIIGLISH
SYSTEM DATE/TIME FORI1AT MOtl DD VYW mt:MM:SS xH
OSIJELL LIQUOR 100 S. OSWELL BAKERSFIELD CA 661-861-9769
SHIFT TIME I : DISABLED SHIFT TINE 2 : DISABLED SHIFT TIME 3 : DISABLED SHIFT TIME 4 : DISABLED
TANK .PER TST NEEDED WRN DISABLED TANK Atm TST tiEEDEO WRN DISABLED
LINE RE-ENABLE METHOD PASS LINE TEST
LINE PER TST NEEDED WRN DISABLED LINE ANN TST NEEDED WRN DISABLED
PRINT TC VOLUHES ENABLED
TEMP COMPENSATION VALUE <DEG F >: 60.0 STICK HEIGHT OFFSET DISABLED ULLAGE: 90Y.
H-PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVING TIME ENABLED START DATE MAR WEEK 2 SUN START TIME 2:00 AH EtiD DATE NOV WEEK I SUN END TIME 2:00 AH
RE-DIRECT LOCAL PRitlTOUT DISABLED
EURO PROTOCOL PREFIX s
SVSTEH SECURITY CODE : 000000
HAIIITENANCE HISTORY DISABLED
TANK CHART SECURITY DISABLED
CUSTOM ALARMS DISABLED
SERVICE NOTICE DISABLED
ISO 3166 COUNTRY CODE:
VAPOR MONITORltiG TYPE CARB ISO
MASS/DENSITY DISABLED
FISCAL HEIGHT SECURITY DISABLED
I tNENTORY ALARMS UNITS
CONFIG: STAIIDARD
MAX OR LABEL: VOLUME HIGH PRODUCT: :' MAX OVERFill : ~ MAX DELIV NEEDED: U MAX LOW PRODUCT : VOLUME
ALARM REDUCTION ENABLED
COtt1UIUCATIONS SETUP
PORT SETTINGS:
COMM BOARD : I <EDIM > RS-232 SECURilY CODE : DISABLED
COI'V1 BOARD : 2 <RS-232> BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED
AUTO TRANSMIT SETTINGS:
AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLa> AUTO LOW PRODUCT DISABLa> AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EKI'ERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARM DISABLED
RS-232 END OF MESSAGE DISABLa>
IN-TANK SETUP
T 1 :87 Utll.EADED PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL
I .000700 95.50
1 PT 10152
FLOAT SIZE: 4.0 W. WATER MINIMUM : 0.000
WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 WATER ALARM FILTER: LOW
MAX OR LABEL VOLIX1E : 10152
HIGH PRODUCT
%MAX : 95.0 <GALLONS> : 9644
OVERFILL LIMIT ~MAX : 90.0 <GALLONS> : 9137
DELIVERY LIMIT
%MAX : 25.0 <GALLONS> : 2539
LOIJ PRODUCT VOLI.R1E : 500
LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT : 0.00 PROBE OFFSET : o.oo
SIPHON HAilJFOLDED TANKS Til: tiONE LINE MANIFOLDED TANKS Til: tiONE
LEAK MIN PERIODIC:
LEAK MIN ANNUAL
0., ,,
0
OY.
0
PERIODIC TEST lYPE STANDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANti TEST AVERAGWG: OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 3 Mltl PUMP THRESHOLD : IO.OOY.
T 2:87 UtiLEADED PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL
2 .000700 95.50
1 PT 5064
FLOAT SIZE: WATER MINIMUM : 4.0 IN. o.ooo
WATER WARtiiNG : 2.0 HIGH WATER LIMIT: 3.0 WATER AlARM FILTER: LOIJ
MAX OR LABEL VOLU.'1E : 5064
HIGH PRODUCT :: HAX : 95.0 <GALLONS> : 4811
OVERFILL LIMIT
Y. MAX : 90.0 <GALLONS) : 4558
DELIVERY LIMIT
': MAX : 25.0 <GALLONS> : 1266
LOIJ PRODUCT VOLUME : 500
LEAK ALA.RM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT : o.oo PROBE OFFSET : o.oo
SIPHON MANIFOLDED TANKS 111: NONE LINE MANIFOLDED TAflKS Til: NONE
LEAK MIN PERIODIC:
LEAK Ml N ANNUAL : .
