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HomeMy WebLinkAbout#781 FMC RESULTS 7-20-11MONITOWNG SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifornia Authority Cited: Chapter 6 7, Health and Safety 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 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: #781 Fastrip #22 (South) Bldg. No.: _ Site Address: 4013 South "H" Street City: Bakersfield Zip: 93304 Facility Contact Person: Omero Garcia Make/Model of Monitoring System: Veeder -Root TLS 350 B. Inventorytof Equipment Tested /Certified Check the appropriate xes toIndicate 3peci0c equipment Inspected /serviced: Contact Phone No.: 661- 393 -7000 Date of Testing/Servicing: 7/20/2011 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 x] 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: x] Mechanical Line Leak Detector. Model: FX1V Mechanical Line Leak Detector. Model: N/A Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: x] Tank Overfill / High Level Sensor. Model: 847390 -107 111 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 -107 x] 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 X] Piping Sump / Trench Sensor(s). Model: 794380 -208 Fill Sump Sensors(s). Model: Fill Sump Sensor(s). Model: n Mechanical Line Leak Detector. Model: FX1 V x] Mechanical Line Leak Detector. Model: FX1 DV Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: x] Tank Overfill / High Level Sensor. Model: 847390 -107 U 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 8, 4 M Dispenser Containment Sensor(s). Model: 794380 -208 x] 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 ID: 5&6 Dispenser ID: 7 & 8 x] Dispenser Containment Sensor(s). Model: 794380 -208 U Dispenser Containment Sensor(s). Model: 794380 -208 x] Shear Valve(s). 11 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 - 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) )-x S t -up Lx] Alarm histor Technician Name (print): Bryan A Self SignatuCertificationNo: B37501 License 04904 \ Testing Company Name: Confidence UST Services, Inc. Phon o: 800 - 339 -9930 Site Address: 4013 South "H" Street, Bakersfield, CA 93304 D of Testing/Servicing: 712012011 D. Results of Vesting /Servicing Software Version Installed: 326.01 Complete the following checklist: x] Yes No* Is the audible alarm operational? x Yes No* Is t e Visual alarm operational? x Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational? 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? x Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary N/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected? Ifyes: which sensors initate positive shut - down'? Lx] Sump/Trench Sensors [x] Dispenser Containment Sensors Did you confirm positive shut -down due to leaks and sensor failure /disconnected? U Yes; No; X] 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 oftank capasity does the alann trigger? 90 % Yes* X] No Was any monitonng 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* U No Was liquid found inside any secondary containment systems designed as dry systems'? Product; Water. If yes, describe causes in Section E, below. x N * 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: The ATG Probe and Float Kit need to be replace, it was not in working condition when technicain arrived on site. Confidence UST Services, Inc. is scheduled to replace the needed parts on 7/22/2011. F. In -Wank 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: x] Yes I No* Has all input wiring been inspected for proper enter and termination, including testing for ground faults? No* Were all tank guaging probes visually inspected for damage and residue buildup'? x Yes No* Was accuracy of system product level readings tested? FxYes No* Was accuracy of system water level readings tested'? Was the testing apparatus properly calibrated? No* Were all probes reinstalled properly? No 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: x] 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.; 00.2 g.p.h.; x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments? x Yes No* Was the testing apparatus properly calibrated? Yes No For mac amca LLD's, ces the LLD restrict product flow if it detects a leak? N/A Yes No* For electronic LLD's, does the turbine automatically shut off ifthe LLD detects a leak? x] N/A Yes No* For electronic LLD's, does the turbine automatically shut off ifany portion ofthe monitoring system is x] N/A disabled or disconnected'? Yes No* For electronic LLD's, does the turbine automatically shut off ifany portion ofthe monitoring system Fx] N/A malfunction or fails a test'? Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected? Lx] 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: r",3'tRIF• nI 4 CI 13 ' . II ST DkEERSF I ELD JUL -0. 