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HomeMy WebLinkAbout2010 FMC RESULTSI _ A dj D FEUDG 1i OgOgy 11000 N. MoPac Expressway, Suite 500 Austin, Texas 78759 Phone: (512) 451 -6334 Fax: (512) 459 -1459 KERN CTY - ENVIROMENTAL HEALTH 2700 M STREET SUITE 300 BAKERSFIELD, CA. 93301 Test Date: 11/04/2010 Order Number: 3178646 Date Printed and Mailed: 11/17/2010 L V L-`. T Dear Regulator, Enclosed are the results of recent testing performed at the following facility: SAM'S CLUB # SC4819 5625 GOSFORD ROAD BAKERSFIELD, CA. 93313 Testing performed: Leak detector tests Line tests Monitor Certification Secondary Containment -Spill Container Tank Tests Sincerely, Dawn Kohlmeyer Manager, Field Reporting a/7 Q70 0 TANKNOLOGY CERTIFICATE OF TESTING 7' 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451 -6334 FAX (512) 459 -1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 11/04110 WORK ORDER NUMBER: 3178646 CUSTOMER PO: CLIENT: SAM'S CLUB DEPT. 9641 608 SOUTHWEST 8TH STREET BENTONVILLE, AR 72712 -6297 Kevin Allen 479)204 -6131 SITE: SAM'S CLUB # SC4819 5625 GOSFORD ROAD BAKERSFIELD, CA 93313 MANAGER 661)654 -8565 Tank Tinhtness Tests Results TEST TYPE: VacuTect TANK ID PRODUCT TANK CAPACITY TANK DIAMETER TANK MATERIAL PRODUCT LEVEL EXTERNAL* WATER LEVEL TEST RESULT 87 Northl UNLEADED 19,781 118.0 DW FIBERG 58.65 207.00 PASS 87 South2 UNLEADED 19,781 118.0 DW FIBERG 60.50 207.00 PASS 91 3 PREMIUM 11,904 118.0 DW FIBERG 63.00 207.00 PASS DIESEL 4 DIESEL 7,901 118.0 DW FIBERG 60.00 207.00 PASS Where regulations require, for Vacu Iect external water level may be depth of dry well or water is assumed at lowest point tnat can be connrmed dry. Prnrliir-t Pina Tinhtnacc Tact Raciiltc LINE ID LINE MATERIAL DELIVERY TYPE TEST RESULT A B C D FINAL LEAK RATE (gph) A B C D TEST METHOD IMPACT VALVE FUNCTION 87 North 1 DW FIBERG PRESSURE P 0.009 TLD -1 Y 87 South 2 DW FIBERG PRESSURE P 0.009 TLD -1 Y 91 3 DW FIBERG PRESSURE P 0.009 TLD -1 Y DIESEL 4 DW FIBERG PRESSURE P 0.000 TLD -1 Y F_Yistinn Line Leak Detector Test I! LINE EXISTING LEAK DETECTOR 1 EXISTING LEAK DETECTOR #2 ID MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESULT 87 North 1 RED JACKET FX1V 307098751 P 87 South 2 RED JACKET FX1V 307098752 P 91 3 RED JACKET FX1V 307098753 P DIESEL 4 RED JACKET FX1 -DV 307099837 P LINE I MANUFACTURERI MODEL # I SERIAL # I RESULT I MANUFACTURER I MODEL # I SERIAL # RESUL' I or owner detailed report information, visit www.tanknology.com and select On -Line Reports -WRAP, or contact your local Tanknology office. Tester Name: PATRICK M PFRANG Technician Certification Number: 1590 INDIVIDUAL TEST DATE: 11/04/10 CLIENT: SAM'S CLUB TANK INFORMATION AND Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512) 451 -6334 TEST RESULTS WORK ORDER NUMBER3178646 SITE:SAM' S CLUB # SC4819 Printed 11/17/2010 09:02 TANK INFORMATION Tank ID: 87 North 1 Tank manifolded: NO Bottom to top fill in inches: 163.0 Product: UNLEADED Vent manifolded: YES Bottom to grade in inches: 188.0 Capacity in gallons: 19,781 Vapor recovery manifolded: YES Fill pipe length in inches: 40.5 Diameter in inches: 118.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 401 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESULTS Test Method:vacuTect LEAK DETECTOR TEST RESULTS Test method: LDT -5000 Start (in) End (in) Dipped Water Level: 0.00 0.00 New /passed Failed /replaced New /passed Failed /replaced Dipped Product Level: 58.65 58.65 L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: 0.075 0.075 Make: RED JACKET Ingress Detected: Water N Bubble N UllageN Model: Fx1v Test time: 13:26-15:27 SIN: 307098751 Open time in sec: 3.00 Inclinometer reading: 0.00 Holding psi: 18 VacuTect Test Type: Multiple tanks Resiliency cc: 130 NOT VacuTect Probe Entry Point: Gauge Test leak rate ml /m: 189.0 TESTED Pressure Set Point: 0.70 Metering psi: 11 Tank water level in inches: 0.00 Calib. leak in gph: 3.00 Water table depth in inches: 207.00 Results: PASS Determined by (method): MONTR WELL Result: PASS COMMENTS COMMENTS LINE TEST RESULTS Test type: TLD -1 LINE A B C D Material: DW FIBERG Diameter (in): 2.0 Length (ft): 300.0 Test psi: 50 Bleedback cc: 0 Test time (min): 30 NOT NOT NOT Start time: 16:27 TESTED TESTED TESTED End time: 16: 57 Final gph: 0.009 Result: PASS Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 11/17/2010 09:02 INDIVIDUAL TEST DATE:11 /04/10 CLIENT: SAM'S CLUB TANK INFORMATION AND r Tanknobgy 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512) 451 -6334 TEST RESULTS WORK ORDER NUMBER3178646 SITE:SAM' S CLUB # SC4819 Printed 11/17/2010 09:02 TANK INFORMATION Tank ID: 87 South 2 Tank manifolded: NO Bottom to top fill in inches: 163.0 Product: UNLEADED Vent manifolded: YES Bottom to grade in inches: 190.0 Capacity in gallons: 19,781 Vapor recovery manifolded: YES Fill pipe length in inches: 40.0 Diameter in inches: 118.