HomeMy WebLinkAboutFMC 2012MONITORING SYSTEM CERTIFICATION ssF
For Use By All Jurisdictions Within the Slate ofCalifornia
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. 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: Metro Station
Site Address: 4600 Stine Road
Facility Contact Person: Sam Bassem
Make /Model of Monitoring System: Veeder -Root TLS 350
B. Inventory of Equipment Tested /Certified
Check the appropriate boxes to indicate specific equipment inspected /serviced:
City: Bakersfield
Bldg. No.:
Zip: 93309
Contact Phone No.: 661 - 496 -0838
Date of Testing/Servicing: 3/26/2012
Tank ID: 12000 gal. Regular 1 Tank ID: 12000 gal. Regular 2
xj In -Tank Gauging Probe. Model: 847390 -107X] In -Tank Gauging Probe. Model: 847390 -107
Lx] Annular Space or Vault Probe. Model: 794390-420 x] Annular Space or Vault Sensor. Model: 794390 -420
x] Piping Sump / Trench Sensor(s). Model: 794380-208 Piping Sump / Trench Sensor(s). Model: 794380 -208
Fill Sump Sensor(s) Model: Fill Sump Sensor(s). Model:
J Mechanical Line Leak Detector. Model:FX1y U Mechanical Line Leak Detector. Model: FX1y
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
L] 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. Super Tank ID: 12000 gal. Diesel
x] In -Tank Gauging Probe. Model:847390 -107 Lx] 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 Piping Sump / Trench Sensor(s). Model: 794380 -208
Fill Sump Sensors(s). Model: Fill Sump Sensor(s). Model:
x_1 Mechanical Line Leak Detector. Model:FX1y Lx] Mechanical Line Leak Detector. Model: FX1Dy
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
Fx1 Tank Overfill / High Level Sensor. Model: 847390 -107 Lx] Tank Overfill / High Level Sensor. Model: 847390 -107
Other (specify equip. type and model in Sec. E on Pg. 2) Other (specify equip. typs and model in Sec. E on Pg. 2)
Dispenser ID: 1 - 2 Dispenser ID: 3 - 4
F] Dispenser Containment Sensor(s). Model: 794380 -208 Dispenser Containment Sensor(s). Model: 794380 -208
X] Shear Valve(s). Lx] 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
L] Dispenser Containment Sensor(s). Model: 794380 -208 Dispenser Containment Sensor(s). Model: 794380 -208
rx] Shear Valve(s). Shear Valve(s).
Dispenser Containment Float(s) and Chains(s). Dispenser Containment Float(s) and Chain(s).
Dispenser ID: 9-10 Dispenser ID:
xl Dispenser Containment Sensor(s). Model: 794380 -208 Dispenser Containment Sensor(s). Model:
z] 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 System Set -up Fx] Alarm history report
Technician Name (print): Kristopher Karns Signature:,.i
Certification No: 834106 License No: 804904
Testing Company Name: Confidence UST Services, Inc. Phone No: 800 - 339 -9930
Site Address: 4600 Stine Road, Bakersfield CA 93309 Date of Testing/Servicing: 3/26/2012
D. Results of Testing /Servicing
Software Version Installed: 331.00
Complete the following checklist:
UYes No* Is the audible alarm operational?
x Yes No* Is the Visual alarm operational?
x Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational?
x I Yes No* Were all sensors installed at the lowest point of secondary containment and positioned so that other
equipment will not interfere with their proper operation?
Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) 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? If yes:
which sensors initate positive shut -down? E Sump /Trench Sensors [x] Dispenser Containment Sensors
Did you confirm positive shut -down due to leaks and sensor failure /disconnected? Lx] Yes; No;
UYes No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at
the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm
trigger? 9p
Yes* I_ I No Was any monitoring equipment replaced? If Yes, identify specific sensors, probes, or other equipment
replaced and list the manufacturer name and model for all replacement parts in Section E, below.
Yes* No Was liquid found inside any secondary containment systems designed as dry systems?
Product; Water. Ifyes, describe causes in Section E, below.
x No* Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable.
LxJ Yes I E 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.
Complete the following checklist:
X] Yes No* Has all input wiring been inspected for proper enter and termination, including testing for ground faults?
x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
x Yes No* Was accuracy of system product level readings tested?
x Yes No* Was accuracy of system water level readings tested?
x Yes 7 No* Were all probes reinstalled properly?
Lx] Yes No* Were all items on the equipment manufacturer's maintenance checklist completed?
In the Section H, below, describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD): Check this box if LLD's are not installed.
Complete the following checklist:
L] Yes No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance?
Check all that apply) Simulated leak rate: fx 3 g.p.h.: 00.1 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* Waste testing apparatus properly calibrated?
Yes No For machamca LLD's, does the LLD restrict product ow if it detects a leak?
N/A
Yes No* For electronic LLD's, does the turbine automatically shut off ifthe LLD detects a leak?
Lx] N/A
Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is
x] N/A disabled or disconnected?
Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system
X] N/A malfunction or fails a test?
Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected?
