HomeMy WebLinkAbout#725 FMC Results 7-13-11MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the Slate ofCalifornia
Awhorily 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: #725 Fastrip #19 Bldg. No.: _
Site Address: 4901 South Union Avenue City: Bakersfield Zip: 93307
Facility Contact Person: Omero Garcia
Make /Model of Monitoring System: Veeder -Root TLS 350
B. Inventory of Equipment Tested /Certified
Cheek the appropriate boxes to indicate specific equipment inspected /serviced:
Contact Phone No.: 661 - 393 -7000
Date of Testing/Seryicing: 7/13/2011
Tank ID: 12000 gal. Regular Tank ID: 12000 gal. Super
X] In -Tank Gauging Probe. Model: 847390-107 x] In -Tank Gauging Probe. Model: 847390 -107
x] Annular Space or Vault Probe. Model: 794390-420 x] Annular Space or Vault Sensor. Model: 794390 -420
x] Piping Sump / Trench Sensor(s). Model: 794380-208 Piping Sump / Trench Sensor(s). Model: 794380 -208
Fill Sump Sensor(s) Model: Fill Sump Sensor(s). Model:
XI Mechanical Line Leak Detector. Model: FX1V x] Mechanical Line Leak Detector. Model: FXIV
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
L] Tank Overfill / High Level Sensor. Model: 847390 -107 Tank Overfill / High Leval Sensor. Model: 847390 -107
Other (specify equip. type and model in Sec. E on Pg. 2) Other (specify equip. type and model in Sec. E on Pg. 2)
Tank [D: 12000 gal. Diesel Tank ID:
x] In -Tank Gauging Probe. Model:847390 -107 In -Tank Gauging Probe. Model:
x] Annular Space or Vault Sensor. Model:794390 -420 Annular Space or Vault Sensor. Model:
X] Piping Sump / Trench Sensor(s). Model: 794380-208 Piping Sump / Trench Sensor(s). Model:
Fill Sump Sensors(s). Model: Fill Sump Sensor(s). Model:
xx] Mechanical Line Leak Decector. Model:FX1V Mechanical Line Leak Detector. Model:
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
L] Tank Overfill / High Level Sensor. Model: 847390-107 Tank Overfill / High Level Sensor. Model:
Other (specify equip. type and model in Sec. E on Pg. 2) Other (specify equip. typs and model in Sec. E on Pg. 2)
Dispenser ID: 9&10 Dispenser ID: 11 & 12
Fx] Dispenser Containment Sensor(s). Model: 794380 -208 E Dispenser Containment Sensor(s). Model: 794380 -208
X] Shear Valve(s). X] Shear Valve(s).
Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s)
Dispenser 1 D: 13&14 Dispenser I D: 15&16
x] Dispenser Containment Sensor(s). Model: 794380 - 208 X] Dispenser Containment Sensor(s). Model: 794380 -208
Lx] 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 ofgenerating
such reports, 1 have attached a copy of the report; (check all that apply) x System Set- up history report
Technician Name (print): Kristopher Karns Signature: .ti p C4
Certification No: B34106 License No: 804904
Testing Company Name: Confidence UST Services, Inc. Phone No: 800- 339 -9930
Site Address: 4901 South Union Avenue, Bakersfield, CA 93307 Date of Testing/Servicing: 7/13/2011
D. Results of Testing /Servicing
Software Version Installed: 327.04
Complete the following checklist:
x] Yes No* Is the audible alarm operational?
x Yes No* is t e Visua a arm operationa ?
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)
x N/A operational?
x Yes No* For pressurized piping systems, does the turbine automatically shut down ifthe 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 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 %
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* No Was liquid found inside any secondary containment systems designed as dry systems?
Product; Water. Ifyes, describe causes in Section E, below.
x No* Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable.
x Yes 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' During the Leak Detector testing, the Super FX I V failed to catch a leak. We replaced the old FX I V with
a new FX I V. After the repair the new Leak Detector was retested and confirmed operational.
F. In -Tank Guaging / SIR Equipment: [X] Check this box if tank guaging is used only for inventory control.
Check this box iftank 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 No* Has all input wiring been inspected for proper enter and term ination,including testing for ground faults?
Tx1 Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
TX1 Yes No* Was accuracy of system product level readings tested?
x Yes D No* Was accuracy of system water level readings tested?
Fxj Yes No* Were all probes reinstalled properly?
Yes 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): Check this box if LLD's are not installed.
Complete the following checklist:
Lx] Yes No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance?
Check all that apply) Simulated leak rate: [x]3 g.p.h.: 0. I g.p.h.; 0.2 g.p.h.;
x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments?
x Yes No* Waste testing apparatus properly calibrated?
X] Yes No For mac amca 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?
x] 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
x] N/A malfunction or fails a test?
Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected?
Fxj N/A
x Yes 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: During the Leak Detector testing, the Super FX 1 V failed to catch a leak. We replaced the old Super FX 1 V
with a new FX I V. After the repair, the new Leak Detector was retested and confirmed operationnl.
FASTRII '725
ELL,
661 - 1`- 17 -9387
JUL 1j• --'Oil 11 :111 Hit
SySTEH s*rtaufi. REPORT
ALL FLINCTKAT IloPh-;L.
INVENTOR—; REPORT
r I :UrIL.EHbEr, 725
VOLUME . 9071
ULLAGE . q2q
90% ULL,-;43E= 17'29 1.-,H
Tl-- VOLI-WIE = IJC463 C-1;1_S
HEIGHT = x•'7.88 1 NCHES
WATER VOL = 0
WATER . 0.0 11, 1 (' HE
TEMP _- 7`,.0 DFi3 F
T 2: PREN I LIM 7, ', 15
VOLUME . ,31 0
ULI_AGE . 6690 GALS
90'. ULLA,: E- 5.39", ' 1Hl_,S
59TCV - 3- ' C;ALSC)LU11F, .-
HE I G HT - 43.66 1 N(_`HF2-
LMTER VOL - 14 CALS
L414TER . 0.78 1 11IC-HES
TEMP . 80.9 bEi3 F
T '3:DIESEL 725
VOLUME - 6490 C:1iL
ULLA13E . 5510 4:;AL.13
90% ULLj,-it:.E- 4310 o';ALS
TC V0LLq'1E - 6416 (;HI-S
HEIGHT - 51.08 1 NC FiE2
WATER VOL - 10 i:ALS
WATER = 0.91 1 NCHES
TEMP = 85.1 DEG F
END
SOFTWfiRE WIlsi cm i LEVEL
VEPSION 3'0.02
SOMIARE-0, 3419,330- 100-.-
CREmTEDI — I I . 01 . 1 -1 . I I
2'.Wal FEiiTURES;
PERIC-Dll-' IN-TAIC TE8M;3
ANNI."L 11-1-TANK TE!1`-1,
ISD
SISTFN SETUP
JUL. ):3• 201 1) :01 viri
TE111 UNITS
I U.S.