o::
0
OY. 0
PERIODIC TEST TYPE STANDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AV£RAGitiG: OFF PER TEST AVERAGit«;: OFF
TAl:K TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 3 MIN PUMP THRESHOLD : 10.00~
T 3:91 PREMll.t1 PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL
~ .000700 95.50 I PT 5064
FLOAT SIZE: WATER MINIMIJ1 : 4.0 IN. o.ooo
WATER WARNING : 2.0 HIGH WATER LIMIT! 3.0 WATER ALARM FILTER: LOW
MAX OR LABEL VOLU1E : 5064
HIGH PRODUCT :-;MAX : 95.0 <GALLONS> : 4911
OVERFILL LIMIT
Y. MAX : 90.0 <CALLOUS> : 4558
DELIVER\' LIMIT
Y. MAX : 25.0 <GALLONS> : 1266
LOW PRODUCT VOLUME : 500
LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT : o.oo PROBE OFFSET : o.oo
SIPHON MANIFOLDED TANKS Til: NONE LINE MANIFOLDED TANKS Til: UONE
~
LEAK MIN PERIODIC:
LEAK Mltl ANNUAL :
o~:
0
()}' 0
PERIODIC TEST TYPE STANDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : ~ MIN PUMP THRESHOLD : 10.0ID;
T 4!DIESEL PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL
4 .000450 95.50
I PT 10152
FLOAT SIZE: 4.0 lN. WATER MINIHU'I : 0.000
WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 WATER ALARM FILTER: LOW
MAX OR LABEL VOLll'1E : 10152
HIGH PRODUCT Y. MAX : 95.0 (GALLONS> : 9644
OVERFILL LIMIT
Y. MAX : 90.0 (GALLONS> : 9137
DELIVERY LIMIT Y. MAX : 25.0 (GALLONS> : 2538
LOW PRODUCT VOLUME : 500
LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99
TANK TILT . o.oo .
PROBE OFFSET : o.oo
SIPHON MANIFOLDED TAtiKS Til! NONE LlflE MANIFOLDED TANKS Til: NONE
LEAK MIN PERIODIC: OY.
0
LEAK MIN ANNUAL : OY.
0
PERIODIC TEST TYPE STANDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
CROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAGING! OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 3 MIN Pl.t1P THRESHOLD : IO.OOY.
LEAK TEST METHOD
TEST ON DATE : ALL TANK JUN 7. 201~ START TIME : DISABLED TEST RATE :0.20 GAL./HR DURATION : 2 HOURS
TST EARLY STOP!DISABLED
LEAK TEST REPORT FORMAT NORMAL
LIQUID SENSOR SETUP
L 1 :87 ANNULAR TRI-STATE <SINGLE FLOAT> CATEGORY : STP SUMP
L 2:91 ANNULAR TRI-STATE <SINGLE FLOAT> CATEGORY : ANNULAR SPACE
L 3!DIESEL ANNULLAR TRI-STATE <SINGLE FLOAT> CATEGORY : ANNULAR SPACE
L 4:87 STP SUMP TRI-STATE <SINGLE FLOAT> CATECORV : STP SUMP
L 5: 87 S'IP SUMP TRI-STATE <SINGLE FLOAT> CATEGORY : PIPING SUMP
L 6:91 STP SUMP TRI-STATE <SINGLE FLOAT> CATEGORY : STP SUMP
L ?:DIESEL STP SUMP TRI-STATE <SINGLE FLOAT> CATEGORY : STP SUMP
L S:DISP 1-2 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAN
L 9:DISP 3-4 TRI-STATE (SINGLE FLOAT> CATEGORY : DISPENSER PAN
LIO:DISP 5·6 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAN
Lll :DJSP 7-8 TRI-STATE <SINGLE FLOAT> CATEGORY : DISPENSER PAtl
EXTERNAL INPUT SETUP
I I :HJRT VP PROCESSOR
NORMALLY OPEN
OIITPUT RELAY SETUP
R 3:87 SHUT DOWN TYPE:
STANDARD NORMALLY CLOSED
TANK It!