U N/A
Lx] Yes I Ej 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:
METRO STATION
4600 STINE ROHD
BAKERSFIELD. CA
MAR 26, 2012 8:38 AM
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
INVENTORY REPORT
T 1:REGULAR
VOLUME = 4394 GALS
ULLAGE = 7606 GALS
90% ULLAGE= 6406 GALS
TC VOLUME — 4358 GALS
HEIGHT = 38.03 INCHES
WATER VOL = 0 GALS
WATER = 0.00 INCHES
TEMP = 71.0 DEG F
T 2:REGULAR 2
VOLUME = 4342 GALS
ULLAGE = 7658 GALS
90% ULLAGE= 6458 GALS
TC VOLUME - 4308 GALS
HEIGHT = 37.70 INCHES
WATER VOL = 0 GALS
WATER . 0.00 INCHES
TEMP = 70.3 DEG F
T 3:SUPER
VOLUME = 2333 GALS
ULLAGE = 9667 GALS
90% ULLAGE= 8467 GALS
TC VOLUME = 2309 GALSHEIGHT = 24.03 INCHES
WATER VOL - 0 GALS
WATER m 0.00 INCHES
TEMP = 73.3 DEG F
T 4:DIESEL
VOLUME - 2090 GALS
ULLAGE = 9910 GALS
90% ULLAGE= 8710 GALS
TC VOLUME = 2078 GALS
HEIGHT = 22.23 INCHES
WATER VOL = 14 GALS
WATER = 0.77 INCHES
TEMP = 72.0 DEG F
MANIFOLDED TANKS
INVENTORY TOTALS
T I:REGULAR I
T 2:REGULAR 2
VOLUME = 8736 GALS
TC VOLUME - 8665 GALS
x x iO x« END x o x 4
SOFTWARE REVISION LEVEL
VERSION 331.00
SOFTWAREit 346331 -100 —A
CREATED — 11.0'2.10.12.31
S— MODULE4 330160 -004—a
SYSTEM FEATURES:
PERIODIC IN —TANK TESTS
ANNUAL IN —TANK TESTS
ISD /APM
SYSTEM SETUP
MAR 26. 2012 8 :39 AM
SYSTEM UNITS
U.S.
SYSTEM LANGUAGE
ENGLISH
SYSTEM DATE. %TIME FORMAT
MON DD YYYY HH:MM:SS XM
METRO STATION
4600 STINE ROAD
BAKERSFIELD• CA
SHIFT TIME I DISABLED
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 RE— ENABLE METHOD
PASS LINE TEST
LINE PER TST NEEDED WRN
DISABLED
LINE ANN TST NEEDED WRN
DISABLED
PRINT TC VOLUMES
ENABLED
TEMP COMPENSATION
VALUE (DEG F ): 60.0
STICK HEIGHT OFFSET
DISABLED
ULLAGE: 90%
H— PROTOCOL DATA FORMAT
HEIGHT
DAYLIGHT SAVING TIME
DISABLED
RE— DIRECT LOCAL PRINTOUT
DISABLED
LUNU PXO'1'0(_:OL PREFIX
S
SYSTEM SECURITY
CODE : 000000
MAINTENANCE HISTORY
DISABLED
TANK CHART SECURITY
DISABLED
CUSTOM ALARMS
DISABLED
SERVICE NOTICE
DISABLED
ISO 3166 COUNTRY
CODE:
VAPOR MONITORING TYPE
CARD I SD
MASS./DENSITY
DISABLED
COMI °IUI4IC :AT IONS SETUP IN -TANK SETUP T 2:REGULAR 2
PRODUCT CODE 2
THERMAL C:OEFF :.000750
T 1:REGULAR 1 TANK DIAMETER 96.50
PORT SETTINGS: PRODUCT CODE I TANK PROFILE 1 PT
THERMAL COEFF :.000750 FULL VOL 12000
COMM BOARD 1 (EUIP1 > TANK DIAMETER 96.50
RS-232 SECURITY TANK PROFILE 1 PT
CODE : DISABLED FULL VOL 12000 FLOAT SIZE: 4.0 IN.
Comm BOARD 2 (RS -232) WATER WARNING 2.0
BAUD RATE 9600 FLOAT SIZE: 4.0 IN. HIGH WATER LIMIT: 3.0
PARITY : NONE WATER ALARM FILTER: LOW
STOP BIT I STOP WATER WARNING 1.5
DATA LENGTH: 8 DATA HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12000
RS -232 SECURITY WATER ALARM FILTER: LOW OVERFILL LIMIT 90°i
CODE : DISABLED 10800
MAX OR LABEL VOL: 12000 HIGH PRODUCT 95%
OVERFILL LIMIT 900 11400
AUTO TRANSMIT SETTINGS: A 10800 DELIVERY LIMIT 15%
HIGH PRODUCT 95`' 1800
AUTO LEAK ALARM LIMIT 11400
DISABLED DELIVERY LIMIT 15e LOW PRODUCT 400
AUTO HIGH WATER LIMIT 1800 LEAK ALARM LIMIT: 99
DISABLED SUDDEN LOSS LIMIT: 99
AUTO OVERFILL LIMIT LOW PRODUCT 400 TANK TILT 0.00
DISABLED LEAK ALARM LIMIT: 99 PROBE OFFSET 0.00
AUTO LOW PRODUCT SUDDEN LOSS LIMIT: 99
DISABLED TANK TILT 0.00
AUTO THEFT LIMIT PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS
DISABLED TO: NONE
AUTO DELIVERY START LINE MANIFOLDED TANKS
DISABLED SIPHON MANIFOLDED TANKS TO: 01
AUTO DELIVERY END T#: NONE
DISABLED LINE MANIFOLDED TANKS
AUTO EXTERNAL I Nl ON TO: 02 LEAK 11111 PERIODIC: 014
DISABLED 0
AUTO EXTERNAL INPUT OFF
DISABLED LEAK MI14 PERIODIC: ov, LEAK MIN ANNUAL 0 °/.