ENGL V H
S'.1STEM DHTE. T] HE Fopmf-a
1-1014 DD 'e"YY 1-11-1:1-11`1:'; d"I
FASTRI P 7 =5
1901 S.U1,110i'l
BAE'ERSFIELE, 1:t-)
661 - "J" `77-9:3737
SHIFT 1 12: 00 A11
SH I FT T I ME '-:, F., I ;HDLED
SMl:'T TINI: 3 1 j I:- HBI-El'
SHIFT TiFIE .1 U k-MBLEL)
TANK PEk TST NEEDED WRIII
DISABLED
TA•).: AMN T.ST NEEDEL, klk'N
DISABLED
L I NE RE-Eh)mBLE METHOD
PiASS L I 14E TEST
L I NE PER *r;-,T 1V1:EbEf) 1JPN
DISABLED
L I NE i-iNN TST NEEF11:1)
D I ciABLELs
PRINT TC- V01-1.11"IES
ENmBLED
TEMP '*OMPEN.c,-i"T I ON
V1-%LUE (LIEC; F ) : E0.0
sTIC'I! HEIGHT OFFSET
D I SIABLED
LILLAGE: 90;.;
H-PROTOCOL DmTiA F-DRI-VAT
HEIGHT
DAYLIGHT SAVINt_.; TIHE
ENABLED
STARTTART DATE
MAR 1JEEE ' 21jill
START *r I ME
2:00 (411
END DATE
Nov WEEK I SLIN
END TIME
2: 00 "1
I
PE-DIPE1*,*T LCIC-t-il_ PkINTOLIT
Li I SABLE11
E1JR0 P'ROTOC'OL. PFEIFI'.:
SYSTEM SECURITY
I.-ODE : 000000
MAINTENAr$'_'E HISTORY
DISABLED
TAiV, CHART SEC'UPIT_','
DISABLED
UST011 ALORNIS
DISABLED
SERVICE
DISABLED
1St? 31 06 GOUPlTR1`
E:
mAss "DENS )TV`
DISABLED
C4,11lIUNIl'HT1vN2 SETUP I N-TANK SETUP T '-,:PREllI ljl-I 725
PRODUCT "'.)DE
T I : UNLEADED ?'7r:, THERMAL l-'DEFF 01
FORT I-ETT I PRODUCT CODE I THIC DIHMFTER 4r, . 110
THER11iiL GOEFF Cif)0700 TAW. PROFILE I IIT
COMM 8OHRI.- I (EDIN 3 TANK Ll I It. 00 FULL VOL 12000
RS-232 S;E(*LlRITY THNI: PPOFILE I FIT
CODE : DISABLED FULL VOL 12,000 FLOAT SIZE:
COMM BOHRL, 2 t F%- 2:32-
Eii%Ur.t RATE ':i600 FLOAT 517E: 4. U I N. Wf4TEP
PARITY NONE HIGH WHTEP 1-11-1IT:
STOP D I T I STOP WATER WiRN I PJC 2. 0
BATH LEI,IC;'I*H: e. bmTH H1011 WATER LIHIT: 3. 0 MAX OR LABEL VOL: I '-,i-'IGCI
ISECI-IRITY OVERFILL LIHIT 4(in,
CODE 612-:ABLED MAX OF.' LABEL WIdl 1 0 Cl J-j 081DO
OVERFILL LIMIT 90 HIG'li PROCOU"T 95%
101300 I 1400
AU*rO TPIANSH IT SETT INC*:: H I PRODUCT 95% DELIVERY LIMIT, 10'. H
I 1400 12100
mliTO Lb,41: mLiPI'l L I I'l I T DELIVERY LIMIT I cm
D I,,HbLEr- 1 12 0 0 LOW PRODUCT 11110
AUTO HIGH WtiTER I.Itill' LEAK ALARM LIMIT: 99
G IsABLED LOW F-Po[,Ui-'*r 1200 SUDDEN LOSE; LIMIT: 99
HUTC) OVERFILL L I N I T LEAY ALHPI,I Llt,,I]T; 99 TANY. TILT 0 . I'l0
DI liiABLED SUDDEN LOSS LIMIT: 99 PROBE OFFSETD o
AUTO LOW rR()r)ljk':T TWO!* T J LT u. CIO
1) 1 SABLED PROBE OFFSET 0.00
AUTO THEFT LIMIT SIPHON MAN IFOLDED THN)"2.
DI SAIRLE11 T9; NONE
AUTO DELIVER"` START SIPHON MAN IFOLDED THNES LINE MAN IFOLDED TmNK'--
DISABLED Tu: NONE TO: NONE
AUTO DELIVERY ENL- LINE MAN IFOLDED THIC'S
DISABLED Tv 14C•PlE
HUTO EXTERNAL INPUT 014 LEA)" 11111 PERIODI --.: I %
1:11 SABLED 120
rWTO C<I`EkNAI- INPUT 01=F LEH): MIN PERIODIC: I
D ISABLED 120 LEHK 11111 ANNUAL I
HUTS'' SEN.-sOP FL117-L F;Li-41-1 121--1
D 12 iBLED LEH)" H I Iq ANNUAL
Har• SENSOR LNATER hI.HPI'l 1 0
DISABLED PERIODIC: TEST T"'PE
4UT0 f!'-EIl6OR OUT IAIJ-0-1 ST;ApII:,ARr.l
D I Sr -iBLEI, PERIODIC TEST r,,PE
2T;AIlD;-;RL- ANNUAL TEST FAIL
AL -IRT'l D I ::mRLED
ANNUAL rE.ST FIAII.