2011 8:36 Pill SY:2TE1'1 STATUS REPORT ALL FUNCTIONS NORMAL I NVENTOR'Y REPORT T I : UNL I 9898 GALS VOLUME 496.1 (;ALS ULLi GE 7098 GALS 90% ULLAGE- 5891 GALS TC: VOLUME 4895 GALS HI -IGHT 47.90 1NC.HES WATER VOL 0 GALS WATER 0.00 INCHES TEMP 79.7 DEC; F T 2:UNL 2 VOLUME - 5063 GALS ULLAGE - 6999 GALS 90%: ULLAGE - 5792 GALS TG; VOLUME - 4997 GALS HEIGHT - 48.70 INCHES WATER VOL - 11 GALS WATER = 0.77 INCHES TEMP - 78.4 DEC F T 3:PNL VOLUME - 3541 GALS ULLAGE 8521 GALS 90% ULLAGE- 7314 GALS fC VOLUME - 3483 GALS HEIGHT - 37.33 INCHES WATER VOL - 0 GALS WATER - 0.00 INCHES TEMP - 83.2 DEG F T 4:DIMEL. VOLUME - 9898 GALS ULLAGE - 2164 GALS 9&° ULLAGE- 957 GALS TC VOLUME - 9769 GALS HEIGHT - 85.27 INCHES WATER VOL - 0 GALS wi-JER - 0.00 1 N+: HF_S TEMP = 84.5 DEC F W s END r n t k X SOFTWARE REV t S• 1 ON LEVEL VERi310N 329.02 SOFTWHREO 346329— I00—C: CREATED — 09.07.01.16.29 S-MODULEP 3:30160 -004 —a SYSTEM FEATURES: PERIODIC IN —TANK TESTS ANNUAL I N —TANY TESTS 1SD SY s'('Lht SETUP RE—DIRECT LOCkL PR 1 tfrOUT D ! SABLED 1111- 20, 2011 8:36 AM EURO PROTOCOL PREF 1 Y S SYSTEM UNITS U.S. SYSTEti LANGUAGE EN(;L I SH SYSTEI-I DATEIT I ME FOPI ViT MON DCj YYYY HH : MM : E:S xi °l FASTRIP 761 4013 S.H ST BAKERSFIELD CH.93304 SHIFT TIME 1 D) SABLED SHIFT TIME 2 DISABLED SHIFT TIME 3 DISABLED SHIFT TIME 4 DISABLED TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED LINE FE—ENHBLE METHOD PASS LINE TEST L 1 NE PER TS'T NE=EDED URN D I SABLED LINE ANN TST NEEDED URN D I SiiBLED PRINT TC VOLUMES ENABLED TEMP COMPENSAT ION VALUE (DE(; F ) : 60.0 STIC'Y HEIGHT OFFSET DISABLED ULLAGE: 9M H— PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVING TIME ENABLED START DATE MAR WEEK 2 SUN START TIME 2:00 AM END DATE NOV WEEK 1 SUM END TIME 2:00 AM 0 SYSTEM SECURITY CODE : 000000 MAINTENANCE HISTORY DISABLED TANK CHART SECURITY DISABLED CUSTOM ALARMS DISABLED SERVICE NOTICE DISABLED ISO 3166 C=OUNTRY CODE: VIASS, DENS I TY DISABLED COMMUNICATIONS 111-•TAIIK SETUP T 2: UNL 2 SETUP PRODUCT CODE 2 THERMAL COEFF :.000700 T I:UNL I TANK DIAMETER : 111.50 PORT SETT l IW:: PRODUCT CODE i TANK' PROFILE I PT THERi-IAL COEFF :.000700 FULL VOL 120612 Oi 41 BOARD I (RS -232) TANK DIAMETER I TANK PROFILE 1 1 .50 I PTBAUDRATE9600FULLVOL12062 FLOAT SIZE: 4.0 IN, PARITY NONESTOPBITISTOPDATALENGTH: 8 DATA WATER WARNING 2.0 RS -232 SECURITY FLOAT SIZE: 1110 IN. H16H WATER LIMIT: 3.0 CODE : DISABLED WATER WARNING 2.0 Max OR LABEL VOL: 12062 COMM BOARD 2 HIGH WATER LIMIT: 3.0 OVERFILL LIMIT 90% IRS -2321BAUDRATE9600 Mk -: OR LABEL VOL: 12062 HIGH PRODUCT 10855 90'/. PARITY NONE OVERFILL LIMIT 90% 10855STOP61TIS'I'OF , 10855 DELIVERY LIMIT 15 %: DATA LENGTH: 8 DATA HIGH PRODUCT 90% 1809RS -232 'E%. LIR I TY 1 0855CODEIl1s: - +BLED DELIVERY LIMIT 1 5 %t LOW PRODUCT 500 CC.f1' l POHREl : 3 t L'U 1 Il 1809 LEAK ALARM LIMIT: 99 RS-23` SEl `UK 1 I `r SUDDEN LOSS LIMIT: 99 LOW PRODUCT 500 TANK TILT 2.00ODEUI:;ABL£[' LEAK ALARM LIMIT: 99 PROBE OFFSET 0100 SUDDEN LOSS LIMIT: 99 AUTO TRAr•tanIT 2ETT1NG5: TAN }: T l LT PROBE OFFSET 2.00 0.00 SIPHON MANIFOLDED TANKS AUTO LEH1; ; -iLAMl LIMIT TO: NONE LINE MHN I FOLDED TANKSDISALLELSIPHON11ANIFOLDEDTANKSTA: NONEAUTOH1C:H WATER LIMIT To: NONEDISABLED r,UTO OVERFILL L11.11T LINE I•IANIFOLDED TANKS E' I RABLED TO! NONE LEAK MIN PERIODIC: 0. AUTO LOu Pk(*U.T 120 DISABLED AUTO THEFT LIMIT LEAK MIN PERIODIC: 17: LEAK MIN ANNUAL : 1% DISABLED 120 120 AUTO DELIVERY START LEAK 1.11 N ANNUAL 1 %;; DISABLED HyTo DELIVERY END 120 PERIODIC TEST TYPE D I SHBLF.D STANDARD AUTO EXTERNAL INPUT ON PERIODIC: TEST T'l'PE ANNUAL TEST FAILDISABLED AUTO EXTERNAL INPUT OFF STANDARD ALARM DISABLED DISABLED AUTO SENSOR FUEL ALARM ANNUAL TEST FAIL PERIODIC TEST FAIL DISABLED ALARM DISABLED ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED PERIODIC TEST FAIL GROSS TEST FAIL. AUTr, SENSOR OUT ALARM ALARM DISABLED ALARM DISABLED DISABLED GROSS TEST FAIL ANN TEST AVERAGING: OFF ALARM DISABLED PER TEST AVERAGING: OFF ANN TEST AVERAGING: OFF TANK TEST NOTIFY: OFF PER TEST AVERAGING,: OFF TNK TST SIPHON BREAK:OFF TANK TEST NOTIFY: OFF DELIVERY DELAY I MIN RS -232 END OF MESSAr:;E TN1: TST SIPHON BREAK :OFF PUMP THRESHOLD : 10.00 %s DISABLED DELIVERY DELAY I MIN PUMP THRESHOLD 10.00%: 1' 3:PNL PRODUCT CODE 3 THERMAL COEFF :.00070.1 TANS; DIAMETER 11 1 .50TANKPROFILEIPT FULL VOL 12062" FLOAT SIZE: WATER WARNING HlGli WATER LIMIT M}vX OR LABEL VOL OVERFILL LIMIT H113H PRODUCT DELIVERY LIMIT LOW PRODLrT LEAK ALARM LIMIT: 1II)DFI4 LOSS LIMIT TANK. TILT PROBE OFFSET 4.0 1N. 2.0 3.0 12062 90 10855 90'i 10855 15% 1809 500 99 99 0.00 0.00 SIPHON MHNIFOLDED TANKS TO: NONE LINE MANiFOLDED TANKS TO: NONE LEAK MIN PERIODIC: in 120 LEAK MIN ANNUAL . 120 PERIODI1 TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL HLAP.M DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST HVERH131NG: OFF PER TEST AVERAGIl4<:: OFF TANK TEST NOTIFY : OFF T14K TST SIPHON BREAK :OFF DEL I VER`; DELAY I MIN PLUIP THRESHOLD 10.002. T 4:DIE:SEL PRODUCT CODE 4 THERMAL COEFF :.000450 TANK D 1 AME1'ER 1 1 1 .50 TANK' PROF I LE I PT FULL VOL 12062 FLOAT SIZE: 4.0 IN. WATER. UJARN I NG 2.0 HIGH WATER LIMIT: s.0 MAX OR LABEL VOL: 12062 OVERFILL LIMIT 9011. 10855 II I GH PRODUCT 90 %: 10855 DELIVERY LIMIT IOY. 1206 LOW PRODUCT 500 LEA), ALARM 1-11-11T: 99 SUDDEN LOSS LIMIT: 99 TANI: TILT 0.00 PROBE OFFSET 0.00 SIPHON FIANIFOLDED TANKS To : 14014E LINE MAN IFOLDED TANKS To: NINE LEAI: MIN PERIODIC: I% 120 LEAK. M I N ANNUAL : 1% 120 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALAR11 DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERHGIrN;: OFF PER TEST AVERAGING,: OFF TANK TEST NOTIFY: OFF T14Y TST SIPHON BREAK :OFF DELIVERY DELAY 1 1h1N ' PUMP THRESHOLD 10.00% LEA; TEST METHOD TEST ON DATE : ALL TANK JAN 16. 