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 401 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESULTS Test Method:vacuTect LEAK DETECTOR TEST RESULTS Test method: LDT -5000 Start (in) End (in) Dipped Water Level: 0.00 0.00 New /passed Failed /replaced New /passed Failed /replaced Dipped Product Level: 60.50 60.50 L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: 0.070 0.069 Make: RED JACKET Ingress Detected: Water N Bubble N UllageN Model: Fx1V Test time: 13:26 -15:27 S /N• 307098752 Open time in sec: 3.00 Inclinometer reading: 0.00 Holding psi: 18 VacuTect Test Type: Multiple tanks Resiliency cc: 115 NOT VacuTect Probe Entry Point: Gauge Test leak rate ml /m: 189.0 TESTED Pressure Set Point: 0.76 Metering psi: 12 Tank water level in inches: 0.00 Calib. leak in gph: 3.00 Water table depth in inches: 207.00 Results: PASS Determined by (method): MONTR WELL Result: PASS COMMENTS COMMENTS LINE TEST RESULTS Test type: TLD -1 LINE A B C D Material: DW FIBERG Diameter (in): 2.0 Length (ft): 300.0 Test psi: 50 Bleedback cc: 0 Test time (min): 30 NOT NOT NOT Start time: 16: 27 TESTED TESTED TESTED End time: 16 : 57 Final gph: 0.009 Result: PASS Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 11/17/2010 09:02 INDIVIDUAL TANK INFORMATION AND TEST RESULTS r Tanknobgy TEST DATE:11 /04/10 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3178646 CLIENT:SAM' S CLUB AUSTIN, TEXAS 78759 (512) 451 -6334 SITE:SAM' S CLUB # SC4819 Printed 11/17/2010 09:02 TANK INFORMATION Tank ID: 91 3 Tank manifolded: NO Bottom to top fill in inches: 164.0 Product: PREMIUM Vent manifolded: YES Bottom to grade in inches: 189.0 Capacity in gallons: 11,904 Vapor recovery manifolded: YES Fill pipe length in inches: 40.0 Diameter in inches: 118.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 268 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESULTS Test Method:vacuTect LEAK DETECTOR TEST RESULTS Test method: LDT -5000 Start (in) End (in) Dipped Water Level: 0.00 0.00 New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: 63.00 63.00 Probe Water Level: 0.085 0.084 Make: RED JACKET Ingress Detected: Water N Bubble N UllageN Model: Fx1V Test time: 15:57 -17:24 S /N• 307098753 Open time in sec: 2.00 Inclinometer reading: 0.00 Holding psi: 18 VacuTect Test Type: Multiple tanks Resiliency cc: 145 NOT VacuTect Probe Entry Point: Gauge Test leak rate ml /m: 189.0 TESTED Pressure Set Point: 0.60 Metering psi: 12 Tank water level in inches: 0.00 Calib. leak in gph: 3.00 Water table depth in inches: 207.00 Results: PASS Determined by (method): MONTR WELL Result: PASS COMMENTS COMMENTS LINE TEST RESULTS Test type: TLD -1 LINE A B C D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): 300.0 Test psi: 50 Bleedback cc: 0 Test time (min): 30 NOT NOT NOT Start time: 16:27 TESTED TESTED TESTED End time: 16: 57 Final gph: 0.009 Result: PASS Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 11/17/2010 09:02 INDIVIDUAL TEST DATE: 11 /04/10 CLIENT: SAM'S CLUB TANK INFORMATION AND tip ianknolloegr 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512) 451 -6334 TEST RESULTS WORK ORDER NUMBER3 17 8 6 4 6 SITE:SAM'S CLUB # SC4819 Printed 11/17/2010 09:02 TANK INFORMATION Tank ID: DIESEL 4 Tank manifolded: NO Bottom to top fill in inches: 164.0 Product: DIESEL Vent manifolded: NO Bottom to grade in inches: 189.0 Capacity in gallons: 7,901 Vapor recovery manifolded: NO Fill pipe length in inches: 41.0 Diameter in inches: 118.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 250 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESULTS Test Method:vacuxect LEAK DETECTOR TEST RESULTS Test method: LDT -5000 Start (in) End (in) Dipped Water Level: 0.00 0.00 New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: 60.00 60.00 Probe Water Level: 0.101 0.100 Make: RED JACKET Ingress Detected: Water N Bubble N UllageN Model: Fxl -Dv Test time: 15:57 -17:24 S /N• 307099837 Open time in sec: 1.00 Inclinometer reading: 0.00 Holding psi: zo VacuTect Test Type: Multiple tanks Resiliency cc: 105 NOT VacuTect Probe Entry Point: Gauge Test leak rate ml /m: 189.0 TESTED Pressure Set Point: 0.61 Metering psi: 11 Tank water level in inches: 0.00 Calib. leak in gph: 3.00 Water table depth in inches: 207.00 Results: PASS Determined by (method): MONTR WELL Result: PASS COMMENTS COMMENTS LINE TEST RESULTS Test type: TLD -1 LINE A B C D Material: DW FIBERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: 50 Bleedback cc: 