ALARM DIS-MBIYP PERIODIC TEST FAIL
ALARM r- ISHBLED
PER I „Lj I C: TEST FA I L TE::,!T FA I L
HLrtkhl NS;-iBLE1-
GROSS TE,T F;AIL fAIIN TEST i-ivERiIC, I tll: OFF
PER TEST HVER66 I NG: OFF
Am.4 TEST AVERA(.; I N(,: OFF
PER TEST WERH131 PIG: OFF TAN ): TEST NOT I F'-.': OFF
THN): TEST NOTIFY: i"'IFF
I TIC 1"21' SIPHON BREAK :OFF
TNK. TST S 1 YI IN BRE,K:0FF DEL I VER"i” DELAY 1 11111
flUI,IP THRESHOLD 10.00::
DELIVERY DELk%.l 1 hl 11'I
PumP TIIRU-HOLD : I Cl - 00-
LIO:DISF* 15-16
NORMALLY CLOSED
4:,FiTEC;0RY : DISPEMSER PAN
OUTPUT RELAY; SET! W
2 - rl I ESEL 725 LEAK TESL' l-IETH(,-)[-
1-01IRCIP1117 "IE
rm IHL VOEFV^ UUIj-A5U TLST ON lifATE ALL THWI: P I
TANK DIA!lY-rER 96.00 JAN 14 . 201 1 TYPE:
TAN)' PROFILE I pl, START TIME DISABLED
FULL VOL 1201)0 TEST RATE 0.20 l3lml- - PIR NORIIALL" CLOSED
rlUPJAT I ON HOURS
TANK a: I
FLC4AT SIZE: I.t) 114. TST EARLY STOP:fift-ifiBLED
timTER WARN W; 2.0 LEAK TEST REr•oRT FORMAT LIQUID SENSOR AU -IS
HIGH WATEk LIMIT: 3.1:1 14ORMO-tL L I: FUEL f4l-HRM
L 7:FUEL ALJAPM
M;W. OR LABEL VOL: 1200-1 L 8:FUEL fAU-01
OVERFILL LIMIT 90% L 9:FUEL ALARM
10800 LIO:FUEL ALAPH
H I GH PRODUCT 951. L I :SENSOR OUT ALAEll
11400 L 7: SENSOR OUT OLIARN
EU.IVEP'i, LIMIT 10 %, L 9: SENSOR OUT FiLHR(,l
12, CIO L 9:SENSOR OUT FrLmPll
LIO:SENSOR OUT F,LAPII
Low rRobly-`T I 200 L 1: SHORT ml-i-01
EAl' HLk,•l,l 1-11-IIT: 99 L 7: SHORT ALARM
SUDDEN LOSS LIMIT: 919 LIOUID SENSOR SETUP L 8:SHORT ALARM
TAN)" TILT CIO L 9:SHORT ALARI•l
PROBE OM —AEI' 0. 00 LICI:SHORT ALARM
L I : L114L STP
TRI-STATE cSIW.;LE FI-0i.,T) ISE, SITE ALARMS
SIPHON II-"NIFOLDED Ti-;14 `3 hTrt, (;OR'/ : c)'Tp Su-11• ISE, CROSS PRES FAIL
TO: IKoPtE ISE, DE@'RD PRES Ff-;IL
LINE 1-641`11FG-LbEP ISD VAPOR LEAK FAIL
TII: IK)PJE L 2:UNL ANN I SD VP PRES; Fm I L
Tpi-IsTmTt ES110A.E ISD VP STATUS FAIL
CATEuoR%l ' HNNULAP SPACE
1. EMY, I l l N PER 10D I I ISD HOSE ;ALARMS
I Cl ALL :,-.4ROSS COLLECT FAIL
ALL :1)EGRE, C:OLI-EC,r FAIL
I.Em): I I I N jNNUtiL L 3: PPEN STP ALL :FLOW COLLECT FfAIL
I'l TR I -STATE (S I I-ICLE FLOAT)
A*rEr*.ORY : STP SUMP p 21. PREII I Ut•l
T', PE:
PER 1011 1 C TE:=T 'r,,,j,u
L 4:PREm ;AP41-1 NORK'ALL" CLOSED
TRI-STATE (SlIK;LE FLOAT)
Atipjut-ii. •rF::,,T FAIL 6ATb,;c-R,/ : ANNULF4., SPW:E TAN)' 111: 21
FAbAkl-1 01S ULEI,
I•EPItAlll` TEST FAIL LIQUID SErh.;OR MIJ-If;
kt-iAPII P I ABLEL- 1. rj:li' L STP L 3:FUEL ALARM
TRI -STmTE (SIPA.-;LE Ft -OAT) L 7: FUEL ALARM
TEST Fi-ill- FiTEl';0RY : :31`f SLWIP L 8:FUEL ALARN
iALAPI 1 1) 1 BLED 1, 9: FUEL ALARM
LICI:FUEL ALARM
ANN TE:( AVERml-;IPP;: JI -F L 6:1,.31- ANN L 3:SENSOR OUT AL•)RM
F-EF., TENT OFF NURT•li-iLLY CLOSED L 7:SENSOR OUT ALARM
Icw,TEl3'ORl' : IANNUI-Ak SPACE L 8:cSENSOR OUT ALARM
Tim.ji: NOTIl'i': OFF L 9: SENSOR OUT HLARI-I
1.10:SENSOR OUT HI-f4RI-i
13IRLME:OFF L 3:SHORT ALARM
L 7: El I SP 9-10 L 7:SHORT ALARM
GEL IVEk", IiELAV 1 11,1114 TRI -STi-iTE (S'INGLE FLOAT) L 8:SHORT ALARPI
PUl'IP THRF-RHOLF, 10.00%. ATEGORY : DISPENSER PfAIJ L 9:SHORT ALARM
LIO:SHORT ALARM
ISD SITE ALARMS
L 8:1" 1SP 11-12 1 SD c;Ross PRIES Ft•t 11.
TPI -STATE ic-Apil'a-F Fl.oia) ISD DEGRD PRIES FAIL
C.'ATEI'OPY : DISPERSER PHN ISE) VAPOR L.EA), FAIL
ISD VP PRES FAIL
ISD VP STATUS FAIL
L 9:DISP 12-14 ISE, HOSE ALARMS
TRI -STATE FLOAT) ALL :GROSS COLLECT FAIL
ATEGORY : 111SPENSEP r•i•oi ALL :EIEGRD (:OLLECT Fri ll-
ALL :FLOW 1`01-LEC7 FAIL
LIO:DISF* 15-16
NORMALLY CLOSED
4:,FiTEC;0RY : DISPEMSER PAN
R 3:DIESEL
T'rF•E :
S1'HNDAR'D
NOPPI ALL`! CLOSED
TANK 0: 3
L I OU I D SENSOR ALP'L
L 5 : FLIF:L HLARM
L 8 : FIJEL ALARM
L 10: FUEI. ALARM
L 5:5ENSOR OUT HL-tRrl
L B:SEtGOR OUT ALA0r1
L 10 : SENSOR OUT HLARM
L S:SHORT ALARM
L B:SHORT ALARM
L10:SHORT ALARM
R 4:OVERFILL HLAR11
TYPE:
STANDHRD
NOPMiALL'r OPEN
TANK: 13: NONE
i N- 1'AN1: Hl-ARM ,
ALL :OVERFILL AL.ARrI
ALL :HIGH PROEPUrT ALARI.1
ALL : MH: -. PRODO-T HLARM
S1•o +RTSENS,'R SETUP
g I:VP II -I
1:'ATE*R'. v4OF. PRM UY.E
s :F1.1 y -;11
H I F'. FLOW HETER
s 3:F11 I I -1?