2006 START TIME : DISABLED TEST RATE :0.20 GAL /HR DURATION : 2 HOURS TST EARL`; STOP:DISABLED LEAK TEST REPORT FORMAT NORMAL LIQUID SENSOR SETUP L I:UNL I STP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 2:UNL I ANN TRI -STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS L 3:DIESEL STP TRI -STATE (SINGLE FLOAT) C :ATEGORY : STP SUMP L 4 :I1 1 ESEL ANN 1'RI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 5:REG2 STP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 6:REC 2 ANN TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 7 :SUPER STP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 8:SUPER ANN TRI -STATE (SINGLE FLOAT) C=ATEGORY : ANNULAR SPACE L. 9:DISP 1-2 TRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN LIO:DISP 7 -8 TRI -S "FATE (SINGLE FLOAT) CATEGORY : DISPENSER. PAN LII:DISP 5 -6 TRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L12:DISP 3 -4 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L13: NO. TRANS TRI -STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS L 1 4 : SO . TRA14S TRI -STATE (5114,;LE FLOAT) CATEGORY : OTHER SENSOR: PUMP SENSOR SETUP R 2:FNL TYPE PUMP C014TROL OUTPUT S I:UNL I TANY. 0: 3 TANK 0. 1 DISPENSE MODE: LIQUID SENSOR ALMSSTANDARDLS:FUEL ALARM S 3:PN1. L 7:FUEL ALARM TANK 0: 3 L 9 :FUEL ALARM DISPENSE MODE: LIO:FUEL ALARM STANDARD LII:FUEL ALARM L12:FUEL ALARM L :SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:8ENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L 3:SHORT ALARM L 9:SHORT ALARM LIO :SHORT ALARM LII:SHORT ALAWI L12:SHORT ALARM OUTPUT RELAY SETUP ISD SITE ALARMS ISO GROSS PRES FAIL R I:UNL 1 ISO DEGRD PRES FAIL TYPE: ISO VAPOR LEAK FAIL PUMP CONTROL OUTPUT ISO V.P PRES FAIL TANK 0: 1 ISO VP STATUS FAIL ISD HOSE ALARMS l_ I iU I L SEtVSOR ALMS ALL : GROSS COLLECT FAIL L 1:FUEL ALARM ALL:DEGRD COLLECT FAIL L 4 :FUEL ALARM ALL:FLOW COLLECT FAIL L 9 :FUEL ALARM R 3:DIESELLIO:FUEL ALAP.M TYPE: LII:FUEL ALARM STANDARDLI2:FUEL ALARM NORMALLY CLOSEDLI :SENSOR. OUT ALARM L 3 :SENSOR OUT ALARM TANK 0: 4L9:SEN.SOR OUT ALARM LID :SENSOR OUT ALARM LII:SENSOR OUT ALARM LIQUID SENSOR ALMSL12:SENSOR OUT ALARM L 3:FUEL ALARMLI:SHORT ALARM L 7:FUEL ALARML3:SHORT ALARM LIO:FUEL ALARML9 :SHORT ALARM L12:FUEL ALARMLID :SHORT ALARM LI3:FUEL ALARMLII:SHORT ALARM L14 :FUEL ALARML12:SHORT ALARM L 3:SENSOR OUT ALARM L 7:SENSOR OUT ALARMISOSITEALARMSLIO:SENSOR OUT ALARMIOUGROSSPRESFAILLII:SENSOR OUT ALARMISDDEGRDPRESFAILL12 :SENSOR OUT ALARMISDVAPORLEAKFAILL13:SENSOR OUT ALARMISOVPPRESFAILLICSENSOROUTALARMISDVPSTATUSFAILL3:SHORT ALARM L 7 :SHORT ALARMISDHOSEALARMSLIO:SHORT ALARMALL:GROSS COLLECT FAIL SHORT ALARMALL:DEGRD COLLECT FAIL 1- :SHORT ALARML13ALL:FLOW COLLECT FAIL L11 : SHORT ALARM LI4:SHORT ALARM R 4:OVERFILL ALARM TYPE: STANDARD NORMALLY OPEN TANY 0: NONE IN -TANK ALARMS ALL :OVERFILL ALAR1a ALL :NIGH PRODUCT AL. -P.M ALL:MAX PRODUCT ALF+kI: ShIAkTSEIVSOR SETUP s I:V.P.:;ENSOR DISP 1 -2 iATEGORY VAPOR PRESSURE s 2:F-ht DISP 1 -2 CATEGORY AIR FLOW METER s 3:F.M DISP 3 -4 CATEGORY ;SIR FLOW METER s 4:F.M DISP 5-6 CATEGORY AIR FLOW METER s 5:F.M DISP 7 -6 CATEGORY AIR FLOW METER EVR.•ISD SETUP EVR TYPE: VACUUM ASSIST VACUUM ASSIST TYPE HEALY VAC: NOZZLE A;L RANGE MAX: 1,15 MIN: 0.95 VAPOR PROCESSOR TYPE NONE ANALYSIS TIMES TIME: 10:00 AM DELA" MINUTES: 1 ACCEPT HIGH ORVR: MAP El*-iBLED SERIAL NUM LABEL 1 25186 F.M ISD HOSE TABLE 8456 F.M ID FP FL HL AA RR Ol 01 01 02 OI UU 02 02 02 02 01 UU 03 03 03 02 02 UU 04 04 04 02 02 UU 05 05 05 02 03 UU 06 06 06 02 03 UU 07 07 07 02 04 UU 08 08 08 02 04 UU ISD AIRFLOW METER. MAP ID SERIAL NUM LABEL 1 25186 F.M DISP 1 2 8456 F.M DISP 3 8280 F.M DISP 5 4 7092 F.M DISP 7 ISD FUEL GRADE HOSE 14AP 1 2 3 4 FP MHH I °1HH MHH MHH AA 01 201 301 901 U U 1 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 08 208 308 908 5 U 4 09 9 U 2 U 3 U 5 U 0 10 2 U 3 U 9 U 5 U 0 11 2 U 3 U 9 0 0 0 0 12 2 U 3 U 9 U U U 0 LABEL TABLE 1: UNASSIGNED 2: BLEND3 3: REGULAR 4: h1 I D GRADE 5: PREMIUM 6: COLD 7: BRONZE 6: SILVER 9: BLEND2 10: BLEND4 PMC SETUP PMC VERSION: 01.02 VAPOR PROC -ESSOR TYPE NONE PROCESSOR CONTROL LEVEL NONE ALf RP,I HISTORY REPORT SYSTEM ALARM -- - -- PAPER OUT MAR IB. 2011 8 :22 API PRINTER ERROR MAR 18. 2011 8:22 AM x 'r, ri m A END a A k X X ALARM HISTORY REPORT I N- THI'11' ALARN - T 1 : UIVL 1 OVERFILL ALARM DEC 28. 2010 11:01 PM OCT 27. 2010 12:37 PM SEP 19. 2010 4:36 Aft SUDDEN LOSS ALARM MAR 18. 2011 9:37 AM MAR 14. 2011 4:33 PM FEB 27, 2011 4:42 AM HIGH PRODUCT ALARM DEC; 28, 2010 11 :01 PM OCT 27. 2010 12:37 PM OCT 19, 2010 12:54 PM PROBE OUT MAR 14, 2011 4:34 P11 DELIVERY NEEDED MAR 14. 2011 4:33 PM FEB 18. 2011 6 :19 PM AUG 6, 2010 8 :36 PM ix a x k r. END 'i A *' x ALARM HISTORY REPORT IN -TANK ALARM - T 2:UNL 2 OVERFILL ALARM MAR 24. 2011 10:45 PM DEC '8. 2010 11:11 PM AUG 12• 2010 10:48 AM HIGH PRODUCT ALARM MAR 24. 2011 10:45 PM DEC 28. 2010 11:11 PM OOT 19, 2010 12:55 PM DELIVERY NEEDED AIX.: 6. 2010 9:12 PM JUL 21. 2010 4:45 PM x x A R Yi EIVD k x r R ALARM HISTORY REPORT IN-TANK ALARM - - - -- T 3:P1vL HIGH PRODUCT ALARM OCT 19. 2010 12:55 PIN DELIVERY NEEDED JUN 19, 2011 1:08 PM APR 5, 2011 1:38 PM NOV 5. 2010 2:20 PM 4 i( k A END A ** A^ ALPaI HISTORY REPORT IN-Ti-Wk ALARM - - - -- T 4:DIESEL HIGH PRODUb T ALARM 01:7 19, 2010 12:56 PM I w w. r r END r} x k x ALARM HISTORY REPORT SENSOR ALARM - - - -- L I:UNL 1 STP STP SUMP FUEL ALARM JUN 26. 2011 2 :12 AM FUEL ALARM OCT 19. 2010 11:28 HM X. A( END w x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L 2:UNL 1 ANN OTHER SENSORS FUEL ALARM Oi: T 19. 2010 11 :46 All A x x r x EIVD x r r x x ALARPI HISTORY REPORT SENSOR ALARM - - - -- L 3 :DIE3EL STP STP SUMP FUEL ALARM MAR 2. 2011 11:23 AM FUEL ALARM MAR ), 2011 2:56 PM FUEL ALARM OCT 19. 2010 11:38 All v t - r* END f x X n X ALAR14 1115TORY REPORT SENSOR ALARM -- -- L 4:DIESEL ANN ANNULAR SPACE SENSOR OUT ALARM OCT 19, 2010 1:03 PM FUEL ALARM OCT 19. 2010 12:15 Pll FUEL ALARM OrT 19. 2010 12:06 PM x x v x. E14D r- x ALARM HISTORY REPORT SENSOR ALARM - - --- L 5:REG2 STP STP SUMP FUEL ALARM JUN 26, 2011 9:24 AM FUEL ALARM JUN 26, 2011 9:23 AM FUEL ALARM JUN 26. 