0 Test time (min): 30 NOT NOT NOT Start time: 15 : 23 TESTED TESTED TESTED End time: 15: 53 Final gph: 0.000 Result: PASS Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 11/17/2010 09:02 MONTI'ORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner /operator, The owner /operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: SAM'S CLUB # SC4819 Site Address: 5625 GOSFORD ROAD City: BAKERSFIELD Contact Phone No: 654 -8565 Date of Testing /Service: 11/04/2010 Facility Contact Person: MANAGER Make /Model of Monitoring System:TLS -350 Work Order Number: 3178646 B. Inventory of Equipment Tested /Certified Check the appropriate boxes to indicate specific equipment inspected /serviced CA Zip: 93313 Tank ID: T-187 Tank ID: T -2 87 X In -Tank Gauging Probe. Model: VR MAG PLUS X In -Tank Gauging Probe. Model: VR MAG PLUS X Annular Space or Vault Sensor. Model: VR 303 Annular Space or Vault Sensor. Model: VR 303 X Piping Sump/Trench Sensor(s). Model: VR 208/ 304 Piping Sump/Trench Sensor(s). Model: VR 208/304 X Fill Sump Sensor(s). Model: VR 208/ 304 Fill Sump Sensor(s). Model: VR 208/304 X Mechanical Line Leak Detector. Model: FX1V X Mechanical Line Leak Detector. Model: FX1V Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: X Tank Overfill /High -Level Sensor. Model: EXTERNAL Tank Overfill /High -Level Sensor. Model: EXTERNAL Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Tank ID: Tank ID: T-4 DIESEL In -Tank Gauging Probe. Model: VR MAG PLUS In -Tank Gauging Probe. Model: VR MAG PLUS X Annular Space or Vault Sensor. Model: VR 303 Annular Space or Vault Sensor. Model: VR 303 X Piping Sump/Trench Sensor(s). Model: VR 208/ 304 X Piping Sump/Trench Sensor(s). Model: VR 208/ 304 X Fill Sump Sensor(s). Model: VR 208/ 304 71 Fill Sump Sensor(s). Model: VR 208/ 304 X Mechanical Line Leak Detector. Model: FX1V X Mechanical Line Leak Detector. Model: FX1 DV Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill /High -Level Sensor. Model: EXTERNAL Tank Overfill /High -Level Sensor. Model: EXTERNAL Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Dispenser : 1 - 12 Dispenser ID: Dispenser Containment Sensor(s) Model: VR 2081304 Dispenser Containment Sensor(s) Model: X Shear Valve(s). Shear Valve(s) 0 Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: F] 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). Dispenser ID: Dispenser ID: Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). Shear Valve(s). ID 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 /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 Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): MX System set -up X Alarm history report Technician Name (print): PATRICK M PFRANG Signature: Certification No.: A29052 License. No.: 743160 (Class 'A' General Enginering Contractor License) Testing Company Name:Tanknology Phone No.: (800) 800 -4633 Site Address: 11000 N. MoPac Expressway, suite 500, Austin, TX 78759 Date of Testing /Servicing: 11/04/2010 Monitoring System Certification Page 1 of 3 Based on CA form dated 03/08 Site Address 5625 GOSFORD ROAD D. Results of Testing /Servicing Software Version Installed 329.02 Complete the following checklist: Monitoring System Certification Date of Testing /Service: 11/04/2010 In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: Removed me s of water from 87 - and diesel turbine sumps. Page 2 of 3 Based on CA form dated 03/08 No • Is the audible alarm operational? VFFx-]Yes No Is the visual alarm operational? No Were all sensors visually inspected, functionally tested, and confirmed operational? No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? X Yes No' N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? Yes No N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (check all that apply) X Sumpffrench Sensors; [Z] Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure /disconnection? 0 Yes No X Yes No El For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 90 % Yes' O 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. O Yes' No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) Product; 0 Water. If yes, describe causes in Section E, below. X Yes No Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable. Q Yes No Is all monitoring equipment operational per manufacturers' specifications? In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: Removed me s of water from 87 - and diesel turbine sumps. Page 2 of 3 Based on CA form dated 03/08 Monitoring System Certification Site Address: 5625 GOSFORD ROAD Date of Testing /Service: F. In -Tank Gauging / SIR Equipment Check this box if no tank gauging or SIR equipment is installed. 