ATE UR` AIR FLOW METER
s 4:F1'l 13 -14
1:'tiI'EWR1• HIP FLOW HETFRI
s 5:FM 15 -16
C'1iTE1:OR'. H I F.• FLOW METER
EVR I SD SETUP
EVR 1''; PE: VH' ::IJU1'l H`i. I 6'1'
VA'-'tJLJt'1 ASSIST TYPE:
HEAL.Y VA.
NOZZLE A%L RAWE
1IAX: I.15 MIN: 1).95
VAPOR PROCESSOR TYF E
NONE
ANHL`rSIS TIMES
TINE: 10:00 All
DELHY MINUTES: 1
AC'i'EFT HIGH QR1JR :
DISABLED
FUEL ALANJ•IISDHOSETABLE
FUEI. ALARM
MAY 2:9. 2011
ID FP FL HL HH RR
01 - 03 o i OZ 1:11 02
02 1 02 02 u1 02
03 It 03 02 02 02
04 12 0.1 0'2• 02" 0'
05 17 05 02 0,1 0'?
Ut 18 Ot 04 U i 02
07 19 07 02 O4 02
08 21D 06 02' 04 U^
1SD AIRFLOW METER MAP
ID SER 1 HL NUM !.ABEL
1 8639 - - -- F11 9 -10
2 14880 FM 11 -1
3 13666 FI.1 13-14
4 H625 FM 15 -16
SD FUEL C:RmDE HOSE i-IHP
1 2 3 4
FP MHH P11111 PIHH P1HH rk
09 201 301 901 U U 1
IU ^02 302 90% U u 1
11 203 303 903 5 11 ?
12 204 304 904 5 U 2
17 205 305 90F U U 3
18 206 306 96t. U U 3
19 207 307 907 5 U 4
20 206 306 908 5 U 4
LABEL TABLE
I : UNASS I GNEI.1
2: BLENDS
3: REGULAR
4: MID GRADE
5 : PREM I UI.1
6 : GOLD
7: BP.ON'`E
8: SILVER
9: BLEND'2
10: BLEND:1
P K-' SETUP
PMC' VERSION: 01.03
VAPOR F'POc-,Essop TvPE
PI{i NE
PRU:E.`Ok COPrIT. -CAL LEVEL:
NONE
i•II.NF'J 1 H I ;T'JF''I REF OR1
SEtII;OR ALARM - ---
L 1 : UNL STI'
STF SUMP
FUEL ALANJ•I
JUN 30. 1011 E. HH
FUEI. ALARM
MAY 2:9. 2011 8:30 HM
FUEL 14LAP.I•I
KAY 26. 121-11 1 3:1'7 HM
a p - ENE, A t A A
HLAFTI HISTORY REPORT
SENSOP, ttiLHRhI - ---
I. 2 : UNL ANN
ANNULAR. SPACE
SENSOR OUT (ALHPM
MAY 13, 201 1 tit : ` U i-91
FUEL HLHP.P1
PAY 9. 2011 6:41-1 F'I•l
X - . END P. A . • n
H ISTORILI REPORT
iLARM H STORY REPORT
SEWz()R ALARvi ALARM HI 'STOPY REPORTL6:SL A1414tS')R ALARM 1.)
L 3:PREM STP Al-4141JLAR SPi:v' E
STP SUMP FUEL ALARM L cl:DISF, 13-14FUEL ;;LARI,l MHY 18. 201 1 t,: 415 mH D I 'SPENSER PANMAR '213, 2011 •1:2-2 FIN
FUEL IALARII
HPR 8. 2011 1:26 Hill
FUEL ALARM
APR 7. 2011 5:53 rIll
END
x A A A A END A ;- A A 1-
A w w - - END - * - -
A A x )< A END A - -
END
f-;LmPPl IIISTOR',` REPORT
At-AH,i ii i:7,rroRY REPPT SEtrSOR fILAFII
E;ENSOR ALARM ------
T I :fjNl_Eo4.,ECt
Lli-1:1.*llcP 15-16
L 4:FIRFJ'l ANN
PROBE OUT
Di,3PENSER PrAl.4
iANNLILAR SPACE
JUL 1 , 2011 11 :05 4,1
FUEL ALARM HLARN HISTORY REPOR'r
MAR 3• :Cii 1 10:513 ,-wl
SENSOR t41-44-1
ALmRl-1
FUEL FiLmkm
L 8: D I 2P I I - 121
L 7:DISP 9-10
MAR ;'I • '-201 1 10:47 AVI DISPENSER PAN
FUEL i4LmRrl
MAR 3, 2011 0: 44 AM END
A A x )< A END A - -
END
T I :fjNl_Eo4.,ECt 725
PROBE OUT
JUL 1 , 2011 11 :05 4,1
1-11STORY REPORT
SENSOR t41-44-1
L 8: D I 2P I I - 121
iAL iRl-1 H l'_3T,,)R'; REP(iRT DISPEN13ER PAN
3EI,4SOR F;LAPH
L 15:r)SL STP
STP SLIHP T ]:UNLEADED 725
LCAJ TEMP WAPNINC;
JUL 13. 2011 11 :1.16 H11
t • . - END *- - .