AUTO SENSOR FUEL ALARM 0 0
DISABLED
AUTO SENSOR WATER ALARM LEAK MIN ANNUAL 0x
DISABLED 0 PERIODIC TEST TYPE
AUTO SENSOR. OUT ALARM STANDARD
DISABLED
PERIODIC TEST TYPE ANNUAL TEST FAIL
STANDARD ALARM DISABLED
ANNUAL TEST FAIL PERIODIC TEST FAIL
ALARM DISABLED ALARM DISABLED
PERIODIC: TEST FAIL GROSS TEST FAIL
ALARM DISABLED ALARM DISABLED
RS -232 END OF MESSAGE
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 5 MIN
TNK TST SIPHON BREAK.:OFF PUMP THRESHOLD 10.00
DELIVERY DELAY 5 MIN
PUMP THRESHOLD 10.00%
T 3:SUPER
PRODUCT CODE 3
THERMAL COEFF 000750
TANK DIAMETER 96.50
TANK PROFILE I PT
FULL VOL 12000
FLOAT SIZE: 4.0 IN.
WATER WARNING 1.5
HIGH WATER LIMIT: 2.0
WATER ALARM FILTER: LOW
MAX OR LABEL VOL: 12000
OVERFILL LIMIT 90:
10800
HIGH PRODUCT 95%
11400
DELIVERY LIMIT 151%
1800
LOW PRODUCT 400
LEAK ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 99
TANK TILT 0.00
PROBE OFFSET 0.00
SIPHON MANIFOLDED TANKS
Td: NONE
LINE MANIFOLDED TANKS
TO: NONE 1
LEAK MIN PERIODIC:
LEAK MIN ANNUAL : F 0•
0
PERIODIC TEST TYPE
STANDARD
ANNUAL TEST FAIL
ALARM DISABLED
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF
TANK T1ST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY 5 MIN
PUMP THRESHOLD 10.00%
T 4:DIESEL
PRODUCT CODE 4
THERMAL COEFF 000450
TANK DIAMETER 96.50
TANK PROFILE 1 PT
FULL VOL 12000
FLOAT SIZE: 4.0 IN.
WATER WARNING 2.0
HIGH WATER LIMIT: 3.0
WATER ALARM FILTER: LOW
MAX OR LABEL VOL: 12000
OVERFILL LIMIT 90%
10800
HIGH PRODUCT 95%
11400
DELIVERY LIMIT 15%
1800
LOW PRODUCT 400
LEAK ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 99
TANK TILT 0.00
PROBE OFFSET 0.00
SIPHON MANIFOLDED TANKS
Td: NONE
LINE MANIFOLDED TANKS
TO: NONE
LEAK MIN PERIODIC: 0%
0
PERIODIC TEST TYPE
STANDARD
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY 5 MIN
PUMP THRESHOLD 10.00%
LEAK TEST METHOD
TEST ON DATE : ALL TANK.
FEB 10, 2011
START TIME : DISABLED
TEST RATE :0.20 GAL /HR
DURATION : 2 HOURS
TST EARLY STOP:DISABLED
LEAK TEST REPORT FORMAT
NORMAL
LIQUID SENSOR SETUP
L 1:DISP 1 -2
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
L 2:DISP 3 -4
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
L 3:D1SP 5 -6
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER FIA14
L 4:DISP 7 -8
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
L 5:DISP 9 -10
TRI -STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
L 9:REGULAR I STP
TRI -STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L10:REGULAR I ANN
TRI -STATE (SINGLE FLOAT)
CATEGORY : AN14ULAR SPACE
L11:REGULAR 2 STP
TRI -STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L12 :REGULAR 2 ANN
TRI -STATE (SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
L13:SUPER STP
TRI -STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L14:SUPER ANN
TRI -STATE (SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
L15:DIESEL STP
TRI -STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L16:DIESEL ANN
TRI -STATE (SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
X e: Xh(.xULHK e
TYPE: R 3 :SUPER
PUMP SENSOR SETUP PUMP CONTROL OUTPUT TYPE:
TANK #: 2 STANDARD
NORMALLY CLOSED
S I:REGULAR i
TANK #: 1
DISPENSE MODE:
MANIFOLDED: ALTERNATE
S 2 :REGULAR 2
TANK #: 2
DISPENSE MODE:
MANIFOLDED: ALTERNATE
OUTPUT RELAY SETUP
R 1:REGULAR I
TYPE:
PUMP CONTROL OUTPUT
TANK #: I
IN-TANK ALARMS
T I :HIGH WATER ALARM
T t:LOW PRODUCT ALARM
LIQUID SENSOR ALMS