11/04/2010 MCheck this box if tank gauging is used only for inventory control. 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: Yes No • Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Q Yes No • Were all tank gauging probes visually inspected for damage and residue buildup? QYes No • Was accuracy of system product level readings tested? Yes No Was accuracy of system water level readings tested? X Yes No • Were all probes reinstalled properly? 0 Yes No Were all items on the equipment manufacturers' 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 LLDs are not installed. Complete the following checklist: Q Yes No • N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: X 3 h 0.1 h 0.2 h9.p. g.p. g.p. X Yes No' Were all LLDs confirmed operational and accurate within regulatory requirements? EYes No' Was the testing apparatus properly calibrated? X Yes No' N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? Yes No' X N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes No ' Q N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes No' Q N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes No' Q N/A For electronic LLDs, have all accessible wiring connections been visually inspected? 0 Yes No' Were all items on the equipment manufacturers' 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 Based on CA form dated 03/08 SWRCB, January 2002 Page 1. Secondary Containment Testing Report Form This form is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages ofthis form to report resultsfor all components tested. The completedform, written test procedures, and printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: SAM'S CLUB # SC4 819 Date of Testing: 11/04/2010 Facility Address: 5625 GOSFORD ROAD BAKERSFIELD, CA, 93313 Facility Contact: MANAGER Phone: (661) 654 -8565 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (ifpresent during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY , INC. Pass Technician Conducting Test: PATRICK M PFRANG Repairs Made Credentials: Pass CSLB Licensed Contractor SWRCB Licensed Tank Tester Repair Made License Type: tank tester License Number: 051590 E Manufacturer Manufacturer Training Component(s) Date Training Expires OPW Fill bucket 10/03/2012 Spill Box 2 UNL FILL F—,1 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repair Made Spill Box 1 UNL FILL E Spill Box 2 UNL FILL F—,1 Spill Box 3 PRE FILL X Spill Box 4 DIE FILL El D 1:1 El El El D E El El El 1:1 F-1 El 1:1 D El El El El El E El I El E El El El E El El El El El El El El El I Eli 01 El I El I If hydrostatic testing was performed, describe what was done with the water after completion of tests: used gas CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's Signature: Z2 Date: 11/04/2010 SWRCB, January 2006 90 Spill Bucket 'Testing Report Form Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: SAM'S CLUB # SC4 819 Date of Testing: 11/04/2010 Facility Address: 5625 GOSFORD ROAD BAKERSFIELD, CA, 93313 Facility Contact: MANAGER Phone: (6 61) 654-8565 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (ifpresent during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY , INC. Technician Conducting Test: PATRICK M PFRANG Credentials 1: 0 CSLB Contractor El ICC Service Tech. E SWRCB Tank Tester E Other (Specify) tank tester License Number: 051590 3. SPILL BUCKET TESTING INFORMATION Test Method Used: Ifl Hydrostatic Vacuum E Other Test Equipment Used: Tape measure Equipment Resolution: Visual Identify Spill Bucket(By Tank Number, Stored Product, etc.) i 1 UNL FILL 2 2 UNL FILL 3 3 PRE FILL 4 4 DIE FILL Bucket Installation Type: Direct Bury Contained in Sump Direct Bury X Contained in Sump Direct Bury Contained in Sump Direct Bury X Contained in Sump Bucket Diameter: 12 12 12 12 Bucket Depth: 14.5 15.5 15.5 15 Wait time between applying vacuum/water and starting test: 0 0 0 0 Test Start Time (TI ): 0835 0835 0835 0835 Initial Reading (Ri ): 9.25 9.5 10.0 11.0 Test End Time (TF ): 0935 0935 0935 0935 Final Reading (RF ): 9.25 9.5 10.0 11.0 Test Duration: 1 hr 1 hr 1 hr 1 hr Change in Reading (R F - R1 ): 0 0 0 0 Pass/Fail Threshold or Criteria: 0 Loss 0 Loss 0 Loss 0 Loss Test Result: fl Pass E] Fail K] Pass El Fail Pass Fail 0 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 in full compliance with legal requirements. Technician's Signature: Date: 11/04/2010 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements Work Order: 3178646 Monitoring System Certification Form: Addendum for Vacuum /Pressure Interstitial Sensors LG 163-1, Enc. IH L Results of Vacuum/Pressure Monitoring Equipment Testing This page should be used to document testing and servicing of vacuum and pressure