t )% -; A i, END . - p
IN-THNK HLi-iPlI
r 2:PREMIUM 7213
PROBE OUT
JUL IJ. 201 1 I 1 :0-:-- 61"1
I N-T-N), if-mPl I - -
9:PREmIjjj.I 725 ---- IPI-T,410: FASTR I P
L - T 3:111ESEL 7,5 -1901
Cki PPOL'U':'T ALARM PROBE OUT - 9A' ): E FI ELb CA
1 UL I I - ' - 2 0 1 1 11 :07 Ai•I JUL 15. 2011 11 :0*:' (4.1 661 - 397 --<:87
T
DELIVERY NEEDE1,
JUL 1,3- :--,Oil II:rj7 Am
Fo-kSTRIF 7"r,
JUL 13. *20 1 1 1 1 : 11,
11
f4t1
SY3'1*Etl STiiTl.)!.i REPORT
ALL Ftjhh'TIOW-. POKIIAL
111-TWO: ;-il,iPli - - --
T ',':[-ILI;EL 725
LOId i,p(%r.Lfi,j Ai-HF.ii
I "I. 201 I I 1: 0 4 4111
IN 'FAN),'. fAj.tjRj-1
I' 3:1:01ESEL 725
DEL I VER, ' I NEEDED
JI JL 13. :011 I I :OH HM
11`1 TaNI: ;4LAkl-1 - -- - -
1- 3:L'IESEL. ".:5
INVALID FUEL LEVEL
JUL 13. 2011 11:09 HIl
I PICPEkSE END
JUL 13. 2011 11:10 AM
VOLLPIE .
JUL 13. X011 11:07 rJ1
VOLWE 709 xALS
HE I GHT - 111. -17 1 VIC'NES
WATER . 1 .06 1 m-1-117C;
TEI1IF, . 80.1 DEG F
I PICPEkSE END
JUL 13. 2011 11:10 AM
VOLLPIE . 9.15 ',;ALS
HE I C;HT - 70.155 1 NC'HEL,
6IMTER . 0.00 INCHES
TEMP . @3. t, DE(; F
ROSS I"'PlEim6E- 0*74.1
Tr. NET IpK'PEmSE- 8 7
Ifl-THIA: ml-oPfl
T ,:DIESEL 725
I-NO TEMP WmPI,III,A;
JUL 13. `3011 11 : I
SEI'r.-30P i4.rAklll
L I :I.INL STP
STP SLIFIP
FUEL ai-i-iRM
JUL 13. 2011 11:10W
t
JUL 1.1. 2011 11 :10 HI"I
s,,,s,rEh -;,r;A-rLLc-; PEPORT
ALL FuliCTIONS
L 3:PREP1 E;TF'
FUEL FALhRI`1
JUL 13, 2UII 11 :I'D All
cSEW;OF.,
L 3;PREM STP
SIT SUMP
FUEL ALARM
J Ul- 10, 2011 1 1 : I I MI-1
L 5:161- STP
STP SU1'IP
FUEL ALARM
JUL 13, 2011 11:11 "'1
8EIjSoP iAi-.A431
NiN
FUEL ALARM
JUI., 13. 2011 1 1 1 hil
Zve ,)R HLARI °I -
L 8: 1', 1'3f' 11 -1 2
DISPENSED PAN
FUEL ALARM
JUL 13. 2011 11:1'.] 1-41
SENSOR olj+pl I
L 9:L)ISP 0-1-1 SEWOP
L 9:1)1';F' 13-1-1 11 ISPENSEP Pmpi L`: : LrSL STP
DISPENSER PWI SENSOR OUT HLi-+F11 STP SUMP
FUEL iALARM JUL 13, 2Cm it; i o t-ivi FUEL MLAFJI
JUL 13. 21011 1 1: 13 HI 1 JUL 1:3. 2201 1 11:19 HM
ErrsOR hLJ43-1 SDIS'OPSErqSORHb4PI11.1:1141SP 15-16
1.10:1.11SP 15-16 lo ISPENSER PAN L 7*1SP 9-10
1)[1:5PENSEP PH14 FUEL ALAPI-I clltiPEPJSE? PAN
FUEL HLAPH JUL 13, FUEL Ab-iRl-1
JUL 13. 2011 1 1: 14 W) -3111. 13 - 201 1 1 1: 2i1 4-1
SENSOR 041-1-0-1
L I : UNL STP 2EM OR HI-Hpfl
L _"UwL AiiN S)Tp Suit/ L 0 : b 15P I I -12
HwItili-iR Sl_-;Av-E FUEL r,1- Rrl N SPEDESEP PAN
FUEL Mb4RN JUL 13, -2,01 1 1 1 : 19 pm FUEL ml-ARV
JUL 13. 2011 11 :14 Al"I JUL 13. '2011 11 :2U :)f•l
UII)L ANN
L 4;1,PEIl WIN iAl-INULHR SNACE 'r I :U11IL&II)EI) 7'25
WINULAkl r'JrL ALARI-1 OVERF I LL ALAKII
FUEL. r,LHRl I lul- 13. 201 1 1 1 : I 'Am JUL 13. 201 1 1 1 :25 41
JUL 1.3. 2011 l I :I
Ili-i'mwl: mLRll ---
T l:LINLE,-i[1E1p 725L9:P160 F, 1 ST
L CSTFI IqL0•115 PROBE 01 rr
WINUI.;• FUEL. AL AR1-1 JUL. 13. 201 1 1 1 :25 i it I
FUEL tAIJAPII JUL 13. 201 1 1 1: 1? HM
JUL I'{. '_"CI I I I I : 15 r"H
I N-THNI: 0-ALMpi-I • - - - -
SEN20P T 2: PRE• I LIM 7'2"3
Fii,13TRIP 725 L 4:PPEM ANN OVERFILL kl_AFM
4901 HNNULHR JUL 13. '1011 1 1 1 i4'l
13iil!EP13FIEL1- !'H FUEL HLfm;RII
661 -s97 -9387 JUL 13. 2011 I I : 19 HM
1U1. 13. 21011 1 1 : 17 AM
T 725
PROBE OUT
J UL 1 '3. 201 1 11 : 27 oH
I : UNI-EHIC1
JUL 13. 2011 11
VOLUME ?523 C:4,1_1'.