2011 9 :20 AM r x x x END x x. is R ALkRlt H I STOW. REPORT SENSOR ALARM - ---- L 6 : RE(; 2 ANN ANNULAR SPACE FUEL ALARM APR 26. 2011 11 :45 00 FUEL ALARM APR 24, 2011 4 ::s1 AM FUEL ALARM APR 22. 2011 4 :09 PM x k w ±W END E e x x x ALARM HISTORY REPORT SENSOR ALARii - - - -- L 7:SUPER STP STP SUMP FUEL ALARM JUN 212. 2011 7:31 AM FUEL ALARM MAR 2. 2011 7:46 Ai FUEL ALARM OCT 19, 2010 11:35 AM A a R- END A t P. A A ALARM HISTORY REPORT SENSOR ALARM - - - -- L 8:SIJPER ANN ANNULAR SPACE FUEL_ ALARM 00T 19. 2010 11:48 All FUEL ALARM AUK 5. 2010 9:56 ki FUEL ALARM Alb:: 5. 2010 9:55 All A 4 0 A A END r ALARM HISTORY REPORT SENSOR ALARM - - - -- L 9:DISP 1 -2 DISPENSER PAN FUEL ALARM OCT 19, 2010 11:39 AM r A x t x END A r 0. s K ALARM HISTORY REPORT SENSOR ALARM -- - -- LIO:DISP 7 -8 DISPENSER PAN FUEL ALARM OCT 19. 2010 11:44 All HLARPI HISTORY REPORT SENSOR ALARM - - - -- LII:DISP 5 -6 DISPENSER PAN FUEL ALARM OCT 19. 2010 11:45 AM x x. END ). r A X I ALARM HISTORY REPORT SENOR ALARc-1 - - - -- L12:DISP 3 -4 DISPENSER PAN FUEL ALARM OCT 19, 2010 11:43 AM W A * END A x R i ALARM HISTORY REPORT SENSOR ALARM - - --- L13:NO.TRANS OTHER SENSORS FUEL ALARM JUN 22. 2011 12:19 PIN FUEL AL #ARm JUN 20, 2011 9:11 AM FUEL ALARM JUN 13, 2011 8:20 PM r END A t ALARM H I 1'ORV REPORT 5Ehwr0R HLARhI - - - -- L14: SO. TRANS OTHER SENSORS FUEL ALARM MAR 22. 2011 2:18 PM FUEL ALARM MAR 17, 2011 12:31 Phi FUEL ALARM MAR 17, 2011 11:57 N1 a)v 4 X ( END A; ; r x FASTF. I P 781 4013 S.H ST ti BAKERSFIELD 0A.93304 JUL 20. 2011 9:013 All SENSOR ALARM - - - -- FKSTRIP 781L5 : RE,32 STP 4 1) 13 S. H 5T1'Sl'FI'1 STATUS REPORT STP SUMP FUEL ALARM BAKEF.;FIELU C04.93204 T 4 : PROBE OUT JUL 20. 2171 1 9:09 AM JUL 20. 2011 9:14 All SYSTEM STATUS REPORT T a:PROBE OUT IN -TANY ALARM - - - -- T I:UNL I 1-1113H PRODO1'T ALARM JUL 20. 2011 9:03 AM FI113TR 1 P 781 4013 S.H ST FASTR I P 781Go'A a3Ul "S.H STrimNERSFIELDCA.93304 F+AI;ERSF I ELD CA . 93304 IN-TANK ALARM - - --- JUL 20. 2011 9:05 All JUL 20. ''011 ?:10 Fv1T4: DIESEL. PROBE OUT JUL 2G. 2011 8:42 AI•I III STATUS REPORT' SYSTFJt STHTI-6; REPORT T 4:PROBE OUT T a : PROSE OUT L 5:FUEL ALARM 1N -TANK ALARM - - - -- T 3: PNL PROBE OUT JUL 20. 2011 8:44 AM IN -TANK ALARM - - - -- T 2:UNL 2 H1(.:H PRODUi:T ALARM 1 PJUL20, 2011 9:05 (4-1 °t 3 S . F114013 ST401 BAYERSFIELD CA.93304 JUL 20. 2011 9:11 AllIN -TANK ALAP.M - - - -- f 3:P14L L()W TEMP WARN I NCB JUL 20, 2011 8:45 AM SYSTEM STATUS REPORT SENSOR ALARM - - - -- T 4:FROBE OUTL3:C,IESEL STP STP SUMP L 5:FUEL ALARMFUELALARM JUL 20. 2011 9:08 All 111 -Tml,t); ALARM - - - -- T a:DIESEL PROBE OUT JUL 2U. 2011 8: AM SENSOR ALARM - -- SENSOR ALAR11 - - - -- L '7:SUPEP. STP L 5:REG2 STPSTPSUMPI'P SUMPFUELALARMFI,I;L ALARMJUL20, 2011 9:09 AM JJL 20, 2011 9:13 AN FASTF. I P 781 4013 S.H ST ti BAKERSFIELD 0A.93304 JUL 20. 2011 9:013 All SENSOR ALARM - - - -- FKSTRIP 781L5 : RE,32 STP 4 1) 13 S. H 5T1'Sl'FI'1 STATUS REPORT STP SUMP FUEL ALARM BAKEF.;FIELU C04.93204 T 4 : PROBE OUT JUL 20. 2171 1 9:09 AM JUL 20. 2011 9:14 All SYSTEM STATUS REPORT T a:PROBE OUT IN -TANY ALARM - - - -- T I:UNL I 1-1113H PRODO1'T ALARM JUL 20. 2011 9:03 AM SENS'OR FASTI IP 7ti1 FH2TRIP 781 Lf I :DISP 5 -6 4013 S.H ST 4013 S.H ST DISPENSER PAN BAKERS{ 1 ELD CA-933i'14 BAF:ERSF I ELD Ct;. 4:3304 FUEL ALARM JUL 2U. 2011 9:30 All JUL 20. 2011 9:19 Foi JUL ''20. 2011 9:25 AM SYSTEM STATUS REPORT SYSTEM STATUS REPORT T 4:PROBE OUT T 4:PROBE OUT SENSOR ALARM - - - -- IL/VENTORY REPORT LIO:DISP 7 -8 DISPENSER PAN FUEL ALARM L 1 JUL 2U• 2011 9:s1 AM VOLUME 4977 GALS ULLAGE 7085 GALS 9ire, ULLAGE- 5878 GALS TC VOLUME 4907 GALS HEIGHT 48.07 INCHES SENSOR HLr+RI °i - - - -- MATER VOL WaiTER 0 GALS 0.00 1 NCHESLI : 11Ni I STP TEMP 79.7 DEC; FSTPSUMP FUEL ALARI•I JUL 20. 2011 9:20 HM SEN:sOR ALARM - - - -- T ^:UNL 2 LI:80. N&IVOLUME5040GALSOTHHERSEENSORS ULLAGE 7022 1ALS FUE1. 9Cm ULLAGE- 5815 GALS ALAP.M JUL -0. -01I 9:3I iif`1 TC' VOLUME 4974 GALS HEIGHT 48.53 INCHES WATER VOL 11 GALS WATER D.77 IWHES TEMP 78.4 DEG F FASTRIP 781 4013 S.H ST T 3:PNLHAI:EkSFtELD CA.933U4 VOLUME 7966 GALS ULL.#xJE 4096 GALS SENSOR ALARM - - --- 20, '2011 9:2:3 AM 9C`. ULLAGE- 2889 GALS L13:NO.TRANSJULTCVOLUME7774GALBOTHERSENSORS HEI4::HT 69.95 1NCHES FUEL ALARMWATERVOL0GALSJUL20. 20111 9:32 PPI S'lSTEM STATUS REPORT WHTER 0.00 INCHES TEMP 94.2 DEG F T 4:PROBE OUT r. ii x k !t END X X h k r SENSOR ALARM -- - -- L 2 : UNL I ANN a OTHER SENSORS FUEL ALARM JUL 20. 2011 9:33 HhI SENSOR ALARM - - - -- L 9 :DISP 1 -2 D I SPENSER PAN FUEL ALARM JUL ''20. 2011 9:28 AM SENc.AR ALARM L 6:REG 2 ANN ANNULAR SPACE FUEL ALARM JUL 20, 2011 3:33 AM 5Elt50R ALARM I.1;':DISP 3 -4 DISPENSER PAN FUEL ALARM JUL %0. 2011 9:29 AM SENSOR kLARM - - - -- - - - -• SENSOR ALARM - - - -- - - - -- SENSOR ALARPI - - - -- L B:SUPER ANN L14:SU.TRANS L 6:REG 2 ANN ANNULAR SPi:v':E OTHER SENSORS ANNULAR SPACE FUEL ALARM ;;ENSOR OUT ALARM SENSOR OUT ALARM JUL 20, 2011 :+:34 AM JUL 20, 2011 9:41 Al JUL 20. 2011 9:41 AM 2:EW,OR ALARM - - -- L 4:DIESEL ANN ANNULAR SPACE FLIEL ALARM JUL 20. 2011 9:35 AM SENSOR AL,AR1•I - - - -- 1- ):DISP 1 -2 DISPENSER PAN SENSOR OUT AL Ql JUL 20. 2011 9:41 All SENSOR ALARM - -- -- L10:11ISP 7 -8 DISPENSER PAN SENSOR OUT ALARM JUL 20. 2011 9:41 W9 SENSOR ALARM -- - -- L 13: 1110. TRANS OTHER SENSORS SENSOR OUT ALARM JUL 20. 2011 9:41 AM SENOR ALt;RPI - LII:DISP 5 -6 DISPENSER PAN SENSOR. OUT ALARM JUL 20. 21.11 I 9:41 W SENSOR ALARM - - - -- L12:DISP 3 -4 DISPENSER PAN SENSOR OUT ALARM JUL 20. 