LIQUID SENSOR ALMS L I :FUEL ALARM
L 4!FUE!. ALARM L 5:FUE!. ALARM
L 8:FUEL ALARM
L 9: FUEL ALARM Lll :FUEL ALARM
L I :SENSOR OUT ALARM
L 4 :SENSOR OUT ALARM L S:SENSOR OUT ALARM
!. e:sENSOR OUT ALARM L 9 :SENSOR OUT ALARM LIO:SENSOR OUT ALARM Lll :SENSOR OUT ALARM
L 1 :SHORT ALARM L 4:SHORT ALARM
L S:SHORT ALARM
L B:SHORT ALARM
L 9 :SHORT ALARM
LIO:SHORT ALARM
Lll :SHORT ALARM
lSD SITE ALARMS
lSD GROSS PRES FAIL lSD DEGRD PRES FAIL
lSD VAPOR LEAK FAIL
ISO VP PRES FAIL
lSD HOSE ALARMS
ALL:GROSS COLLECT FAIL
ALL:DEGRD COLLECT FAIL
ALL:FLOW COLLECT FAIL
Pt1C ALARMS
VP EMISSIONS FAIL VP PRESSURE FAIL
VP DUTY CYCLE FAIL
R 4:91 SHIIT-DOWN TYPE:
STANDARD
~LLV CLOSED
TANK p: 3
LIQUID SENSOR ALMS L 6 :FUEL ALARM
L B :FUEL ALARM
L 9 :FUEL ALARM
LIO:FUEL ALARM Lll :FUEL ALARM
L 6 :SENSOR OUT ALARM L e:SENSOR OIIT ALARM L 9:SENSOR OUT ALARM
LIO:SENSOR OUT ALARM Lll :SENSOR OUT ALARM L 6:SHORT ALARM L 9:SHORT ALARM
L 9:SHORT ALARM LIO:SHORT ALARM
Lll :SHORT ALARM
lSD SITE ALARMS
lSD GROSS PRES FAIL
lSD DEGRD PRES FAIL
ISO VAPOR LEAK FAIL
ISO VP PRES FAIL
I SO HOSE ALARMS
ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL
ALL:FLOW COLLECT FAIL
Pt1C ALARMS
VP EMISSIONS FAIL VP PRESSURE FAIL
VP DUTY CYCLE FAIL
R 5:DIESEL SHUT-DOWN
TYPE: STANDARD
NORMALLY CLOSED
TANK 11: 4
LIQUID SENSOR ALMS
L 3: FUEL ALARM
L 7: FUEL ALARM
L 9:FUEL ALARM
Lll :FUEL AlARM L 3:SENSOR OUT ALARM
L ?!SENSOR OUT AI.ARH
L 9:SENSOR OUT ALARM
Lll :SENSOR OUT AI.ARH
L 3:SHORT ALARM
L ?!SHORT ALARM L 9:SHORT ALARM
Lll :SHORT ALARM
R 6:
TYPE:
STANDARD NORMALLY OPEN
TANK P! NONE
-NO ALARM ASSIGNMENTS -
SMARTSEtlSOR SETUP
:s I :FM 1-2 CATEGORY AIR FLOW METER
:s 2:FM 3-4
CATEGORY AIR FLOW METER
:s 3:FM 5-6
CATEGORY AIR FLOW METER
:s 4:FM 7-B
CATEGORY AIR FLOW METER
:s 6:VP SENSNOR 3-4 CATEGORY VAPOR PRESSURE
EVRI'ISO SETUP
EVR T'IPE: BAl.AtiCE
BALANCE tiOZ2LE TYPE vsr
VAPOR PROCESSOR T'IPE HIRT VAPOR PROCESSOR
ANALYSIS TIMES TINE: 10:00 AM DELAY HINliTES:
ACCEPT HIGH ORVR: DISABLED
lSD HOSE TABLE ID FP FL HL AA RR
01 01 ·01 02 01 04 02 02 02 02 01 04 03 03 03 02 02 04 04 04 04 02 02 04 05 05 05 02 03 04 06 06 06 02 03 04 07 07 07 02 04 04 08 08 08 02 04 04
ISO AIRFLOW METER NAP 10 SERIAL NUN LABEL
I 60123 2 60127 3 59678 4 60125