interstitial sensors. A copy of this form must be included with the Monitoring System Certification Form, which must be provided to the tank system owner /operator. The owner /operator must submit a copy of the Monitoring System Certification Form to the local agency regulating UST systems within 30 days of test date. Manufacturer: Model: V 7p System 'Type: Pressure; Xvacuum Sensor ID Component(s) Monitored by this Sensor lQQ 0e 7 Sensor Functionality Test Result: ass; Fail Interstitial Communication Test Result:01'ass; Fail Component(s) Monitored by this Sensor: Vh-,Aj 7 Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: ,Pass; Fail Component(s) Monitored by this Sensor: 4e) DuG7- E Sensor Functionality Test Result: 91'ass; Fail Interstitial Communication Test Result:19 Pass; Fail Component(s) Monitored by this Sensor: VC Al Sensor Functionality Test Result: ass; Fail Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: 191 10 P0404C7 © V Sensor Functionality Test Result: XPass; Fail Interstitial Communication Test Result Pass; Fail Component(s) Monitored by this Sensor: ACD,.Ot le7' A,10 r Sensor Functionality Test Result: ass; Fail Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: Aaf 7— v Sensor Functionality Test Result: ,Pass; Fail Interstitial Communication Test Result,Z Pass; Fail Components) Monitored by this Sensor: r L 7' O9SensorFunctionalityTestResult: Pass; Fail Interstitial Communication Test Result:OPass; Fail D Component(s) Monitored by this Sensor: 01.E-r Z51_ a Sensor Functionality Test Result.-Apass; Fail Interstitial Communication Test Result:APass; Fail How was Interstitial communication verified? Leak Introduced at Far End of Interstitial Space;' Gauge, X Visual Inspection; Other (Describe in Sec. J, below) Vucuum was restored to operating levels in all Interstitial spaces: XNCS No (If no, describe in Sec. J, below) J. Comments: 5 `/ i S L e,U T"— .10,45; 11SS Page of H the sensor successfully detects a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the sensor, vacuum/pressure has been demonstrated to be communicating throughout the interstice. Tanknology Inc. 11000N. MoPac Expressway, Suite 500, Austin, Texas 78759 Work Order: 3178646 ESO) & (FSV) Testing Form - Version 1- 6/25!2007 Emergency Shut Off (ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCATIONS AND TEST DATA Testing Company: A)01- Date: Location Name: ell L 5e Zly19 Store #: rX4N Stag: ID #: Address: Z 605'tgxz9 c1ty: sftSFi te: Emerge9ey Shut Off ESO Testing Results On in accordance with "ESO Vendor Letter (3- 21 -05).doc ", from t s Retail Compliance Department, as a part of annual compliance testing, this representative tested the Emergency Shut Off (ESO) switches indicated on this sketch. Findings listed below: Emergency Shut Off (ESO) if No, Provide Operational? rX4N Maintenance Log # Date Called Dispenser EmerQencv Shutoff Valve (ESV) Testing Results On _#1f4m_ in accordance with NFPA 30A this representative tested the automatic - closing feature ofthe Dispenser Emergency Shutoff VALVE(S) (ESV) located in the supply lines at the base of each individual island type dispenser indicated on the diagram below. Each device { #)_ in all, would automatically close. Findings listed below: Disp. Emergency Shut Off If No, Provide Valve (ESV) Operational? Maintenance Log # Date Called: Tanknology Inc. 11000 N. MoPac Expressway, Suite 500, Austin, Texas 78759 I. ian/vnologr 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 512) 451 -6334 FAX (512) 459 -1459 TEST DATE:11 /04/10 WORK ORDER NUMBER9178646 CLIENT: SAM'S CLUB SITE: SAM'S CLUB # SC4819 COMMENTS Conduct Line, LD, Impact Valve, ATG, SB( fill only). Site contacted 10/29/10, confirmed with IAN". Found and removed water from both 87 grade tanks, 91 and the Diesel STP sumps. Replaced 4) red jacket snap taps, (8) Brass fittings, (1) OPW 61 -VAS vapor adaptor, (1) OPW diesel nozzle since it was leaking, (2) Hour labor for parts replaced. PARTS REPLACED QUANTITY DESCRIPTION 1 NOZZLE LEADED - GREEN 1 SWIVEL DAYBREAK 4 SNAP -TITE KIT 8 Brass fittings HELIUM PINPLAN I 11:5 1 KESUL 15 (IF APPLIUABLE) ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 11/17/2010 09:02 ACRAMER TEST DATE: 11/04/10 CLIENT: SAM'S CLUB SITE DIAGRAM 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 512) 451 -6334 FAX (512) 459 -1459 WORK ORDER NUMBER3 17 8 6 4 6 SITE: SAM'S CLUB # SC4819 1 #7 L14 \/ L17 ESO #2 #8 3 #9 KIOSK L13 L16 TSL ESO #5 #11 L3 A A L A L11 L12 L15 DSL 6 #12 L10 REG REG Overfill L2 L L8 Alarm SOP O A L9 CASVENT L1 OI OI L I L7VENT O Printed 11/17/2010 09:02 ACRAMER ATG Information Work Order # 3178646 150301 NOV 4, 2010 5:45 PM 1:281428 SAMS CLUB 481 