L 2 :FUEL ALARM
L 3 :FUEL ALARM
L 4 :FUEL ALARM
L 5:FUEL ALARM
L 9:FUEL ALARM
L11:FUEL ALARM
L 2:SENSOR OUT ALARM
L 3:SENSOR OUT ALARM
L 4:SENSOR OUT ALARM
L 5:SENSOR OUT ALARM
L 9:SENSOR OUT ALARM
LII:SENSOR OUT ALARM
L 2 :SHORT ALARM
L 3:SHORT ALARM
L 4:SHORT ALARM
L 5:SHORT ALARM
L 9:SHORT ALARM
L11: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 SETUP FAIL
ISD SENSOR OUT FAIL
PC -ISD FAILURE
ISD HOSE ALARMS
ALL :GROSS COLLECT FAIL
ALL:DEGRD COLLECT FAIL
ALL :FLOW COLLECT FAIL
IN -TANK ALARMS
T 2:HIGH WATER ALARM
T 2:LOW PRODUCT ALARM
LIQUID SENSOR ALMS
L 2:FUEL ALARM
L 3:FUEL ALARM
L 4:FUEL ALARM
L 5:FUEL ALARM
L 9:FUEL ALARM
L11:FUEL ALARM
L 2:SENSOR OUT ALARM
L 3:SENSOR OUT ALARM
L 4 :SENSOR OUT ALARM
L 5:SENSOR OUT ALARM
L 9:SENSOR OUT ALARM
LII:SENSOR OUT ALARM
L 2:SHORT ALARM
L 3:SHORT ALARM
L 4:SHORT ALARM
L 5:SHORT ALARM
L 9:SHORT ALARM
LII: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 SETUP FAIL
ISD SENSOR OUT FAIL
PC -ISD FAILURE
ISD HOSE ALARMS
ALL:GROSS COLLECT FAIL
ALL:DEGRD COLLECT FAIL
ALL:FLOW COLLECT FAIL
TA14K 0: 3
IN -TANK ALARMS
T 3:HIGH WATER ALARM
T 3:LOW PRODUCT ALARM
LIQUID SENSOR ALMS
L 2:FUEL ALARM
L 3:FUEL ALARM
L 4:FUEL ALARM
L 5:FUEL ALARM
L13:FUEL ALARM
L 2:SENSOR OUT ALARM
L 3:SENSOR OUT ALARM
L 4:SENSOR OUT ALARM
L 5:SENSOR OUT ALARM
L13:SENSOR OUT ALARM
L 2:SHORT ALARM
L 3:SHORT ALARM
L 4:SHORT ALARM
L 5:SHORT ALARM
L13:9HORT 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 SETUP FAIL
ISD SENSOR OUT FAIL
PC -ISD FAILURE
ISD HOSE ALARMS
ALL:GROSS COLLECT FAIL
ALL:DEGRD COLLECT FAIL
ALL:FLOW COLLECT FAIL
R 4:DIEBEL
TYPE:
STANDARD
NORMALLY CLOSED
TANK #: 4
IN -TANK ALARMS
T 4:HIGH WATER ALARM
T 4:LOW PRODUCT ALARM
LIQUID SENSOR ALMS
L 1:FUEL ALARM
L 2:FUEL ALARM
L 3:FUEL ALARM
L15:FUEL ALARM
L I:SENSOR OUT ALARM
L 2 :SENSOR OUT ALARM
L 3:SENSOR OUT ALARM
L15 :SENSOR OUT ALARM
L 1:SHORT ALARM
L 2:SHORT ALARM
L 3:SHORT ALARM
L15:SHORT ALARM
R 5 :OVERFILL ALARM
TYPE:
STANDARD
NORMALLY OPEN
TANK #: NONE
IN -TANK ALARMS
ALL:OVERFILL ALARM
ALL:HIGH PRODUCT ALARM
ISD
EVR./ISD SETUP
METER MAP
1D SERIAL NUM LABEL
PMC SETUP
ALARM HISTORY REPORT
1 40348
PMC VERSION: 01.04
EVR TYPE: BALANCE
40070
VAPOR PROCESSOR TYPE
SENSOR ALARM --- --
BALANCE NOZZLE TYPE
FM 7 -8
VEEDER -ROUT POLISHER
4
UST
FM 9 -10 DISPENSER PAN
SMARTSENSOR SETUP
FUEL ALARM
VAPOR PROCESSOR TYPE
FUEL GRADE HOSE MAP
VEEDER -ROOT POLISHER
3 4 SETUP DATA WARNING
FP
3 2:FM 3 -4
MHH MHH AA MAY 17, 2011 8:50 AM
01 1 0 0 0
CATEGORY AIR FLOW METER
02 2 0 0 0 U U U U 0
ANALYSIS TIMES
201 101 901 3 U l
s 3:FM 5 -6 TIME: 11:59 PM
902 3 U 1
05
CATEGORY AIR FLOW METER DELAY MINUTES: t
06 204 104 904 3 U 2
07 105 905
SOFTWARE REVISION LEVEL
s 4:FM 7 -8
08 206 106 906 U U 3
VERSION 331.00
CATEGORY AIR FLOW METER ACCEPT HIGH ORVR:
907 U U 4
SOFTWARE# 346331-100 -A
208 108
DISABLED
x END
CREATED - 11.02.10.12.31
s 5: FM 9 -10
CATEGORY AIR FLOW METER ISD HOSE TABLE S- MODULE# 330160 -004 -a
ID FP FL HL AA RR SYSTEM FEATURES:
s 6:VP PRESSURE SEN. PERIODIC IN -TANK TESTS
CATEGORY VAPOR PRESSURE 01 03 03 02 01 01 ANNUAL IN -TANK TESTS
02 04 04 02 01 01 ISD /APM
s 7 :CANISTER 03 05 05 02 02 Ol
CATEGORY VAPOR VALVE 04 06 06 02 02 01
05 07 07 02 03 01
s B:ATM P SENSOR 06 08 08 02 03 01
CATEGORY ATM P SENSOR 07 09 09 02 04 01
08 16 10 02 04 01
ISD AIRFLOW METER MAP
1D SERIAL NUM LABEL
ALARM HISTORY REPORT
1 40348 FM 3 -4