HE 1 1 Ph: FIE
WATER 0.00 1114CHE,,
TEMP 4 93.2 L,Et F
I WPEA-T END
JUL 1'3. 20 1 1 1 1
VOLIPIE I 102":1 ";HLS
14E I 131-IT 83.021 lf+'HFS
iTER 0.80 Ml_.:HU
TEMP 9n.2 r,F-,'.; F
GROS:`. :350*
T- NET M"REiA,Z- J4Z
72'
llqV#ALIE, FUEL LEVEL
3UL 13- 21011 1 1 : '20 "1
IN-Ti;Nf: FiL,PVI
T 2:1-PEMIL6-1 725
1
JUL 0. 2011 11:2c ,I,l
7:.'S
DELIVERY NEEDED
JUL IJ, 2011
r 2:PREMILA1 7215
I ip_RFisE
I S!'I'mIRT
JUL 13, 201 1 1 1 ; :-'E, i41
VOLI.PiE . 94t.-I
HE ff - 70. St-, I NC_*HE:-,'
WATER . 0.00 1 NC'HES
TEMP . 9'j.8 DEC, F
I NCPEi-,SE END
JUL 13. Oil 11 :29 mil
VOLUME 10934 041_2
HE I :; HT 02.16 1 pi1-:11ES
wm,rEP 0.00 1 Nt:. HES
I*FJ1P 9,5 . 8 DEt"; F
GROSS 1480
1*1,. NET INt`REySE- 1.145
i LARVI - -
T 3:1)11ESEL 725
OVEPF I LL i4l-f-iRI•I
JUL 13. 2011 1 1 :30 ;4PI
I N-TiAl 41: 1 - -- -
T j:DIESEL 7`5
PROBE OUT
JUL I .3. 21 0 1 1 1 1 :3 mtI
11,10iLID FUEl. LLVEL
J LIL 1 3. _'0l 1 11 :'111 fif9
T J:DIESEL 7'--'S
1-061 PRODI-i*T mh-kRM
JUL 13. 2011 H :31 AM
is
1Iq-T;;NV* f•b-+Pfl --- -
T J:DIESEL 725
DELIVER`! NEEDEL)
J UL 13 . '201 1 1 1 : 31 i4'I
T 3: L, I ESEL 725
I K,.IEIITC)Re I NC'REriSE
I rK:KTAS3E snwr
JUL 13. 211I 1 11 :28 F41
VC11-1-01E . 63CI0
HE I GHT - 4'i.89 l hr: HD_:
WATER - n.orj IrjC:HE2
TEMP . 95.8 DEC; F
I 1,0-T&GE END
JUL I : _ j - 20 1 1 11 ::32 4-1
VOLU11E - 10745 1,ALS
HE i wr - 80.94 1WHES
WATER - 0.00 1rll:'HE2*
TFJIF' . 95.3 DEC; F
1", r, RO -2 I I'A`REASE- 4495
TC, NET I W-REt•SF- •7.12`
3EI,1 ,OF., ;;Li -MI --- -
L R:L)ISr- 11-12
DISPENSER PmN
FUEL mD-,,Prl
JUL 13, 21311 11 :'3.1 k'l
i:+-6,rp i r, !, - -
901 S.UNIQN
13h):EK;F1EI_f) 0A
661-397-9387
Jul. I.*-". '-Doll
1. 8: FUEL
L I :111!1. STP 725
il-TP Suir,
F'UFI. HLARI I BAKERSF I ELD
JUL 173. 201 1 r41 661-397-9367
JUL 13, 2011 P-1
Pn-rmri REPORT
ALL
A R ,i * END !w
0
STHTUr- REPORT
I NVENTOR'll PEPOPT
L I : U1,11- 2;TP
STY,
FUEL ALi-APTI T I 'Ul4LEHE,Efj
301, 13, 2,0] 1 1 1 51 f4,l VOLUME . 9066 ALL:
ULLH,:;E . 2934 14 LP,
90",4 ULL"CAE- 1 '134 HLS
Ti' VOLUME - 8956 1--oLS'
HE I C:HT - 67.04 1 "-HESS,
WATER VOL. - 0 C ;FAI-S*
WATER - 0.110 1 NCHF
TFJ•IVI . 7'7.3 DEC; F
I'ENSOP I T 2:PPENIUM 725
L 8: Ls I SP I I - 12, VOLUME 5_78
r)l'-"F,Er)P,EP P-irl LILLAl-,E t3722 GP '1.::i
FljEl. 9CM. ULLi-iGE- 5522, C"HLS
JUL 1:". 2011 12: 01 PN Ti: VOLUME - 5200
HEIGHT - 43.46 INCHES
WATER VOL = 0 A L7: '
14ATER . 0.00 1 Nl.':HEM;
TEIIP . 81 Cj DEC; F
T J:DIESEL
VOLUHE - 6,1 9 i-iL,.;'
LILLAGE . 5501 clw4-S
Fms,rR I 1-- 901. ULLi-;C,*F- 4'301 GALS
1901 TC VOLUIIE = 64 25 GALS
BFiKERSF I ELF, HE I GHT = 51.14 1 PICHES
WATER VOL = 23 ALS
WATER = I . CitS I N,'HES
JLJI- 1::- '2111 1 14 PH TEl•IF' = 85 . 2, DE' .* F
Pn-rmri REPORT
ALL
A R ,i * END !w
0
SWRCB, January 2006
Spill Bucket Vesting Report Form
Thisform is intendedfor use by contractors performing annual testing of LISTspill containment structures. The completedform and
printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: #725 Fastrip #19 1 Date of Testing: 7/13/2011
Facility Address: 4901 South Union Avenue, Bakersfield, CA 93307
Facility Contact: Omero Garcia I Phone: 661 - 393 -7000
Date Local Agency Was Notified of Testing: 6/27/2011
Name of Local Agency Inspector (ifpresent during testing): Ester Estrada
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Kristopher Karns
Credentials: X CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester Other (Specify)
License Number(s): CSLB #804904 ICC #5264406 -UT SWRCB # 09 -1743
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 Regular 2 Super 3 Diesel 4
Bucket Installation Type: Direct Bury
x Contained in Sump
Direct Bury
x Contained in Sump
Direct Bury
x Contained in Sump
Direct Bury
Contained in Sum
Bucket Diameter: 12.00" 12.00" 12.00"
Bucket Depth: 14.50" 13.75" 15.00"
Wait time between applying
vacuum /water and start of test:
5 min. 5 min. 5 min.
Test Start Time (Ti): 11:45 AM 11:45 AM 11:45 AM
Initial Reading (Ri): 11.00" 11.00" 12.00"
Test End Time (TF): 12:45 PM 12:45 PM 12:45 PM
Final Reading (RF): 11.00" 11.00" 10.00"
Test Duration (TF — Ti): 1 hour 1 hour 1 hour
Change in Reading (RF - Rj): 0.00" 0.00" 2.00"
Pass/Fail Threshold or
Criteria:
0.0625" 0.0625" 0.0625"
Test Result: I X Pass Fail I X Pass Fail 1 Pass X Fall Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed 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: Date: 7/14/2010
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
0
l ®g
C, 4
U
WM[iIAM[f WITw WyVtICGK[- Invoice No.: 27183
Site: #725 Fastrip # 19
4901 South Union Avenue
Bakersfield, CA 93307
Repairs Requested:
Repairs completed: During the Leak Detector testing, the Super
FX1V failed to catch a leak. I replaced the old Super FX1V with a
new FX1V. After the repair the new FX1V was retested and
confirmed operational.