150302 NOV 4, 2010 5:45 PM 2:5625 GOSFORD RD El 150303 NOV 4, 2010 5:45 PM 3:BAKERSFIELD CA.93313 150304 NOV 4, 2010 5:45 PM 4:J09202125405001 3178646 El 151700 NOV 4, 2010 5:45 PM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATEMME FORMAT MON DD YYYY HH:MM:SS xM 150F00 NOV 4, 2010 5:45 PM MON DDYYYY HH:MM:SS xM 110200 NOV 4, 2010 5:45 PM 281428 SAMS CLUB 481 5625 GOSFORD RD. BAKERSFIELD CA.93313 J09202125405001 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 4 PROBE I G.T. 162316 162027 2 INTERSTITIAL BD 201300 200762 3 INTERSTITIAL BD 201750 201243 4 INTERSTITIAL BD 201142 200831 5 8SMARTSENSOR BD 39314 39292 6 8SMARTSENSOR BD 39335 39270 7 7SMARTSENSOR BD 507305 505484 B UNUSED 4833263 4757976 9 RELAY BOARD 14965 14957 10 RELAY BOARD 14902 14915 11 STP SENSE BOARD 32844 32834 12 UNUSED 4834223 4748728 13 UNUSED 4832523 4746876 14 UNUSED 4831943 4747234 15 UNUSED 4833000 4746561 16 UNUSED 4833208 4743867 COMM 1 RS232 SERIAL BD 14944 14936 3178646 14TG Information Work Order# 3178646 COMM 2 ELEC DISP INT. 100919 100740 COMM 3 SERIAL SAT BD 481999 481114 COMM 4 UNUSED 4834182 4746203 COMM 5 UNUSED 4832689 4748265 COMM 6 UNUSED 4830761 4746518 160100 NOV 4, 2010 5:46 PM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 87 NORTH ON 2 87 SOUTH ON 3 91 ON 4 DIESEL ON El 160200 NOV 4, 2010 5:46 PM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 87 NORTH 2 87 SOUTH 3 91 4 DIESEL 160300 NOV 4, 2010 5:46 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 87 NORTH 1 2 87 SOUTH 2 3 91 3 4 DIESEL 4 160400 NOV 4, 2010 5:46 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 87 NORTH 19781 2 87 SOUTH 19781 3 91 11904 4 DIESEL 7901 El 160700 NOV 4, 2010 5:46 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 87 NORTH 118.50 2 87 SOUTH 118.50 3 91 118.50 4 DIESEL 118.50 160900 NOV 4, 2010 5:46 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 87 NORTH 0.000700 2 87 SOUTH 0.000700 3 91 0.000700 3178646 ATG Information Work Order# 3178646 4 DIESEL 0.000450 161200 NOV 4, 2010 5:46 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL 1 87 NORTH 2 2 87 SOUTH 1 3 91 NONE 4 DIESEL NONE 162100 NOV 4, 2010 5:46 PM TANK LOW PRODUCT LIMIT SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS NONE NONE NONE NONE TANK PRODUCT LABEL GALLONS 1 87 NORTH 950 2 87 SOUTH 950 3 91 500 4 DIESEL 400 162200 NOV 4, 2010 5:46 PM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 87 NORTH 18792 2 87 SOUTH 18792 3 91 11308 4 DIESEL 7506 162300 NOV 4, 2010 5:46 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 87 NORTH 17803 2 87 SOUTH 17803 3 91 10713 4 DIESEL 7110 162400 NOV 4, 2010 5:46 PM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 87 NORTH 3.0 2 87 SOUTH 3.0 3 91 3.0 4 DIESEL 3.0 162800 NOV 4, 2010 5:46 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 87 NORTH 19781 2 87 SOUTH 19781 3 91 11904 4 DIESEL 7901 cl 162900 3178646 ATG Information Work Order# 3178646 NOV 4, 2010 5:46 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 87 NORTH 1978 2 87 SOUTH 1978 3 91 1190 4 DIESEL 790 El 170300 NOV 4, 2010 5:46 PM LIQUIDTYPE SENSOR LOCATION TYPE 1 87 N ANNULAR DUAL POINT HYDROSTATIC 2 87 87 N FILL DW SUMP 2 -1 3 87 N STP DW SUMP 2 -1 4 87 S ANNULAR DUAL POINT HYDROSTATIC 5 87 S FILL DW SUMP 2 -1 6 87 S STP DW SUMP 2 -1 7 91- DIESEL ANNULAR DUAL POINT HYDROSTATIC 8 91 FILL DW SUMP 2 -1 9 91 STP DW SUMP 2 -1 10 DIESEL FILL DW SUMP 2 -1 11 DIESEL STP DW SUMP 2 -1 12 DISP. 5 -6 DW SUMP 2 -1 13 DISP. 3 -4 DW SUMP 2 -1 14 DISP. 1 -2 DW SUMP 2 -1 15 DISP.11 -12 DW SUMP 2 -1 16 DISP. 9-10 DW SUMP 2 -1 17 DISP. 7 -8 DW SUMP 2 -1 18 VENT BOX DW SUMP 2.1 19 TRI -STATE (SINGLE FLOAT) 20 TRI -STATE (SINGLE FLOAT) 21 TRI -STATE (SINGLE FLOAT) 22 TRI -STATE (SINGLE FLOAT) 23 TRI -STATE (SINGLE FLOAT) 24 TRI -STATE (SINGLE FLOAT) 0 172100 NOV 4, 2010 5:47 PM SMART SENSOR CONFIGURATION DEVICE LABEL CONFIGURED 1 87 N PRODUCT ON 2 87 N VENT ON 3 87 S PRODUCT ON 4 87 S VENT ON 5 VAPOR RETURN ON 6 91 PRODUCT SOUTH ON 7 91 PRODUCT NORTH ON 8 91 VENT ON 9 APT LINE TO VENT BOX ON 10 DIESEL PRODUCT ON 11 DIESEL VENT ON 12 AFM DISP 1.2 ON 13 AFM DISP 3 -4 ON 14 AFM DISP 5 -6 ON 15 AFM DISP 7 -8 ON 16 AFM DISP 9 -10 ON 17 AFM DISP 11 -12 ON 18 DISP 1 -2 VP- SENSOR ON 19 OFF 20 OFF 21 OFF 22 OFF 23 OFF 24 ATM PRESSURE SENSOR ON 3178646 ATG Information Work Order# 3178646 172200 NOV 4, 2010 5:47 PM SMART SENSOR LABEL DEVICE LABEL 1 87 N PRODUCT 2 87 N VENT 3 87 S PRODUCT 4 87 S VENT 5 VAPOR RETURN 6 91 PRODUCT SOUTH 7 91 PRODUCT NORTH 8 91 VENT 9 APT LINE TO VENT BOX 10 DIESEL PRODUCT 11 DIESEL VENT 12 AFM DISP 1.2 13 AFM DISP 3 -4 14 AFM DISP 5-6 15 AFM DISP 7.8 16 AFM DISP 9 -10 17 AFM DISP 11.12 18 DISP 1 -2 