FM 1-2
FN 3-4 FN 5-6 FN 7-8
ISO FUEL GRADE HOSE MAP
I 2 3 4 FP NHH HHH NHH HHH AA
01 201 301 901 U U I 02 202 302 902 u u 1 03 203 303 903 5 u 2 04 204 304 904 5 u 2 05 205 305 905 u u 3 06 206 306 906 u u 3 07 207 307 907 5 u 4 08 209 308 908 5 u 4
LABEL TABLE
1 UNASSIGNED 2 BLEND3 3 REGULAR 4 HID GRADE 5 PREMIUM 6 COLD
7 BRONZE
8 SILVER 9 BLEND2 10 BLEND4
SOFTWARE REVISION LEVEL VERSION 333.04 SOFTWAREP 346333-100-E CREATED-13.06.07.08.25
S-HODULEP 330160-004-o SYSTEM FEATURES: PERIODIC ttl-TANK TESTS ANNUAL IN-TANK TESTS ISO/APM
ALARM IHSlORY REPORT
----I N-TAtiK ALARM ---
T 1:87 UNLEADED
LEAK ALARM MAR 7. 2014 12:15 PH
JAN 3. 2014 12:12 PH JAN 2. 2014 1:42 PH
OVERFILL ALARM APR 16. 2014 11!26 AH APR 12. 2014 2!45 PM DEC 29. 2013 4:56 AM
LOW PRODUCT ALARM APR 7. 2014 12:05 PM MAR 28. 2014 6:43 AM MAR 20. 2014 7:49 AH
SUDDEN LOSS ALARM MAR 7. 2014 11:44 AH DEC 17. 2013 7:43 AH
INVALID FUEL LEVEL MAR 28. 2014 7:10AM MAR 20. 2014 8:11 AM MAR 17. 2014 5:18 PH
DELIVERY NEEDED APR 21. 2014 9 43 AM APR 19. 2014 11 49 AM APR 15. 2014 9 48 PH
* X * X X END X X X X M
ALARM HISTORY REPORT
----IN-TANK ALARM -----
T 2:87 UNLEADED 2
OVERFILL ALARM MAR 22. 2014 7:00 PM OCT 31. 2013 4!04 AM
LOW PRODUCT ALARM APR 22. 2014 8!32 AN APR 10. 2014 1:58PM APR 7. 2014 8:22 AN
INVALID FUEL LEVEL MAR 28. 2014 7:54 AM MAR 20. 2014 9:11 AM MAR 17. 2014 6!00 PH
DELIVERY NEEDED APR 21. 2014 II 47 AM APR 19. 2014 I 35 PH APR 16. 2014 7 06 AM
X M M M X END M M X M M
ALARM HISTORY REPORT
----IN-TANK ALARM -----
T 3:91 PREMIUM
LOW PRODLCT ALARM APR 17. 2014 5:47 PM APR 2. 2014 5:29 PM MAR 25. 2014 4:12PM
INVALID FUEL LEVEL APR 18. 2014 10:15 PM APR 4. 2014 7:55 AM MAR 22. 2014 6:08 AM
DELIVERY NEEDED APR 13. 2014 3 12 PM APR B. 2014 11 50 AM MAR 30. 2014 11 55 AM
M M M M M EtiO M X M M M
l
AlARM HISTORY REPORT
-----SENSOR ALARM -----L l :97 ANNULAR
STPSLt1P SETUP DATA WARNING JUN 7. 2013 9:os AM
M M M M M END M M M K M
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 2:91 ANNULAR
ANNULAR SPACE SETUP DATA WARNING JUN 7. 2013 8:os AM
M H M M H END M X M X K
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 3:DIESEL ANNULLAR
ANNULAR SPACE SETUP DATA WARNING JUN 7. 2013 8:os AM
b ......