Required Repairs, Still Pending: While testing the Spill Buckets the
Diesel OPW Spill Bucket failed. It needs to be replaced and retested.
Technician Name: Kristopher Karns
Signature:
Date: 7/13/2011
725 Fasirip #19
4901 Souil) Union Avenue
Bakersfield, CA 93307
71'13x2011
0IN
1= Veeder Root TLS - 350
2= External Overfill Alarm
3= Emergency Shut Off Switch
4= Veeder Root ATG Probe
5= Veeder Root 208 Sump Sensor
6= Veeder Root 420 Annular Sensor
7= FX1V Line Leak Detector
8= FX1DV Line Leak Detector
9= Regular STP Sump
10= Super STP Sump
11= Diesel STP Sump
12= Regular Fill Sump
13= Super Fill Sump
14= Diesel Fill Sump
6 1 . 12 4.5,7,9 12 11 10 9
5
6) '1 4,5,7,10
V
16 15 14 13
f 6 I 4,5,8,11
14
5 5
MG ITDIUNG SYSTEM cCERUR CATID N
For Use By All Jurisdictions Within the State ofCalifornia
Authority Cited.- Chapter 6 7, Health andSafety Code; Chapter 16, Division 3, Title 23, California Code ofRegulations
This form must be used to document testing and servicing of monitoring equipment. A separate certification or roort 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 ofthis form to the local agency regulating UST systems
within 30 days of this date.
A. General Information
Facility Name: #775 Chevron (North)
Site Address: 4901 South Union Avenue
Facility Contact Person: Omero Garcia
Make/Model of Monitoring System: Veeder -Root TLS 350
B. Inventory of Equipment'Tested /Certified
Check the appropriate uses to indicate specific equipment inspected/serAced:
City: Bakersfield
Bldg. No.:
Zip: 93307
Contact Phone No.: 661 - 393 -7000
Date ofTesting/Servicing: 7/13/2011
Tank ID: 12000 gal. Regular 1 Tank ID: 12000 gal. Regular 2
x] In -Tank Gauging Probe. Model: 847390- 107 x] In -Tank Gauging Probe. Model: 847390 -107
x] Annular Space or Vault Probe. Model: 794390 -420 U Annular Space or Vault Sensor. Model: 794390 -420
x] Piping Sump / Trench Sensor(s). Model: 794380 -208 x] Piping Sump / Trench Sensor(s). Model: 794380 -208
Fill Sump Sensor(s) Model: Fill Sump Sensor(s). Model:
DO Mechanical Line Leak Detector. Model: FX1V x_1 Mechanical Line Leak Detector. Model: syphen
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
x] Tank Overfill / High Level Sensor. Model: 847390 -107 L] Tank Overfill / High Leval Sensor. Model: 847390 -107
Other (specify equip. type and model in Sec. E on Pg. 2) Other (specify equip. type and model in Sec. E on Pg. 2)
Tank ID:_12000 gal. Super Tank ID: 12000 gal. Diesel
x] In -Tank Gauging Probe. Model: 847390 -107x] In -Tank Gauging Probe. Model: 847390 -107
x] Annular Space or Vault Sensor. Model: 794390 -420 x] Annular Space or Vault Sensor. Model: 794390 -420
x] Piping Sump / Trench Sensor(s). Model: 794380- 208 U Piping Sump / Trench Sensor(s). Model: 794380 -208
Fill Sump Sensors(s). Model: Fill Sump Sensor(s). Model:
x1 Mechanical Line Leak Decector. Model: FX1V x] Mechanical Line Leak Detector. Model: FE Petro
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
x] Tank Overfill / High Level Sensor. Model: 847390 -107 x] Tank Overfill / High Level Sensor. Model: 847390 -107
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
Mx Dispenser Containment Sensor(s). Model: 794380 -208 U Dispenser Containment Sensor(s). Model: 794380 -208
x] Shear Valve(s). U Shear Valve(s).
Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s)
Dispenser ID: 5 & 6 Dispenser ID: 718
x] Dispenser Containment Sensor(s). Model: 794380.208 U Dispenser Containment Sensor(s). Model: 794380 -208
Lj Shear Valve(s). X] Shear Valve(s).
Dispenser Containment Float(s) and Chains(s). Dispenser Containment Float(s) and Chain(s).
Dispenser ID: Transition Sump North Dispenser ID: Transition Sump South
x] Dispenser Containment Sensor(s). Model: 794380 -208 x] Dispenser Containment Sensor(s). Model: 794380 -208
Shear Valve(s). Shear Valve(s).
Dispenser Containment Float(s) and Chain(s) Dispenser Containment Float(s) and Chain(s).
If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility.
C. Certification - I certify that the equipment identified in this document was inspected /services in accordance with the
manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that
this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating
such reports, I have attached a copy of the report; (check all that apply) Qx System Set -up U Alarm history report
Technician Name (print): Kristopher Karns Signature: kAA #jc AIA"-
Certification No: 834106
Testing Company Name: Confidence UST Services, Inc.
Site Address: 4901 South Union Avenue, Bakersfield, CA 93307
License No: 804904
Phone No: 800 - 339 -9930
Date ofTesting/Servicing: 711312011
D. Results of Testing /Sery icing
Software Version Installed: 327.04
Complete the following checklist:
El Yes No* Is the audible alarm operational?
x Yes No* Is isual alarm operational?
x I Yes rl No* Were all sensors visually inspected?
x 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?
TilYes No* For pressurized piping systems, does the turbine automatically shut down ifthe 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? E Sump /Trench Sensors U Dispenser Containment Sensors
Did you confirm positive shut -down due to leaks and sensor failure /disconnected? U Yes; No;
U Yes No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
L] N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at
the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm
trigger? L9p %
Yes* U 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* No Was liquid found inside any secondary containment systems designed as dry systems?
Product; Water. If yes, describe causes in Section E, below.
x No* Was monitoring system set -up reviewed to ensure proper settings?
In Section E below, discribe how and when these deficiencies were or will be corrected.
E. Comments:
F. In -Tank Guaging / SIR Equipment: [X] Check this box if tank guaging is used only for inventory control.
Check this box if tank guaging or SIR equipment is installed.