2 40070 FM 5 -6 SENSOR ALARM --- --
3 40350 FM 7 -8 L i:DISP 1 -2
4 40356 FM 9 -10 DISPENSER PAN
FUEL ALARM
OCT 13, 2011 5 :52 AM
ISD FUEL GRADE HOSE MAP
1 2 3 4 SETUP DATA WARNING
FP MHH MHH MHH MHH AA MAY 17, 2011 8:50 AM
01 1 0 0 0 U U U U 0
02 2 0 0 0 U U U U 0
03 201 101 901 3 U l
04 202 102 902 3 U 1
05 203 103 903 3 U 2
06 204 104 904 3 U 2
07 105 905 205 U U 3
08 206 106 906 U U 3
09 207 107 907 U U 4
16 208 108 908 U U 4 x END
LABEL TABLE
1: UNASSIGNED
2: BLEND3
3: REGULAR
4: MID GRADE
5: PREMIUM
6: GOLD
7: BRONZE
8: SILVER
9: BLEND2
10: BLEND4
ALARM HISTORY REPORT ALARM HISTORY REPORT
SENSOR ALARM - - - -- _____ SENSOR ALARM - - - -- L I:DIS 1 L 4:DISP 7 -8DISPENSERRPAAN
FUEL ALARM DISPENSER PAN
OCT 13. 2011 5 :52 AM SETUP DATA WARNING
MAY 17. 2011 5:50 AM
SETUP DATA WARNING
MAY 17, 2011 5:50 AM
x x x* END x x x x x
x x x x x END A x* x x
ALARM HISTORY REPORT
ALARM HISTORY REPORT - - - -- SENSOR ALARM - - - --
L 5:DISP 9 -10
SENSOR ALARM - - - -- DISPENSER PAN
L 2:DISP 3 -4 SETUP DATA WARNING
DISPENSER PAN MAY 17, 2011 5:50 AM
SETUP DATA WARNING
MAY 17, 2011 5:50 AM
x x x x x END x* x x x
x x x x* END x* A x x
ALARM HISTORY REPORT
ALARM HISTORY REPORT ----- SENSOR ALARM - - - --
L 9:REGULAR 1 STP
SENSOR ALARM - - - -- STP SUMP
L 3:DISP 5 -6 FUEL ALARM
DISPENSER PAN MAR 12, 2012 7:19 PM
SETUP DATA WARNING SENSOR OUT ALARMMAY17. 2011 8:50 HM MAR 12. 2012 6:22 PM
SENSOR OUT ALARM
MAR 12. 2012 12:31 PM
x x x ** END * ** x x
0 x 4 x x END **** x
ALARM HISTORY REPORT
SENSOR ALARM - - - --
LIO:REGULAR 1 ANN
ANNULAR SPACE
FUEL ALARM
MAR 12, 2012 7:23 PM
SENSOR OUT ALARM
MAR 12. 2012 11:49 AM
SENSOR OUT ALARM
MAR 12, 2012 11:45 AM
x x x* x END * x x x x
ALARM HISTORY REPORT
SENSOR ALARM - - - --
L12:REGULAR 2 ANN
ANNULAR SPACE
FUEL ALARM
MAR 12, 2012 7:24 PM
SENSOR OUT ALARM
MAR 12, 2012 11:43 AM
SENSOR OUT ALARM
MAR 11, 2012 9:35 PM
x x x* x END * x* x*
ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT
SENSOR ALARM - - - --
L11:REGULAR 2 STP
STP SUMP
FUEL ALARM
MAR 12, 2012 7:18 PM
SENSOR OUT ALARM
MAR 12. 2012 11:44 AM
SENSOR OUT ALARM
MAR 12. 2012 10:58 AM
x x x x x END x x x x x
ALARM HISTORY REPORT
SENSOR ALARM - - - --
L12:REGULAR 2 ANN
ANNULAR SPACE
FUEL ALARM
MAR 12, 2012 7:24 PM
SENSOR OUT ALARM
MAR 12, 2012 11:43 AM
SENSOR OUT ALARM
MAR 11, 2012 9:35 PM
SENSOR ALARM - - - --
L13:SUPER STP
STP SUMP
FUEL ALARM
MAR 12, 2012 7:20 PM
SENSOR OUT ALARM
MAR 12, 2012 10:11 AM
SENSOR OUT ALARM
FEB 22, 2012 11:16 AI ^1
x x x x x END x x x x x
ALARM HISTORY REPORT
SENSOR ALARM - - - --
L14:SUPER ANN
ANNULAR SPACE
FUEL ALARM
MAR 12, 2012 7:21 PM
SENSOR OUT ALARM
MAR 12, 2012 11:43 AM
SENSOR OUT ALARM
MAR 12, 2012 9:06 AM
SENSOR ALARM - - - --
L15:DIESEL STP
STP SUMP
FUEL ALARM
MAR 12, 2012 7:17 PM
SENSOR OUT ALARM
MAR 12, 2012 11:50 AM
FUEL ALARM
MAR 12, 2012 10:56 AM
x x x x x END x x x x x
ALARM HISTORY REPORT
SENSOR ALARM - - - --
L16:DIESEL ANN
ANNULAR SPACE
FUEL ALARM
MAR 12. 2012 7:25 PM
SENSOR OUT ALARM
MAR 12, 2012 12:02 PM
SENSOR OUT ALARM
MAR 12. 2012 11:49 AM
x x x x x END x x x x x x x x x x END x x x x x x x x x x END x x x x x
IN -TANK ALARM - - - -- - - -- I14 -TANK ALARM - -- - - - - -- SENSOR ALARM - - - --
T 3:SUPER T 4:DIESEL L 2:DISP 3 -4
DELIVERY NEEDED PROBE OUT DISPENSER PAN
MAR 26, 2012 9:11 AM MAR 26, 2012 9:15 AM FUEL ALARM
MAR 26, 2012 9:25 AM
IN -TANK ALARM - - - -- - - - -- SENSOR ALARM - - - --