ALARM HISTORY REPORT
-----SENSOR ALARM ----L 4 : 87 STP SIJ1P
STP SIJ'1P SETUP DATA WARNING JUN 7. 2013 8:os AM
M M K M M END M M M K K
ALARM HISTORY REPORT
-----SENSOR ALARM -----
L 5:97 SYP SUMP
PIPING SUMP SETUP DATA WARNING JUN 7. 2013 9:os AM
M M H H X END H M H H K
ALARM HISTORY REPORT
-----SENSOR ALARM -----
L 6:91 STP SUMP
STP SUMP SETUP DATA WARNING JUN 7. 2013 8:os AM
H M H X H END M M M H X
ALARM HISTORY REPORT
----SENSOR ALARM -----L ?:DIESEL STP SIJ1P
STP SIJ1P
FUEL ALARM APR 5. 2014 3:26 PH
FUEL ALARM MAR 1. 2014 11:46 AM
FUEL ALARM FEB 28. 2014 2:52 PH
M M X X K END X X K X X
ALARH HISTORY REPORT
-----SENSOR ALARM ----L 8:DISP 1-2
DISPENSER PAN
SETUP DATA WARNitlG JUN 7. 2013 8:os AM
M X X X M END X X X M X
ALARM HISTORY REPORT
-----SENSOR ALARM -----L 9:DJSP 3·4
DISPENSER PAN SETUP DATA WARNING JUN 7. 2013 8:os AM
M K M M M END X M M X M
ALARM HISTORY REPORT
-----SENSOR ALARM -----LIO:DISP 5-6 DISPENSER PAN SETUP DATA WARN INC JuN 7. 2o13 8:05AM
M M M M M E~ID M M M )( M
ALARM HISTORY REPORT
-----SENSOR ALARM -----L11:DISP 7-8 DISPEIISER PAN SETUP DATA C..'ARNI NG JUN 7. 2013 8:05AM
M M X M M END X M M M M
-----SENSOR ALARM -----L 7 :DIESEL STP Slt1P STP SIJ1P FUEL ALARM APR 24. 2014 9:48 AM
OSWELL LIQUOR 100 S. OSWELL BAKERSFIELD CA 661-861-9769
APR 24. 2014 9:50 AM
S'r'STEM STATUS REPORT
T 1 :SUDDEN LOSS ALARM
T 4:DELIVERY NEEDED
L 7:FUEL ALARM
-----SENSOR ALARM -----L 4:87 STP Sl.t1P SiP Sl.t1P FUEL ALARM APR 24. 2014 9:52 AM
-----SENSOR ALARM -----
L 5:87 S'I'P Sl.t1P PIPING SUMP FUEL ALARM APR 24. 2014 9:53 AM
-----SENSOR ALARM -----L 6:91 STP Sl..t1P STPSLJ1P FUEL ALARM APR 24. 2014 9:56 AM
-----SENSOR ALARM -----L 8:DISP 1-2 DISPENSER PAN FUEL ALARM APR 24. 2014 9:58 AM
-----SENSOR ALARM -----L 9:DISP 3-4 DISPENSER PAN FUEL ALARM APR 24. 2014 10:00 AM
-----SENSOR ALARM -----L10:DISP 5-6
DJSPE~SER PAtl FUEL ALARM APR 24. 2014 10:01 AM
OSWELL LIQUOR 100 S. OSWELL BAl:ERSFIELD CA 661-861-9769
APR 24. 2014 10:02 AM
SYSTEM STATUS REPORT
T I :SUDDEN LOSS ALARM
T 4 :DELIVERY NEEDED
LtO:FUEL ALARM
-----SENSOR ALARM -----LIO:DISP 5-6 DISPENSER PAN FUEL ALARM APR 24. 2014 10:02 AM
-----SENSOR ALARM -----Lil :DISP 7-.8 DISPENSER PAN FUEL ALARM APR 24. 2014 10:07 AM
-----SENSOR ALARM -----L t:87 ANNULAR STPSlJ1P FUEL ALARM APR 24. 2014 10:09 AM
-----SENSOR ALARM -----L 3:DIESEL ANNULLAR ANNULAR SPACE FUEl. ALARM APR 24. 2014 10:10 AM
-----SENSOR ALARM -----L 2:91 ANNULAR ANNULAR SPACE FUEL ALARM APR 24. 2014 10:13 AM
OSWELL LIQUOR 100 S. OStJELL BAY.ERSFIEI..D CA 661-861-9769
APR 24. 2014 10:14 AM
SVSTEM STATUS REPORT
T 1 :SUDDEN LOSS ALARM