This section must be completed if in -tank guaging equipment is used to perform leak detection monitoring.
Complete the following checklist:
Cx] Yes No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults?
x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
Ix Yes No* Was accuracy of system product level readings tested?
xj Yes No* Was accuracy of system water level readings tested?
x Yes No* Were all probes reinstalled properly?
E 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:
L] Yes No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance?
Check all that apply) Simulated leak rate: [x]3 g.p.h.: 0.1 g.p.h.; 0.2 g.p.h.;
xTYes No* Were all LLD's confirmed operational and accurate within regulatory requirments?
x Yes 0 No* Was the testing apparatus proper y ca ibrate ?
Yes No* For machanical 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?
x] N/A
Yes 7 No* For electronic LLD's, does the turbine automatically shut off if any portion ofthe 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
Cx] N/A malfunction or fails a test?
Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected?
L] N/A
x Yes 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:
C :HkVRON rl7 ;5 i ?YSTP.M 'iE:TU P
li I ,BLCU
7501 S.UN10N
MKERS:F 1 ELG CA53'11}7 All. 13. .:01 1 8 : 57 AM I.tiMI°IUN I Crifl ow, = :ETIJP
t °IODU!_Ep C3?01r,U- i}11.1 -,
SYSTEM FEATURES :
Ul. 12. 2U 1 I U: 57 rim
ANNUAL 1111-TANK TESTS
ISD
YSTEll UN! I TS
U S. N.)17I `SE 1-1 I IVI,
STFII LAN-LAGE I-OHM Bj)Apts 1 t FP l M > t;YSTEM s fATW_; I•' J,0RT ENGLISH t3E rtdD21 TYS'YSTEFi Dri: TIME rORMAT ODE t i 4FlHI.EtIODEALLFUNCTIONStdvRtwl_ MON DD ` 'ri t HH : MM :. 4*1
1 tfJENTt}kj• REPORT I. HEVkON 775 Ot il'I BOARD
tIAUD EATS 4600
4901 S.UNION
HAKERSF I ELD CA9yTJU? PARITY NONE
STOP : I ,TOP
T I :UNLEADEDDED 1 661-391-9367 A
LIT
DATA I .SEX,
UH :
8 DATAVOLT (ME 571'7 GALS R•`} ULLW -;E 6275 13ALS SHIFT TIME 1 6:00 Am E : DISABLEDCBI .I DCODEDISABLED9LV; ULL.A! :E4 071 i:ALS SH 1 FT TIME 2 D 1 W' L£D
TO VO ?LIJ11F: - 11682 H I FT TIME 3 : D i eABLF_D OI'N'9 140AP.DHEIGHT - r.. Sty 1 NGHL•:5 SHIFT TIME 4 L I SSAPLED BHIID RATE1JA'fEN VOL a Cl aHl_: PAR I T'l NONEWATER0.00 11,0117b Two: PER TST NLEDED WRN STUP 13 I1' I ST01' TEMP 78, 4 DEC F' D I SABLED DATA t_ENU•TH : B DATATANKANNTSTNEEDEDWRNFtS_? ? SEC.Uk I TYLtlSABLEGDISABLED
T :. UNI_L L G1i
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SWRCB, January 2006
Spill Bucket Testing Report IF®r>i>rI
Thisform is intendedfor use by contractors performing annual testing of USTspill containment structures. The completedform and
printoutsfrom tests (fapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: #775 Chevron (North) I Date of Testing: 7/13/2011
Facility Address: 4901 South Union Avenue, Bakersfield, CA 93307
Facility Contact: Omero Garcia I Phone: 661 - 393 -7000
Date Local Agency Was Notified of Testing: Ester
Name of Local Agency Inspector (cfpresent during testing): 6/27/2011
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Kristopher Karns
Credentials: X CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Specify)
License Number(s): CSLB #804904 ICC #5264406 -UT SWRCB # 09 -1743
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 Regular 1 2 Regular 2 3 Super 4 Diesel
Bucket Installation Type: Direct Bury
x Contained in Sump
Direct Bury
x Contained in Sump
Direct Bury
x Contained in Sump
Direct Bury
x Contained in Sum
Bucket Diameter: 12.00" 12.00" 12.00" 12.00"
Bucket Depth: 13.50" 14.00" 14.00" 14.50"
Wait time between applying
vacuum /water and start of test:
5 min. 5 min. 5 min. 5 min.
Test Start Time (Ti): 9:00am 9:00am 9:00am 9:00am
Initial Reading (R,): 11.00" 11.25" 11.50" 11.00"
Test End Time (TF): 10:00am 10:00am 10:00am 10:00am
Final Reading (RF): 9.00" 11.25" 8.50" 11.00"
Test Duration (TF — T,): 1 hour 1 hour 1 hour 1 hour
Change in Reading (RF - R,): 2.00" 0.00" 3.00" 0.00"
Pass/Fail Threshold or
Criteria: 0.0625" 0.0625" 0.0625" 0.0625"
Test Result: Pass X Fail X Pass Fail Pass X Fail X Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true, accurate, and infull compliance with legal requirements.
Technician's Signature: Date: 7/13/2011
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
M4PU.Mfx WTMC0.F,W-.eL- Invoice No.. 27184
Site: #775 Chevron ( North )
4901 South Union Avenue
Bakersfield, CA 93307
Repairs Requested:
Repairs completed:
Required Repairs, Still Pending: During the Monitoring
Certification, the Regualr 1 Master OPW Spill Bucket, and OPW
Super Spill Bucket both failed. Once the repairs are made we need
to retest both Spill Buckets.
Technician Name: Kristopher Karns
Signature:u,, r1
Date: 7/13/2011
1 2 5 6 1= Veeder Root TLS - 350
2= External Overfill Alarmd
4775 Chevron ( North j 3= Emergency Shut Off Switch
4901 South Union Avenue 5 4= Veeder Root ATG Probe
Bakersfield, CA 93307 5= Veeder Root 208 Sump Sensor
6= Veeder Root 420 Annular sensor
7/13/2011 5 7= FX1V Line Leak Detector58= FX1 DV Line Leak Detector
9= Regular 1 Master STP Sump
1 3 10= Regular 2 Siphon STP Sump
3 4
7 8 11= Super STP Sump
12= Diesel STP Sump
13= Regular 1 Fill Sump
a 14= Regular 2 Fill Sump
15= Super Fill Sump
16= Diesel Fill Sump
4,5,7,9 0
13
4,5,10 00
n4.5,7.11
15
4,5;8,12e ro
16