2011 9:41 AM SENSOR ALARM - -- -- L 3:DIESEL STP STP SUMP SENSOR OUT ALARM JUL 20. 2011 9:41 AM SENSOR ALARM - -- -- L 4 : 01 ESEL AIJIJ iNNULAR SPACE SENSOR OUT ALARM JUL 20. 2011 9:41 Ah1 SENSOR ALARM - - --- L 5:REr2 STN STP SUI °IP SENSOR OUT ALARM JUL 20. 2011 9.41 AM SENSOR ALAR11 - - - -- L I:UNL I STP STP SUMP SENSOR OUT ALARM JUL 20. 2011 9:41 AM SENSOR ALARM - - - -- L 2,UNL 1 ANN OTHER SENSORS SENSOR OUT ALARM JUL 20: 2011 9:41 AM SENSOR ALARM -- - -- L 7:SUPER STP STF' SUMP SENSOR OUT ALARM JUL 20, 2011 9:41 AM SENSOR ALARPt - - - -- L G:SUPER ANN AIJNULAR SPACE SENSOR. OUT ALARM JUL 20. 2011 9:41 WTI FASTR I P 731 4013 S.H ST o BAKERSF I ELD CA . 93304 JUL 20. 2011 5:42 AM SYSTEM STATUS REPURT T 4:PROBE OUT ARCHIVE UTILITY SAVE SETUP DATA: START TIME: JUL 20, 2-011 9:42:18 API ARCHIVE UTILITY IN -TANK ALARM - - - -- T 3:PNL SAVE SETUP DATA: T 3 : PNL HIGH WATER WARNING IVINVENTOkYICkEiE Er1L1 TIME; JUL 20, 2011 $:44:25 Ail JUL 20. 2011 9:55 AM INCREASE START DYTES I6 "'So JUL 20. 2011 9:56 AM VOLUME e 2678 C:HLS HEIGHT - 30.52 1NC!HES WATER n 10.82 INCHES TEMP 98.7 DEG F INCREASE ENDFASTRIP7aIJUL20. 2011 9:58 All 4013 S -H ST BAKERSF I ELD CA . 33304 VOLL311E v 8677 C;ALS IN -TANK ALHRhI - - - -- HEIGHT o '75.38 INCHES T 3 : P1VL WATER m 0.89 INCHES PROBE OUT JUL 20. 2011 9:56 AM TEMP ' 96.6 DEC F JUL 20, 2011 9:48 AM GROSS I PU:kEASE- 5999 5::'fEIW STATUS REPORT TC NET INCREASE- 5849 T +:HIGH WATER A MLAR T 3: H t C;H WATER WARN I Ni: T 4:PROBE OUT FASTPIP 781 4013 S.H '.3T BAYERSF I ELD CL F, 9:3304 JUL 20, 2011 9:48 AM IN -TANK ALARM - -- -- T 4:DIESEL PROBE OUT 13' STEPi STATUS REPORT JUL 20, 2011 10:00 API V V - - - - T 3 : PROBI OUT FF;STR I P 781 401 ; G.H ST T 4:PROBE OUT HAKERSFIELD CH,93304 JUL 20, 21311 9:57 AI °i SYSTEM STHTUfi REPORT FHSTRIP 781 4013 S-.H ST T 3:HIGH WATER ALARM BHKERSF I ELD CA, 93:3U4 T 3 : H I GH WATER WARNING JUL "20- 2011 10:00 All FASTR I P 781 T 4:PROBE 'JUT4013S.H ST EIAKERSF I ELG CA • 93304 S;'STEM STATUS REPORT JUL 20. 2011 9:50 API 1' 4:PROBE OUT SYSTEM STATUS REPORT T 3:PROBE OUT T 4:PROBE OUT FHSTRIP 781 41313 S.H ST BHKERSFIELD CA-93304 JUL 20. °011 10:00 HM 1 N- THI•il•'. HLHRPI - - - -- T 3:PN1_ SYSTEM STATUS REPORT H 1 k;H Wi- TER ALARM - - - - - - - - - - - - JUL '20. Q011 9. 55 AM T 4:PROBE OUT SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing ofUST spill containment structures. The completedform and printoutsfrom tests (ifapplicable), should be provided to the facility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: #781 Fastrip #22 (South) I Date ofTesting: 7/20/2011 Facility Address: 4013 South H Street, Bakersfield, CA 93304 Facility Contact: Omero Garcia I Phone: 661- 393 -7000 Date Local Agency Was Notified of Testing: 6/27/2011 Name of Local Agency Inspector (cfpresent during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Bryan A Self Credentials: x CSLB Contractor x ICC Service Tech. x SWRCB Tank Tester Other (Specify) License Number(s): CSLB #804904 ICC #8022804 -UT Tank Tester# 11 -0756 3. SPILL. BUCKET 'TESTING INFORMATION Test Method Used: M 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 Z Contained in Sump Direct Bury ElContained in Sump Direct Bury x Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" 12.00" Bucket Depth: 14.00" 13.75' 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): 9:30am 9:30am 9:30am 9:30am Initial Reading (RI): 7.50" 7.25" 7.50" 7.00" Test End Time (TF): 10:30am 10:30am 10:30am 10:30am Final Reading (RF): 7.50" 7.25" 7.50" 7.00" Test Duration (TF — Ti): 1 hour 1 hour 1 hour 1 hour Change in Reading (RF - Ri): 0.00" 0.00" 0.00" 0.00" Pass/Fail Threshold or Criteria: 0.0625" 0.0625" 0.0625" 0.0625" Test Result: 1 © Pass Fait 1 ® Pass Fail I ® Pass Fail 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 in ation contained in this report is true, uate, and in full compliance with legal requirements. Technician's Signature: Date: 7/20/2011 State laws and regulations do not curreryt y require testing to be performed by a qualified contractor. However, local requirements may be more stringent. / M®M70MNIG S YS7EM CER71FICAMN 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 ofRegulations 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: #721 Fastrip #22 (North) Bldg. No.: _ Site Address: 4013 South "H" Street City: Bakersfield Zip: 93304 Facility Contact Person: Omero Garcia Make/Model of Monitoring System: Veeder -Root TLS 350 B. Inventory of Equipment 'Tested /CertifiedCheektheappropriateboxestoIndicateap"Ift equipment Inxpectedherviced: Contact Phone No.: 661 - 393 -7000 Date of Testing/Servicing: 7/20/2011 Tank ID: 12000 gal. Regular Tank ID: 12000 gal. Super x] In -Tank Gauging Probe. Model: 847390 -107 Lx] 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 x] Piping Sump / Trench Sensor(s). Model: 794380 -208 Fill Sump Sensor(s) Model: Fill Sump Sensor(s). Model: x] Mechanical Line Leak Detector. Model: FX1 V x] Mechanical Line Leak Detector. Model: FX1 V Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: x] Tank Overfill / High Level Sensor. Model: 847390 -107 x] 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. 