T 4:DELIVERY NEEDED
L 2:FUEL ALARM
-----SENSOR ALARM -----L I :87 ANNULAR STP SUMP SENSOR OUT ALARM APR 24. 2014 10:22 AM
-----SENSOR ALARM -----L 9:DISP 3-4
1 DISPENSER PAN SENSOR OUT ALARM APR 24. 2014 10:22 AM
-----SENSOR ALARM -----L 5:87 SYP SlJ1P PlPWG SUMP SENSOR OUT ALARM APR 24. 2014 10:23 AH
-----SENSOR ALARM -----L 2:91 ANNULAR ANNULAR SPACE SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SENSOR ALARM -----L 3:DIESEL ANNULLAR ANNULAR SPACE SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SENSOR ALARM -----L 4:87 STP SIJ1P STP SIJ1P SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SENSOR ALARM -----L10:DISP 5-6 DISPENSER PAN SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SENSOR ALARM -----Lll :OISP 7-8 DISPENSER PAN SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SEtlSOR ALARM -----L 6:91 STP Slt!P STPSlt1P SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SEtlSOR ALARM -----L 7:DIESE!. STP SIJ1P STPSUMP SENSOR OUT ALARM APR 24. 2014 10:23 AM
-----SENSOR ALARM -----L 8:DISP 1-2 DISPENSER PAN SENSOR OUT ALARM APR 24. 2014 10:23 AM
OSWELL LIQUOR
100 S. OSWELL BAKERSFIELD CA
661-861-9769
APR 24. 2014 10:49 AH
SYSTEM STATUS REPORT
T I :SUDDEN LOSS AI.J\RH
T 4:DELIVERY NEEDED
ItNEtlTORY REPORT
T 1:87 UNLEADED VOLU1E • 3066 GALS
ULLAGE • 7086 GALS 90Y. UUAGE• 6070 GALS
TC VOLUME • 3025 GALS
HEIGHT • 32.64 INCHES
WATER VOL • 0 GALS
WATER • 0.00 INCHES
TEMP • 78.7 DEC F
T 2:97 UNLEADED 2
VOLU1E • 1613 CAts
ULLAGE • 3451 GALS
90% ULI.J\GE• 2944 GALS
TC VOLU1E • 1592 GALS
HEIGHT • 33.94 INCHES
WATER VOL • 0 GAts
WATER • 0.00 INCHES TEMP • 77.5 DEC F
T 3:91 PREMIUM
VOLLt1E • 1380 GALS
ULLAGE • 3684 GALS
9~; ULLAGE• 3177 GALS
TC VOLl.tiE • 1362 GALS
HEIGHT • 30.29 INCHES
WATER VOL • 19 GAts
WATER • 1.64 INCHES
TEMP • 78.7 DEC F
T 4:DIESEL
VOLu-tE • 2052 GALS
ULLAGE • 8100 GALS 90l: ULI.J\GE• 7084 GALS
TC VOLU1E • 2031 GALS
HEIGHT • 24.44 INCHES
WATER VOL • 0 CAts
WATER a 0.00 INCHES
TEMP • 81.5 DEC F
)( * * * * END )( )( )( )( )(
OSWELL LIQUOR
100 S. OSWELL
BAY.ERSFIELD CA
661-861-9769
APR 24. 2014 11:06 AM
SYSTEM STATUS REPORT
T I :SUDDEN LOSS ALARM
T 4:DELIVERY NEEDED
INVENTORY REPORT
T 1:87 UNLEADED
VOLUi'1E • 3066 GALS
ULLAGE a 7086 GALS
90% ULLAGE• 6070 CAts
TC VOLUME .. 3025 GAts
HEIGHT • 32.64 INCHES
WATER VOL • 0 GALS
WATER • 0.00 INCHES
TEMP • 78.6 DEC F
T 2:87 UNLEADED 2
VOLUME • 1613 GALS
ULLAGE • 3451 GALS
90% ULLAGE• 2944 GALS
TC VOLU1E • 1592 GALS
HEIGHT • 33.94 INCHES
WATER VOL • 0 GALS
WATER • 0.00 INCHES
TEMP • 77.6 DEC F
T 3:91 PREMIUM
VOLU1E • 1380 GALS
ULLAGE • 3684 GALS
90'' ULLAGE• 3177 GALS