T 3:SUPER L13:SUPER STP - - - -- SENSOR ALARM - - - --
PROBE OUT STP SUMP L 3:DISP 5 -6
MAR 26. 2012 9:11 AM FUEL ALARM DISPENSER PAN
MAR 26, 2012 9: 21 All FUEL ALARM
MAR 26, 2012 9:27 AM
IN -TANK ALARM - - - --
T 1:REGULAR I ----- SENSOR ALARM - - - --
SUDDEN LOSS ALARM L 9:REGULAR 1 STP - - - -- SENSOR ALARM - - - --
MAR 26. 2012 9:12 AM STP SUMP L 4:DISP 7 -8
FUEL ALARM DISPENSER PAN
MAR 26, 2012 9 :21 All FUEL ALARM
MAR 26. 2012 9:2B AM
IN -TANK ALARM - - - --
T 1:REGULAR I
PROBE OUT --- -- SENSOR ALARM - - - --
MAR 26. 2012 9:12 AI °1 LII:REGULAR 2 STP - - - -- SENSOR ALARM - - - --
STP SUMP' L 5:DISP 9 -10
FUEL ALARM DISPENSER PAN
MAR 26, 2012 9:23 AM FUEL ALARM
MAR 26, 2012 9:30 AM
IN -TANY ALARM - - - --
T 2:REGULAR 2
SUDDEN LOSS ALARM
MAR 26. 2012 9:13 AM SENSOR ALARM - - - --
L15:DIESEL STP - - - -- SENSOR ALARM - - - --
STP SUMP L14:SUPER ANN
FUEL ALARM ANNULAR SPACE
MAR 26, 2012 9:24 AM FUEL ALARM
MAR 26. 2012 9:31 A("I
IN -TANK: ALARM - - - --
T 2:REGULAR 2
PROBE OUT
MAR 26, 2012 9:13 AM SENSOR ALARM - - - --
L I:DISP 1 -2 - - - -- SENSOR ALARM - - - --
DISPENSER PAN L10:REGULAR l ANN
FUEL ALARM ANNULAR SPACE
MAR 26. 2012 9:25 AM FUEL ALARM
MAR 26. 2012 9:32 AM
IN -TANX ALARM - - - --
T 4:DIESEL
DELIVERY NEEDED
MAR 26. 2012 9:15 AM
SENSOR ALARM - - - -- - - - -- SENSOR ALARM ----- L12:REGULAR 2 AIVN L S:DISP 9-10 - - --- SENSOR ALARM - - - --
ANNULAR SPACE DISPENS L 4:DISP 7 -8EkFANDISPENSERPANFUELALARMSENSOROUTALARMMAR26, 2012 9:32 AM MAR 26, 2012 9 :41 AM SENSOR OUT ALARM
MAR 26, 2012 9:41 AM
SENSOR ALARM - - - -- - - - -- SENSOR ALARM - - - -- _____ SENSOR ALARML16:DIESEL ANN L15:DIESEL STP ----- GULAR 2 SAPANNULARSPACESTPSUMPLIISUMPFUELALARMSENSOROUTALARMSENSOROUTALARMMAR6. 2012 9:33 AM MAR 26, 2012 9:41 All MAR 26, 2012 9:41 All
IN -TANK ALARM - - - -- - - - -- SENSOR ALARM - - - --
T 4:O1ESEL L16 :DIESEL ANN ----- SENSOR ALARM - - ---
PROBE OUT ANNULAR SPACE L12:REGULAR 2 ANN
MAR 26. 2012 9:37 AM SENSOR OUT ALARM ANNULAR SPACE
LIAR 26, 2012 9:41 All SENSOR OUT ALARM
MAR 26, 2012 9:41 AM
SENSOR ALARM - - - --
Ll3:SUPER STP - - - -- SENSOR ALARM - - - -- STP SUMP LlO:REGULAR 1 ANN - - - -- SENSOR ALARM - - - --
SENSOR OUT ALARM ANNULAR SPACE L 2 :DISP 3-4
MAR 26. 2012 9:40 AM SENSOR OUT ALARM DISPENSER PAN
MAR 26, 2012 9:41 All SENSOR OUT ALARNI
MAR 26, 2012 9:41 AM
SENSOR ALARM - - - --
L 9:REGULAR I STP - - - -- SENSOR ALARM - - - --
STP SUMP L 1'DI6F' 1 -2 - -~ IN -TANK ALARM - - - --
SENSOR OUT ALARM DISPENSER PAN T 3:SUPER
MAR 26. 2012 9:41 All SENSOR OUT ALARM OVERFILL ALARM
MAR 26, 2012 9:41 All MAR 26. 2012 9:46 AM
SENSOR ALARM - - - -- IN-TANK ALARM - - - -- L14 :SUPER ANN - - - -- SENSOR ALARM - - --- -- T -:SUPERANNULARSPACEL3:DISP 5 -6 PROBE OUTSENSOROUTALARMDISPENSERPANMAR26, 2012 9:47 AllMAR26. 2012 9 :41 All SENSOR OUT ALARI °M
MAR 26, 2012 9:41 AM
IN-TANK ALARM - - - --
T 4:DIESEL
HIGH WATER WARNING
MAR 26, 2012 9:47 AM
IN -TANK ALARM - - - --
T 1:REGULAR 1
OVERFILL ALARM
MAR 26. 2012 9:49 AM
114-TANK ALARM - - - --
T 1:REGULAR 1
PROBE OUT
MAR 26. 2012 9:49 All
T 3:SUPER
INVENTORY INCREASE
INCREASE START
MAR 26, 2012 9:45 All
VOLUME = 8278 GALS
HEIGHT - 62.87 INCHES
WATER = 0.00 INCHES
TEMP = 52.5 DEG F
INCREASE END
MAR 26, 2012 9:52 All
VOLUME - 10865 GALS
HEIGHT - 81.97 INCHES
WATER = 0.00 INCHES
TEMP m 52.5 DEG F
GROSS INCREASE= 2587
TO NET INCREASE= 2601
METRO STATION