VP- SENSOR 19 20 21 22 23 24 ATM PRESSURE SENSOR 172A00 NOV 4, 2010 5:47 PM VACUUM SENSOR VOLUME DEVICE LABEL VOLUME 1 87 N PRODUCT 29.9 GALLONS 2 87 N VENT 16.4 GALLONS 3 87 S PRODUCT 30.3 GALLONS 4 87 S VENT 20.8 GALLONS 5 VAPOR RETURN 61.3 GALLONS 6 91 PRODUCT SOUTH 35.2 GALLONS 7 91 PRODUCT NORTH 35.2 GALLONS 8 91 VENT 25.5 GALLONS 9 APT LINE TO VENT BOX 0.6 GALLONS 10 DIESEL PRODUCT 17.3 GALLONS 11 DIESEL VENT 29.9 GALLONS D 172800 NOV 4, 2010 5:47 PM 3178646 El 172900 NOV 4, 2010 5:47 PM VACUUM SENSOR PUMP NUMBER DEVICE LABEL PUMP NUMBER 1 87 N PRODUCT R 5:87 NORTH 2 87 N VENT R 5:87 NORTH 3 87 S PRODUCT R 6:87 SOUTH 4 87 S VENT R 6:87 SOUTH 5 VAPOR RETURN R 6:87 SOUTH 6 91 PRODUCT SOUTH R 7:91 7 91 PRODUCT NORTH R 7:91 8 91 VENT R 7:91 9 APT LINE TO VENT BOX R 7:91 10 DIESEL PRODUCT R &DIESEL 11 DIESEL VENT R B:DIESEL 172A00 NOV 4, 2010 5:47 PM VACUUM SENSOR VOLUME DEVICE LABEL VOLUME 1 87 N PRODUCT 29.9 GALLONS 2 87 N VENT 16.4 GALLONS 3 87 S PRODUCT 30.3 GALLONS 4 87 S VENT 20.8 GALLONS 5 VAPOR RETURN 61.3 GALLONS 6 91 PRODUCT SOUTH 35.2 GALLONS 7 91 PRODUCT NORTH 35.2 GALLONS 8 91 VENT 25.5 GALLONS 9 APT LINE TO VENT BOX 0.6 GALLONS 10 DIESEL PRODUCT 17.3 GALLONS 11 DIESEL VENT 29.9 GALLONS D 172800 NOV 4, 2010 5:47 PM 3178646 ATG Information Work Order# 3178646 VACUUM SENSOR RELIEF VALVE PRESENT DEVICE LABEL RELIEF VALVE 1 87 N PRODUCT NO 2 87 N VENT NO 3 87 S PRODUCT NO 4 87 S VENT NO 5 VAPOR RETURN NO 6 91 PRODUCT SOUTH NO 7 91 PRODUCT NORTH NO 8 91 VENT NO 9 APT LINE TO VENT BOX NO 10 DIESEL PRODUCT NO 11 DIESEL VENT NO 172C00 NOV 4, 2010 5:47 PM VACUUM SENSOR RELIEF VALVE PRESSURE DEVICE LABEL RELIEF VALVE PRESSURE 1 87 N PRODUCT -9.0 PSI 2 87 N VENT -9.0 PSI 3 87 S PRODUCT -9.0 PSI 4 87 S VENT -9.0 PSI 5 VAPOR RETURN -9.0 PSI 6 91 PRODUCT SOUTH -9.0 PSI 7 91 PRODUCT NORTH -9.0 PSI 8 91 VENT -9.0 PSI 9 APT LINE TO VENT BOX -9.0 PSI 10 DIESEL PRODUCT -9.0 PSI 11 DIESEL VENT -9.0 PSI El El 161500 NOV 4, 2010 5:47 PM TANK PRODUCTLA8EL METER DATA 1 87 NORTH YES 2 87 SOUTH YES 3 91 YES 4 DIESEL YES cl 190200 NOV 4, 2010 5:48 PM SOFTWARE REVISION LEVEL VERSION 329.02 SOFTWARE# 346329100 -C CREATED - 09.07.01.16.29 S- MODULE# 330160.106 -a SYSTEM FEATURES: PERIODIC IN -TANK TESTS ANNUAL IN -TANK TESTS CSLD BIR ISD El 120600 NOV 4, 2010 5:48 PM 281428 SAMS CLUB 481 5625 GOSFORD RD. BAKERSFIELD CA.93313 J09202125405001 TANK ALARM HISTORY TANK 1 87 NORTH HIGH WATER ALARM JAN 20, 2010 6:26 PM 3178646 1 N 1 ATG Information Work Order# 3178646 OVERFILL ALARM NOV 4, 2010 12:25 PM APR 21, 2010 5:01 AM JAN 20, 2010 6:29 PM LOW PRODUCT ALARM NOV 4, 2010 12:02 PM JAN 20, 2010 6:12 PM SUDDEN LOSS ALARM NOV 4, 2010 11:58 AM JAN 20, 2010 6:10 PM HIGH PRODUCT ALARM NOV 4, 2010 12:27 PM NOV 4, 2010 12:25 PM JAN 20, 2010 6:29 PM INVALID FUEL LEVEL NOV 4, 2010 12:02 PM JAN 20, 2010 6:11 PM PROBE OUT NOV 4, 2010 3:54 PM NOV 4, 2010 12:27 PM NOV 4, 2010 12:01 PM HIGH WATER WARNING NOV 4, 2010 12:07 PM JAN 20, 2010 6:16 PM DELIVERY NEEDED NOV 4, 2010 12:02 PM JAN 20, 2010 6:12 PM MAX PRODUCT ALARM NOV 4, 2010 12:27 PM JAN 20, 2010 6:29 PM LOW TEMP WARNING NOV 4, 2010 3:55 PM TANK 2 67 SOUTH HIGH WATER ALARM JAN 20, 2010 6:26 PM OVERFILL ALARM NOV 4, 2010 12:20 PM APR 21, 2010 5:05 AM DEC 6, 2009 12:01 PM LOW PRODUCTALARM NOV 4, 2010 12:00 PM JAN 20, 2010 6:12 PM SUDDEN LOSS ALARM NOV 4, 2010 11:58 AM JAN 20, 2010 6:10 PM HIGH PRODUCT ALARM NOV 4, 2010 12:19 PM JAN 20, 2010 6:33 PM INVALID FUEL LEVEL JAN 20, 2010 6:13 PM PROBE OUT NOV 4, 2010 3:49 PM NOV 4, 2010 12:22 PM NOV 4, 2010 11:58 AM HIGH WATER WARNING NOV 4, 2010 12:51 PM NOV 4, 2010 12:07 PM JAN 20,20`10 6:16 PM DELIVERY NEEDED NOV 4, 2010 12:00 PM JAN 20, 2010 6:12 PM MAX PRODUCT ALARM NOV 4, 2010 12:21 PM JAN 20, 2010 6:33 PM TANK3 91 HIGH WATER ALARM JAN 20, 2010 6:32 PM OVERFILL ALARM NOV 4, 2010 12:17 PM JAN 20, 2010 6:36 PM DEC 6, 2009 10:36 AM LOW PRODUCT ALARM NOV 4, 2010 12:04 PM JAN 20, 2010 6:28 PM SUDDEN LOSS ALARM NOV 4, 2010 12:03 PM OCT 30, 2010 11:48 PM OCT 22, 2010 8:37 PM HIGH PRODUCT ALARM NOV 4, 2010 12:17 PM JAN 20, 2010 6:37 PM INVALID FUEL LEVEL NOV 4, 2010 12:04 PM JAN 20, 2010 6:28 PM 3178646 If. I ATG Information Work Order# 3178646 PROBE OUT NOV 4, 2010 12:19 PM NOV 4, 2010 12:03 PM JAN 20, 2010 8:01 PM HIGH WATER WARNING NOV 4, 2010 12:07 PM JAN 20, 2010 6:32 PM DELIVERY NEEDED NOV 4, 2010 12:04 PM JAN 20, 2010 6:28 PM MAX PRODUCTALARM NOV 4, 2010 12:17 PM JAN 20, 2010 6:37 PM LOW TEMP WARNING JAN 20, 2010 6:41 PM JAN 20, 2010 6:39 PM TANK 4 DIESEL HIGH WATER ALARM NOV 4, 2010 12:20 PM JAN 20, 2010 6:15 PM OVERFILL ALARM NOV 4, 2010 12:23 PM JUL 29, 2010 11:08 PM JUL 15, 2010 4:45 PM LOW PRODUCT ALARM NOV 4, 2010 11:56 AM JAN 