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: x-] Mechanical Line Leak Detector. Model: FX1 DV Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: x] 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 R] Dispenser Containment Sensor(s). Model: 794380 -208 Lx] Dispenser Containment Sensor(s). Model: 794380 -208 7 Shear Valve(s). x] Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s) Dispenser ID: 13 & 14 Dispenser ID: 15 & 16 Lx] Dispenser Containment Sensor(s). Model: 794380.208 x] Dispenser Containment Sensor(s). Model: 794380 -208 x] Shear Valve(s). J Shear Valve(s). Dispenser Containment Float(s) and Chains(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 17 & 18 Dispenser ID: 19 & 20 x] Dispenser Containment Sensor(s). Model: 794380 -208 x] 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). Ifthe 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 o ating such reports, I have attached a copy of the report; (check all that apply) x S t -up L] Alarm hi tory ort Technician Name (print): Bryan A Self Signature: Certification No: B37501 License No: 4904 Testing Company Name: Confidence UST Services, Inc. Phone No: 800 - 339 -9930 Site Address: 4013 South "H" Street, Bakersfield, CA 93304 Date ofTesting/Servicing: 712012011 D. Results of Testing /Servicing Software Version Installed: 327.04 Complete the following checklist: N Yes No* Is the audible alarm operational? s No* Is t e Visual alarm operational? 4xYes s No* Were all sensors visually inspected, functionally tested, and confirmed operational? 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'? x Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary N/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected'? Ifyes: which sensors initate positive shut - down'? Sump/Trench Sensors [x] Dispenser Containment Sensors Did you confirm positive shut -down due to leaks and sensor failure /disconnected? [x] Yes; No; xj 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? 90 % Yes* L_.1 No Was any momtonng 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* x] No Was liquid found inside any secondary containment systems designed as dry systems'? Product; Water. If yes, describe causes in Section E, below. Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable. KYesN No* I 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: 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. the following checklist: E Yes I No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults'? Yes 7 No* Were all tank guaging probes visually inspected for damage and residue buildup'? Yes 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? 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): Complete the following checklist: Check this box if LLD's are not installed. x] 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.: 00.1 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* Was the testing apparatus properly calibrated? U Yes No For mac anica 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 ifany portion of the monitoring system is x] N/A disabled or disconnected'? Yes No* For electronic LLD's, does the turbine automatically shut off ifany portion ofthe monitoring system x] N/A malfunction or fails a test? Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected? X] N/A x 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. H. Comments: F'm$TR I P 721 4IJ 1 3 SO. H ST. FA) :EPbF I ELD .1: A :+3304 661 -0321 -612,3 JUL 20. 2011 11:27 AM SYSTEM 5TM1'US REFvkT ALL FUP1i;PIONS- NORMAL INVENTORY REPORT T I:UNL VOLUME = 55 ^7 GALS ULLAGE 6-4"13 GALS 90% ULLA- E= 5223 GALS TC VOLUME - 5499 GALS HEIGHT - 45.34 1NCHE•S WATER VOL - 0 GALS WATER - 0.00 Ihb'HES TEMP = 79.8 DEC: F T 2:PNL VOLUME a 5190 13ALS ULLAGE 6610 GALS 901 ULLA(3E- 5610 GALS TC VOLUME - 5106 GALS HEIGHT - 42.90 INCHES WATER VOL - 0 t:;ALS WATER - 0.00 INCHES TEMP - 83.2 DEG F T 3: DSL VOLUME = 4707 GHLS ULLAGE - 7 ^93 GALS 90-> ULLAGE- 6093 GALS TO VOLUME = 4653 13ALS FIE IUHT - 39.84 INCHES WATER VOL - 0 GALS WATER = 0.00 INCHES: TEMP = 85.4 DEG F END • 7l It SOFTWARE REVISION LEVEL VERSION 39.01 SOFTWAREO 34632y 100 -19 CREATED - 09.01.::= ,.15..1.1 S-MODULEd 330160 -004 -a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-Ti-+N1: TESTS ISD S'12TEH SETUP JUL 20, 2011 11:2,6 Am SYSTEM UNITS U.S. SYSTEM LANGUHCL E1*3L I SH SYSTEM DATE -T 1 11E FOR.NIAT MON DD Y"'O.' HH:I.1M:S.S x11 FASTRIP 721 4013 SO. H ST. BAKERSFIELD.C'A 93304 661-832 -6124 SHIFT TIME 1 6:00 API SHIFT TIME 2 DISABLED SHIFT TIME 3 DISABLED SHIFT TIME a DISABLED TANK PER TST NEEDED WRN 111 SABLED TANK ANN TST NEEDED WRN DISABLED LINE RE-.ENABLE METHOD PASS LINE TEST LINE PER TST NEEDED WRN DISABLED LINE ANN TST NEEDED WRN DISABLED PRINT TC VUl_1111M ENABLED TEMP COMPENSATION VALUE *Et; F ) : 60.0 STICI: HEIGHT OFFSET DISABLED ULLHC;E : 90% H- PROTOCOL DATA F(:RMAT HEIGHT DAYLIGHT SAVING TIME DISABLED RE- DIRECT LOCAL PRINTOUT DISABLED EURO PROTOCOL PREFIX S COMMUNICATIONS SETUP PORT SE'Fr I NGs : COMM BOARD : I (EDIM ) RS-232 SECURITY CODE : DISABLED COMM BOARD 2 cFS -232> BAUD RATE 9600 PARITY NONE STOP BIT I STOP DATA LENGTH: 8 DATA RS -232 SECURITY 40DE : DISABLED COMM BOARD 3 (.RS -232) BAUD RATE 9600 PARITY NONE STOP BIT 1 STOP DATA LEN!-;1'H: 8 DATA RS -232 SECURITY CODE : DISABLED AUTO TRANSMIT SETT1w;s AUTO LEAK, ALARM LIMIT DISABLED AUTO H113H WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODIU_T DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY STAiRT DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT Oil DISABLED AUTO EXTERNAL INPUT OFF DISABLED AUTO SE19)R FUEL ALARM DISABLED AUTO SENSOR WATER ALARM D 1 SABI_ED AUTO SENSOR OUT HLARM DISABLED SYSTE11 :5ECUR l TY CODE : 000000 MAINTENANCE HISTORY RS -232 END OF MESSAGE DISABLED DISABLED ti TANY CHART SECURITY DISABLED CUSTOM ALARMS DISABLED SERV 1 CE NOT I C :E DISABLFD ISO 3161 COUNTRY C0DE : MA:S , DENS 1 TY DISABLED IN—TANK SETUP T I: UNI_ PRODUCTC CODE ! THERMAL :,(;EFF .000700 TANK DIAMETER 96.00 TANK PROFILE I PT FULL VOL : 12000 FLOAT SIZE: 4.0 1N. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOLT 12000 OVERFILL L I P'l 1 T 90 °: 10801'1 HIGH PRODUCT 95% 11400 DELIVERY LIMIT 158 1806 LOW PRODUCT 1200 LEAK: ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 913 TANK: T 1 LT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS TO: NONE LINE MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 1`c u LEAK MIN HrINUAL I % 1 < < ^0 PEkIODIC TEST TYPE 2TANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARI.1 DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERHV I N( ; : OFF PER TEST AVERHG I Ni; : OFF TANK: TEST NOTIFY! OFF TNK TST SI F•HON BREAK :OFF DELIVERY DELk" I MIN PUMP THRESHOLD 10.00% T 2 : PNL T 3 : DISL PRODUCT GODE 2 PRODUCT CODE 3 THERMAL COEF1= 000700 THERMAL COEFF :.000450 TAN), DIAMETER 96.00 TANK: D I AI•IETER 96.00 TANK PROFILE 1 PT TANK PROFILE I PT FULL VOL 1'2000 FULL VOL 12000 FLOAT SIZE: 4.0 IN. FLOAT SIZE: 4.0 114. WATER WARNING 2.0 WATER WARN) NG 2.0 HIGH WATER LIMIT: 3.0 HIGH WATER LIMIT: 3.0 Ilmx OR LABEL VOL: 1000 MAX OR LABEL VOLT 12000 OVERF I LL L I M I T 90% OVERFILL LIMIT 90% 10800 10800 HIGH PRODUCT 95% H I i:H PRODUCT 95 11400 11400 DELIVERYr LIMIT 15% DELIVERY LIMIT 15/ 1800 1800 LOW PRODLM:T 1200 LOW PRODUCT 1200 LEAK ALARhI LIMIT: 99 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANI•'. TILT 6.00 TANK TILT 0.00 PROBE OFFSET 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS TO: NON!~ LINE MANIFOLDED TANKS TO: NONE LEAK 1,1114 PERIODIC: 1% 120 LEAK 1-111%1 ANNUAL I- 120 PERIODIC: TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TENT FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST mVERAGING: OFF PER TEST AvERAC;1 hIG : OFF TANK: TEST NOTIFY: OFF TIHK TST SIPHON SREAK::OFF DEL, I VERY DELAY 1 III N PUMP THRESHOLD 10,00% t SIPHON MANIFOLDED TANKS TO: NONE LINE MAN I FOLDED TH(VYS TG: NONE LEN1; HIN PERIODIC: l% 120 LEAK. MIN ANNUAL : 1% 120 PERIODIC: TEST TYPE STANDHRD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANI TEST NOTIFY: OFF TNK TST S I PHO14 BREHK.:OFF DELIVERY DELAY I III I N PUMP THRESHOLD 10.00%1 LEAK TEST METHOD TEST ON DATE : ALL TANK JAIJ 29. 2009 START TIME : DISABLED TEST RATE :0.20 GAL.;HR DURATION : 2 HOURS TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT NORMAL L I OU 1 D SENSOR SETUP 1. 1 : UNL STP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 2:01. ANN NORMALLY CLOSED CATEGORY : ANNULAR. SPACE L 3:PNL STP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 4:F'PII_ ANN TRI-STATE ( S 1 I -IGLE FLOAT) CATEGORY : ANNULAR SPACE L 5:DSL STP TRI -STATE (SINGLE FLOAT) ATEGORY : STP SUMP L 6:DSL ANN TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR Sf,o::E L `"i:DISP 1 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN LIO:DISP TRI-STATE (SINGLE FLOAT) CHTE43ORY : DISPENSER PAN LII:DISP :3 TRI -STATE (SIPI;LE FLOAT) CATEGORY : DISPENSER PAN L12:DISP 4 TRI -STATE (SINGLE FLOAT) CATEC',ORY : DISPENSER PHN L13:DISP 5 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L14:DISP U NORMALLY 'LOSED CATEGORY : DISPENSER PAN PUMP SENSOR SETUP S I:UNL THN1 o: I DISPF14SE MODE: STANDARE) S 2 : PNI_ TANK. 9: 2 DISPENSE MODE: STANDARD OUTPUT RELA`,, SETUP R I:UNL TYPE: PU'1P CONTROL OUTPUT TANK a: ) Lf:UID SENSOR ALMS L I:FUEL ALARM L 9:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L 1:SENSOR OUT ALARM L y:SENSOR OUT ALARM L10:SENSOR OUT ALARM LII :SENSOR OUT ALARM L12:SENSOR OUT ALARM L13 :SENSOR OUT ALARM L14:SENSOR OUT ALARM L 1:SHORT ALARM L 9:SHORT ALARM LIO:SHORT ALARM LII:SHORT ALARM L12:SHORT ALARM L13:SHORT ALARM LIC SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS ALL:GROSS COLLE,_T FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL R 2:PNL TYPE: PUMP CONTROL OUTPUT TANK d: 2 LIWUID SERSOR ALMS L I:FUEL ALARM L 3:FUEL ALARM L 9 :FUEL ALARM LIO:FUEL ALARM LII:FUEL ALARM L12:FLIEL ALARM L13:FUEL ALARM L14:FUEL ALARM L I :SENSOR OUIALARM L 3:SENSOR OUT ALARM L 9:SENSOR OUT ALARM LIO:SENSOR OUT ALARM LII:SENSOR OUT ALARM L12:SENSOR OUT HLHRM L13:SENSOR OUT ALARM L14:SENSOR OUT (ALARM L I:SHORT ALARM L 3:SHORT ALARM L 9:SHORT ALARM LIO:SHORT ALARM LII:SHORT ALARM 1.12 :SHORT ALARM L13:SHORT ALARM LIC SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL R 3:DSL TYPE: STANDARD NORMALLY CLOSED TAN4: 0: NONE LIOU1D SENSOR ALMS L I:FUEL ALARM L 5:FUEL ALARM L 9 :FUEL ALARM LIO:FUEL ALARM 1.11:FUEL ALARM L12:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L 5:SENSOR OUT ALARM L 9:SENSOR OUT ALARM LIO :SENSOR OUT ALARM LII:SENSOR OUT ALARM L12:SENSOR OUT ALARM L13 :SENSOR OUT ALAPM L14:SENSOR OUT ALARM L 5:SHORT ALARM L 9:SHORT ALARM LIO:SHORT ALARM LII:SHORT ALARM L12:SHORT ALARM 1.13:SHORT ALARM L W SHORT ALARM R 4:OVERFLI. TYPE: STANDARD NORMALLY OPEN TANK R: 4 IN-TAW ALARMS ALL:LEAK ALARM ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM 3MHRTSENSOR SETUP 5 I:PS -2 t:ATEGOR'Y VAPOR PRESSURE s '2:FM -1 CATEGORY AIR FLOW METER s 3:FM -2 CATEGORY AIR FLOW METER 5 4:FM -3 i:ATFGORY AIR FLOW METER. s 5:FM -4 CATEGORY AIR FLOW NETEP. s 6 :FM -5 CATEGORY AIR FLOW METER s 7:FM -6 GATEGORY AIR FLOW METER EVR • 1 SD :SETUP EVR TYPE: VFC'UUM HSS I ST VACUUM H51ST TYPE HEAL`! VAC' NOZ7LE 14,1- RANGE MAX: 1.15 MIN: 0.95 VAPOR PROI'ESSOP. TYPE NONE ANALY21 ,i TIMES TIME: 10:48 AM DELAY MINUTES: 1 ACCEPT HIGH ORVR: DISABLED ISD HOSE TABLE ID FP FL HL AA RR Ol '-5 C19 02 01 UU 02 26 IU 02 01 UU 03 27 11 OP 02 UU 04 28 1a' 0? 