4600 STINE ROAD
BAKERSFIELD. CA
MAR 26. 2012 9:53 AM
SYSTEM STATUS REPORT
T 4:HIGH WATER WARNING
IN -TANK ALARM - - - --
T 2:REGULAR 2
SUDDEN LOSS ALARM
MAR 26, 2012 9:54 AM
T I:REGULAR 1
INVENTORY INCREASE
INCREASE START
MAR 26, 2012 9:49 AM
VOLUME = 0 GALS
HEIGHT = 0.00 INCHES
WATER = 0.00 INCHES
TEMP 0.0 DEG F
INCREASE END
MAR 26, 2012 9:55 All
VOLUME = 10819 GALS
HEIGHT = 81.57 INCHES
WATER v 0.00 INCHES
TEMP = 63.2 DEG F
GROSS INCREASE- 10819
TO NET INCREASE= 10793
T 2.:REGULAR 2
INVENTORY INCREASE
INCREASE START
MAR 26, 2012 9:49 All
VOLUME = 8973 GALS
HEIGHT = 67.56 INCHES
WATER = 0.00 INCHES
TEPIP = 63.1 DEC; F
INCREASE END
MAR 26. 2012 9 :55 All
VOLUME = 8973 GALS
HEIGHT - 67.56 INCHES
WATER = 0.00 INCHES
TEMP = 63.0 DEG F
GROSS INCREASE= 0
TO NET INCREASE- 0
MANIFOLDED TANKS
INVENTORY INCREASE
T 1 :REGULAR 1
T 2:REGULAR 2
VOLUME - 10619 GALS
METRO STATION
4600 STINE ROAD - --- IN -TANK ALARM - - - --
IN -TANK ALARM - - - -- BAKERSFIELD, CA T 2:REGULAR 2
T 4:DIESEL OVERFILL ALARM
OVERFILL ALARM MAR 26. 2012 9:57 All
MAR 26, 2012 9:55 All MAR 26. 2012 9:57 AM
SYSTEM STATUS REPORT
T 2:OVERFILL ALARM
INVENTORY REPORT IN -TANK ALARM - - - --
IN -TANK ALARM - - - -- T 2:REGULAR 2
T 4:DIESEL PROBE OUT
PROBE OUT T !:REGULAR 1 MAR 26. 2012 9:58 AM
MAR 26. 2012 9:55 AM VOLUME = 4390 GALS
ULLAGE - 7610 GALS
90 % ULLAGE - 6410 GALS
TO VOLUME - 4355 GALS
HEIGHT = 38.00 INCHES
WATER VOL - 0 GALS
WATER - 0.00 INCHES
TEMP = 70.5 DEG F
METRO STATION
IN -TANK ALARM - - - -- T 2 :REt3ULAR 2 4600 STINE ROAD
T 4:DIESEL VOLUME 11229 GALS BAKERSFIELD, CA
INVALID FUEL LEVEL ULLAGE 771 GALS
MAR 26, 2012 9:56 AM 90% ULLAGE- 0 GALS
TO VOLUME - 11192 GALS MAR 26, 2012 10:01 AM
HEIGHT - 85.36 INCHES
WATER VOL - 0 GALS
WATER = 0.00 INCHES
TEMP = 64.3 DEG F SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
T 3:SUPER
VOLUME = 2335 GALS
IN -TANK ALARM - - - -- ULLAGE = 9665 GALS
T 4:DIESEL 90% ULLAGE= 8465 GALS
DELIVERY NEEDED TO VOLUME - 2312 GALS
MAR 26, 2012 9:56 AM HEIGHT = 24.05 INCHES
WATER VOL = 0 GALS
WATER = 0.00 INCHES
TEMP - 72.8 DEG F
T 4:DIESEL
I 14VE14TORY INCREASE
T 4:DIESEL
VOLUME = 2114 GALS INCREASE START
ULLAGE = 9886 GALS MAR 26. 2012 9:54 AM
90% ULLAGE- 8686 GALS
METRO STATION Tr_. VOLUME - 2106 GALS VOLUME - 9831 GALS
4600 STINE ROAD HEIGHT = 22.41 INCHES HEIGHT - 73.67 INCHES
BAKERSFIELD. CA WATER VOL = 21 GALS WATER = 0.00 INCHES
WATER 1.01 INCHES TEMP m 64.4 DEG F
TEMP = 67.8 DEG F
MAR 26. 2012 9:57 AM
INCREASE END
MANIFOLDED TANKS MAR 26, 2012 10:01 AM
INVENTORY TOTALS
SYSTEM STATUS REPORT T I:REGULAP. I VOLUME - 11264 GALS
T 2:REGULAR 2 HEIGHT - 85.70 INCHES
ALL FUNCTIONS NORMAL VOLUME - 15620 GALS WATER = 0.00 INCHES
TO VOLUME - 15548 GALS TEMP = 64.4 DEC; F
x END
GROSS INCREASE- 1433
TO NET INCREASE- 1430
T I:REGULAR I
INVENTORY INCREASE
INCREASE START
MAR 26. 2012 9 :57 AM
VOLUME s 4390 GALS
HEIGHT - 38.00 INCHES
WATER = 0.00 INCHES
TEMP m 70.4 DEC F
INCREASE END
MAR 26. 2012 10:03 AM
VOLUME = 4390 GALS
HEIGHT = 38.00 INCHES
WATER - 0.00 INCHES
TEMP = 70.6 DEG F
GROSS INCREASE= 0
TO NET INCREASE= 0
T 2:REGULAR 2
INVENTORY INCREASE
INCREASE START
MAR 26, 2012 9:57 AM
VOLUME e 7234 GALS
HEIGHT - 56.08 INCHES
WATER - 0.00 INCHES
TEMP = 64.6-DEG F
INCREASE END
MAR 26, 2012 10:03 AM
VOLUME = 11231 GALS
HEIGHT = 85.38 INCHES
WATER = 0.00 INCHES
TEMP = 64.3 DEC, F
GROSS INCREASE- 3997
TO NET INCREASE- 3985