TC VOLIJ1E • 1362 GALS
HEIGHT • 30.29 INCHES
WATER VOL • 19 CAts
WATER • I . 64 INCHES
TEMP • 78.7 DEC F
T 4:DIESEL
VOLUME • 2052 CAts ULI.J\CE • 8100 GALS 90~ ULLAGE• 7084 GALS
TC VOLUME • 2032 GALS
HEIGHT • 24.45 INCHES
WATER VOL • 0 GALS
WATER • 0,00 INCHES
TEMP • 61.5 DEC F
* * M * M END )( )( M )( )(
SWRCB, January 2006
Spill Bucket Testing Report Form
This form is intended for use by contractors pe1f01ming annual testing ofUST spill containment structures. The completed form and
printouts from tests (if applicable}, should be provided to the facility owner/operator for submillalto the local regulat01y agency.
1. FACILITY INFORMATION
Facility Name: Indieco I Date ofTesting: 04/24/2014
Facility Address: 100 S Oswell St Bakersfield CA, 93307
Facility Contact: Ben Dashtipour I Phone: 661-366-2511
Date Local Agency Was Notified of Testing: 4/16/2014
Name of Local Agency Inspector (if present during testing): Shane Gardener
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A Self
Credentials1: lEI CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester 0 Other (SpecifY)
License Number(s): CSLB# 804904 ICC# 5264406-UT Tank Tester 09-1743
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: lEI Hydrostatic 0 Vacuum 0 Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
identify Spill Bucket (By Tank 1 Regular UL 2 Regular Slave UL 3 Super UL 4 Diesel
Number, Stored Product, etc.)
Bucket Installation Type: X Direct Bury X Direct Bury X Direct Bury X Direct Bury
0 Contained in Sump 0 Contained in Sump 0 Contained in Sump 0 Contained in Sump
Bucket Diameter: 12.00" 12.00" 12.00" 12.00"
Bucket Depth: 12.00" 12.00" 13.50" 12.00"
Wait time between applying 5MIN 5MIN 5MIN 5MIN vacuum/water and start of test:
Test Start Time (T1): 9:15AM 9:15AM 9:15AM 9:15AM
Initial Reading (R1): 11.25" 11.75" 12.25" 11.00"
Test End Time (TF): 10:15 AM !0:15AM !0:15AM !0:15AM
Final Reading (RF): 11.25" 11.75" 12.25" 11.00"
Test Duration (T F-T1): 1 HOUR 1 HOUR I HOUR 1 HOUR
Change in Reading (RF-R1): 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 0 Fail X Pass OFail X Pass OFail X Pass 0 Fail
Comments -(include iJ?formation on repairs made prior to testing. and recommendedfollow-upfor.failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIDLE FOR CONDUCTING THIS TESTING
1 hereby certifY that all the information contained in this report is true, accurate, and in full compliance with legal requirements.
Teclmician's Signature: ~' ~ Date: 04/24/2014
1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
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