02 UU 05 01 13 02 03 UU 06 02 14 02 03 UU 07 03 15 02 04 UU 08 04 16 02' 04 UU 09 05 17 02 05 OU 10 06 18 02 05 UU Il 07 19 02 06 UU 12 08 20 02 06 UU 1 SD AIRFLOW METER ( 44P 1D SERIAL NUM LABEL 1 8203 FM -1 4 MHH AF; 8256 FM -2 3 8446 FM -3 4 8271 FM -4 5 7983 Fill -5 6 8495 FM -6 I SD FUEL GRADE HOSE 1-14, 1 FP MHH MHH r111H 4 MHH AF; 01 205 305 905 5 U 3 02 206 306 906 5 U 3 03 207 307 907 5 U 4 04 208 308 906 5 U 4 05 209 309 909 U U 5 06 210 310 910 U U 5 07 311 911 21) 5 U 6 08 212 312 912 5 U 6 17 2 U 9 U 3 0 0 0 0 18 3 U 2 U 9 U U U 0 19 2 U 9 U 3 U 5 U 0 102U91J5U3U 0 21 2 U 9 U 3 U 11 U 0 22 9 U 2 U 3 IJ U U 0 113 5 U 2 U 9 U 3 U 6 24 _' U 5 U 3 1! 9 U 0 25 201 301 901 5 U 1 26 202 302 902 5 U 1 27 203 303 903 U U 2 28 204 304 904 U U 2 LABEL TABLE I: UNASSIGNED 2: BLEND3 3: REGULAR 4 : 11114 GRMDE 5 : PRFki I UP9 6: GOLD 7: BRON7E 8-- SILVER 9: BLEND2 10: BLEND4 P 1v: SETUP PIlC• VERS I ON: 01 . u2 VAPOR PROCE`,'SOR T;'PE 14014E PROCESSOR CONTROL. LEVEL : NONE ALARM HISTORY REPORT S' ;'STEr1 ALARM - - - -- PnFER OUT JUN 15, "Oil 3 PRINTER ERROR. JUN 15. 2011 3.20 PM A x r n 1 END r X iii A X P ALARM HISTORY REPORT IN-Tr-;NV. MLA6.H - - - -- T I:UNL HIGH WATER ALARM OCT 19, 2010 9:59 All OVERFILL ALARM JUN 5. 2011 6:15 Phl IIA''' 24, 2011 5:36 AM MAY 24, 201 1 5:25 Arl LOW PRODUCT ALARM JUN 26, 2011 9:18 PM JUN 13. 2011 3:07 Pill JUN 4, 2011 4:59 PM HIGH PRODLR1T ALARM MAY 14. 2011 3:49 PM MAR 3. 2011 11:11 PM JAN 18. 2011 8:33 AM INVALID FUEL LEVEL DEC 23. ^010 7:48 PM DEC 3. 2010 5:18 PM OCT 19. 2010 9:44 AM PROBE OUT OCT 19. 2010 10:01 AM OCT I9. 2010 9:4;3 AM HIGH WATER WARNING OC -T 19. 2010 9:59 API DELIVERY NEEDED JUL 15, 2011 8:21 PM JUI_ 12, 2011 7:43 AM JUL 10, 2011 12 :46 Mil MAX PRODUCT ALARM OCT 19, 2010 9:50 AM LOW TEVIP WARNING OCT 19. 2010 10:01 AM f i x A END x n A x Y ALARM HISTORY REPORT HLARM HISTORY REPORT ALARM HISTORY REPORT SENSOR ALARM SENSOR ALARM - - - -- ALARM HISTORY L I:UNL F PP ALARM H I' '. iF.'! kEPORT L 4:PNL ANNT2 : PNL STP SUMP SENSOR ANNULPIR SPACE SENSOR ALARM - - - -- FUEL ALARM FUEL ALARMLOWPRODUCTALARMOCT19. 2010 10:47 AI•I APR 26. 2011 11 :21 AM01-T 19. 2010 9:43 AM ANNULAR SPACE STP SUMP OCT 19, 2010 9:42 AM SENSOR OUT ALARM FUEL ALARI.1 SENSOR 01_IT ALARM OCT 19. 2010 9:36 AM APR 26. 2011 11:_1 AllHIC:H PRODUCT ALARM II:18 All OCT 19, 2010 9:38 Art Oc,r 19. 2010 9:58 AM FUEL ALARM FUEL ALARM SENSOR OUT ALARM INVALID FUEL LEVEL O!'T 19. 2U 10 9:2.1 AM OCT 19, '2010 9:36 All OCT 19, 2010 9:43 Art OCT 19. 22010 9:25 Arl ALARr1 I I I STS %RY REPORT PROBE OUT OCT I9. 2010 10:02 mM OCT 19. '010 9:36 AI.1 OCT 19. 2010 9:42 Am DELIVER`,' NEEDED T 3:DSL OCT 19. 2010 9: 4 2 All LOW PRODUCT ALARM x x i. EI`ID t : x .t i:ND x :t 1 i x K K END x ri x K x ALARM HISTORY REPORT ALARM H I' '. iF.'! kEPORT SENSOR ALARM - - - -- SENSOR ALARM - - - -- l. 2: UNL ANN L 5 : DSL 5TPANNULARSPACESTPSUMPFUELALHRMSENSOR01_IT ALARMAPR26, 201I II:18 All OCT 19, 2010 9:38 Art FUEL ALARM FUEL ALARMAPR26. 2011 11:17 AM OCT 19. 22010 9:25 Arl ALARr1 I I I STS %RY REPORT FUEL ALARM OCT 19. '010 9:36 AI.1 T 3:DSL LOW PRODUCT ALARM Ot:T 19. '2010 9:41 All Hl ,H PRODUCT ALHRM x END FOCT19, 2010 9:59 AM INVALID FUEL. LEVEL x x x n r END k x k x x OCT 19. 2011: 10:04 AM OCT 19. 20I0 9:41 AM PROBE OUT CT 19. '2010 10:03 AM FOCT19. 2010 9:40 AM DELIVERY NEEDED ALARPI H l STOW REPORTFEB21 . "Fill 3:55 P11 FEB 16. 2011 3:35 Prl SENSOR ALARM - - - -- OCT 19. 2'010 9:41 AM ALARM HISTORY REPORT L 6: DSL ANN SE1,12OR ALHRM - ANNULAR, SPACE SENSOR OUT ALARMLOWTEMPl.laRN I Ni; L 3:FNI_ STP OCT 19, 2010 9:38 Ahl01 T 19. '2010 10:04 All STP SUI'1P SENSOR OUT ALARM FUEL ALARMFUELOCT19 . '201 0 9 : "s9 AM 19. 2010 9:3? AM FUEL ALARM SENSOR OUT ALARMOCT19. 2010 9:25 AM AUG 5. 2010 12:49 Pty FUEL ALARM OCT 19. 2010, 9:24 AM k x x END >i x P, ii 'r x x x A END y * x x x SWRCB, January 2006 Spill Bucket Vesting Report Form This, form is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and printoutsfrom tests (if applicable), should be provided to the facility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: 4721 Fastrip #22 1 Date ofTesting: 7/20/2011 Facility Address: 4013 South H Street, Bakersfield, CA 93304 Facility Contact: Omero Garcia Phone: 661- 393 -7000 Date Local Agency Was Notified ofTesting: 6/27/2011 Name of Local Agency Inspector (cfpresent during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Bryan A Self Credentials: Nx CSLB Contractor Z ICC Service Tech. x SWRCB Tank Tester Other (Specify) License Number(s): CSLB #804904 ICC #8022804 -UT Tank Tester # 11 -1756 3. SPILL BUCKET TESTING INFORMATION Test Method Used: 9 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 Nx Contained in Sump Direct Bury x Contained in Sump Direct Bury Nx Contained in Sump Direct Bury Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 14.25" 14.00" 14.50" Wait time between applying vacuum /water and start oftest: 5 min. 5 min. 5 min. Test Start Time (Ti): 12:15pm 12:15pm 12:15pm Initial Reading (Ri): 11.00" 10.25" 10.00" Test End Time (TF): 1:15pm 1:15pm 1:15pm Final Reading (RF): 11.00" 10.25" 10.00" Test Duration (TF — Ti): 1 hour 1 hour 1 hour Change in Reading (RF - Rj): 0.00" 0.00" 0.00" Pass /Fail Threshold or Criteria: 0.0625" 0.0625" 0.0625" Test Result: Pass Fail Pass Fail Pass Fail Pass Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforjailed 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: 24!t " / State laws and regulations do not curre}Il'y require testing may be more stringent. / Date: 7/20/2011 by a qualified contractor. However, local requirements