20, 2010 6:10 PM SUDDEN LOSS ALARM NOV 4, 2010 11:54 AM HIGH PRODUCT ALARM NOV 4, 2010 12:24 PM JUL 15, 2010 4:46 PM JAN 20, 2010 6:24 PM PROBE OUT NOV 4, 2010 12:24 PM NOV 4, 2010 11:54 AM JAN 20, 2010 6:25 PM HIGH WATER WARNING NOV 4, 2010 11:59 AM JAN 20, 2010 6:15 PM DELIVERY NEEDED NOV 4, 2010 11:56 AM JAN 20, 2010 6:10 PM MAX PRODUCT ALARM NOV 4, 2010 12:24 PM JAN 20, 2010 6:24 PM LOW TEMP WARNING JAN 20, 2010 6:26 PM a 130200 NOV 4, 2010 5:49 PM 281428 SAMS CLUB 481 5625 GOSFORD RD. BAKERSFIELD CA.93313 J09202125405001 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 87 N ANNULAR NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:31 AM LOW LIQUID ALARM NOV 4, 2010 9:31 AM HIGH LIQUID ALARM 2 87 87 N FILL NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:30 AM LOW LIQUID ALARM NOV 4, 2010 9:29 AM FUELALARM 3 87 N STP NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:28 AM LOW LIQUID ALARM NOV 4, 2010 9:26 AM FUELALARM 4 87 SANNULAR NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:34 AM LOW LIQUID ALARM NOV 4, 2010 9:33 AM HIGH LIQUID ALARM 5 87 S FILL NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:36 AM LOW LIQUID ALARM NOV 4, 2010 9:34 AM FUEL ALARM 6 87 S STP NOV 4, 2010 11:15 AM SENSOR OUT ALARM 3178646 J, (' ATG Information Work Order# 3178646 NOV 4, 2010 9:37 AM LOW LIQUID ALARM NOV 4, 2010 9:36 AM FUEL ALARM 7 91- DIESEL ANNULAR NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:39 AM HIGH LIQUID ALARM NOV 4, 2010 9:38 AM LOW LIQUID ALARM 8 91 FILL NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:42 AM LOW LIQUID ALARM NOV 4, 2010 9:41 AM FUEL ALARM 9 91 STP NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:40 AM LOW LIQUID ALARM NOV 4, 2010 9:40 AM FUEL ALARM 10 DIESEL FILL NOV 4, 2010 11:16 AM SENSOR OUT ALARM NOV 4, 2010 9:43 AM FUEL ALARM JAN 20, 2010 6:19 PM SENSOR OUT ALARM 11 DIESEL STP NOV 4, 2010 11:16 AM SENSOR OUTALARM NOV 4, 2010 9:45 AM LOW LIQUID ALARM NOV 4, 2010 9:44 AM FUEL ALARM 12 DISP, 5-6 NOV 4, 2010 11:16 AM SENSOR OUT ALARM NOV 4, 2010 10:05 AM LOW LIQUID ALARM NOV 4, 2010 10:03 AM FUEL ALARM 13 DISP. 3 -4 NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 10:01 AM LOW LIQUID ALARM NOV 4, 2010 9:59 AM FUEL ALARM 14 DISP.1 -2 NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 9:56 AM LOW LIQUID ALARM NOV 4, 2010 9:53 AM FUEL ALARM 15 DISP.11 -12 NOV 4, 2010 11:16 AM SENSOR OUT ALARM NOV 4, 2010 10:07 AM LOW LIQUID ALARM NOV 4, 2010 10:07 AM FUEL ALARM 16 DISP.9 -10 NOV 4, 2010 11:16 AM SENSOR OUT ALARM NOV 4, 2010 10:09 AM FUEL ALARM NOV 4, 2010 10:08 AM LOW LIQUID ALARM 17 DISP.7 -8 NOV 4, 2010 11:15 AM SENSOR OUT ALARM NOV 4, 2010 10:14 AM FUEL ALARM NOV 4, 2010 10:11 AM LOW LIQUID ALARM 18 VENT BOX NOV 4, 2010 11:16 AM SENSOR OUT ALARM NOV 4, 2010 9:49 AM LOW LIQUID ALARM NOV 4, 2010 9:48 AM FUEL ALARM El 131600 NOV 4, 2010 5:49 PM 281428 SAMS CLUB 481 5625 GOSFORD RD. BAKERSFIELD CA.93313 J09202125405001 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 87 N PRODUCT NOV 4, 2010 10:27 AM HIGH LIQUID ALARM NOV 4, 2010 10:22 AM NO VACUUM ALARM NOV 4, 2010 10:21 AM HIGH LIQUID ALARM 2 87 N VENT NOV 4, 2010 10:27 AM HIGH LIQUID ALARM NOV 4, 2010 10:24 AM NO VACUUM ALARM NOV 4, 2010 10:18 AM HIGH LIQUID ALARM 3 87 S PRODUCT NOV 4, 2010 10:37 AM HIGH LIQUID ALARM NOV 4, 2010 10:34 AM HIGH LIQUID ALARM NOV 4, 2010 10:31 AM NO VACUUM ALARM 4 87 SVENT 3178646 L 'w 1 ATG Information Work Order# 3178646 NOV 4, 2010 10:37 AM HIGH LIQUID ALARM NOV 4, 2010 10:35 AM HIGH LIQUID ALARM NOV 4, 2010 10:31 AM NO VACUUM ALARM 5 VAPOR RETURN NOV 4, 2010 10:37 AM HIGH LIQUID ALARM NOV 4, 2010 10:36 AM HIGH LIQUID ALARM NOV 4, 2010 10:31 AM NO VACUUM ALARM 6 91 PRODUCT SOUTH NOV 4, 2010 10:56 AM HIGH LIQUID ALARM NOV 4, 2010 10:54 AM NO VACUUM ALARM NOV 4, 2010 10:51 AM HIGH LIQUID ALARM 7 91 PRODUCT NORTH NOV 4, 2010 11:01 AM HIGH LIQUID ALARM NOV 4, 2010 10:54 AM NO VACUUM ALARM NOV 4, 2010 10:51 AM HIGH LIQUID ALARM 8 91 VENT NOV 4, 2010 11:05 AM HIGH LIQUID ALARM NOV 4, 2010 10:54 AM NO VACUUM ALARM NOV 4, 2010 10:51 AM HIGH LIQUID ALARM 9 APT LINE TO VENT BOX NOV 4, 2010 11:05 AM HIGH LIQUID ALARM NOV 4, 2010 10:54 AM NO VACUUM ALARM NOV 4, 2010 10:51 AM HIGH LIQUID ALARM 10 DIESEL PRODUCT NOV 4, 2010 10:47 AM HIGH LIQUID ALARM NOV 4, 2010 10:45 AM NO VACUUM ALARM NOV 4, 2010 10:41 AM NO VACUUM ALARM 11 DIESEL VENT NOV 4, 2010 10:42 AM HIGH LIQUID ALARM NOV 4, 2010 10:41 AM NO VACUUM ALARM NOV 4, 2010 10:41 AM HIGH LIQUID ALARM 12 AFM DISP 1 -2 13 AFM DISP 3 -4 14 AFM DISP 5 -6 15 AFM DISP 7.8 16 AFM DISP 9 -10 17 AFM DISP 11 -12 18 DISP 1 -2 VP- SENSOR JAN 18, 2010 2:53 PM COMMUNICATION ALARM 24 ATM PRESSURE SENSOR 3178646