MANIFOLDED TANKS
INVENTORY INCREASE
T I :REGULAR 1
T 2:REGULAR 2
VOLUME e 3997 GALS
SENSOR ALARM
L 9:REGULAR 1 STP
STP SUMP
FUEL ALARM
MAR 26, 2012 10:10 AM
SENSOR ALARM - - - --
L11:REGULAR 2 STP
STP SUMP
FUEL ALARM
HAR 26, 2012 10:16 AM
PUMP SENSOR SETUP
S 1 : REi: ULAR 1
TANK #: I
DISPENSE MODE:
MANIFOLDED: ALTERNATE
S 2 : REGULAR 2
TANK #: 2
DISPENSE MODE:
MANIFOLDED: ALTERNATE
METRO STATION
4600 STINE ROAD METRO STATION
BAKERSFIELD, CA 4600 STINE ROAD
BAKERSFIELD, CA
MAR 26, 2012 11:46 AM
PbaR 26, 2012 3:13 FM
SYSTEM STATUS REPORT
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
ALL FUNCTIONS NORMAL
INVENTORY REPORT INVENTORY REPORT
T I :REGULAR l
VOLUME = 4383 GALS T 1:REGULAR 1
ULLAGE - 7617 GALS VOLUME = 4163 GALS
90% ULLAGE= 6417 GALS ULLAGE = 7837 GALS
TC VOLUME - 4346 GALS 90 % ULLAGE- 6637 GALS
HEIGHT - 37.96 INCHES TO VOLUME - 4128 GALS
WATER VOL = 0 GALS HEIGHT - 36.53 1NCHES
WATER - 0.00 INCHES WATER VOL - 0 GALS
TEMP = 71.0 DEG F WATER e 0.00 INCHES
TEMP - 71.0 DEG F
T 2:REGULAR 2
VOLUME = 4342 GALS T 2 :REGULAR 2
ULLAGE = 7658 GALS VOLUME - 4180 GALS
90% ULLAGE 6458 GALS ULLAGE = 7820 GALS
TO VOLUME - 4306 GALS 90% ULLAGE - 6620 GALS
HEIGHT = 37.70 INCHES TC_VOLUME_- 41.47 GALS
WATER VOL - 0 GALS HEIGHT = 36.64 INCHES
WATER = 0.00 INCHES WATER VOL - 0 GALS
TEMP - 70.3 DEG F WATER = 0.00 INCHES
TEMP - 70.3 DEG F
T 3:SUPER
VOLUME = 2335 GALS T 3:SUPER
ULLAGE - 9665 GALS VOLUME = 2323 GALS
90% ULLAGE- 8465 GALS ULLAGE - 9677 GALS
TO VOLUME = 2311 GALS 90% ULLAGE- 8477 GALS
HEIGHT = 24.04 INCHES TC VOLUME = 2299 GALS
WATER VOL - 0 GALS HEIGHT = 23.96 INCHES
WATER = 0.00 INCHES WATER VOL = 0 GALS
TEMP - 73.4 DEG F WATER = 0.00 INCHES
TEMP = 73.5 DEG F
T 4:DIESEL
VOLUME = 2114 GALS T 4:DIESEL
ULLAGE = 9886 GALS VOLUME - 1993 GALS
90% ULLAGE= 8686 GALS ULLAGE = 10007 GALS
TO VOLUME = 2102 GALS 90% ULLAGE= 8807 GALS
HEIGHT - 22.41 INCHES TO VOLUME = 1981 GALS
WATER VOL - 21 GALS HEIGHT - 21.50 INCHES
WATER = 1.01 INCHES WATER VOL = 21 GALS
TEMP v 72.0 DEG F WATER = 1.01 INCHES
TEMP - 72.0 DEG F
MANIFOLDED TANKS
INVENTORY TOTALS MANIFOLDED TANKS
T (:REGULAR 1 INVENTORY TOTALS
T 2:REGULAR 2 T 1:REGULAR 1
VOLUME = 8725 GALS T 2:REGULAR 2
TO VOLUME - 8654 GALS VOLUME o 8343 GALS
TO VOLUME - 8275 GALS
x * END h
END * * x
SWRCB, January 2006
Spill Bucket Testing Report Form
Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and
printoutsfrom tests (ifapplicable), should be provided to the facility owner /operator for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: Metro Station Date of Testing: 3/26/2012
Facility Address: 4600 Stine Road
Facility Contact: Mike Phone: 661 -831 -0836
Date Local Agency Was Notified of Testing : 3/21/2012
Name of Local Agency Inspector (rfpresent during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Kristopher Karns
Credentials: x CSLB Contractor x ICC Service Tech. x SWRCB Tank Tester Other (Specify)
License Number(s): CSLB# 804904 ICC# 5264406 -UT TT# 09 -1743
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: x Hydrostatic Vacuum Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank
Number, Stored Product, etc.)
1 Regular #1
Product
2 Regular #2
Product
3 Super (Product) 4 Diesel (Product)
Bucket Installation Type: x Direct Bury
Contained in Sump
x Direct Bury
Contained in Sump
x Direct Bury
Contained in Sum
x Direct Bury
Contained in Sum
Bucket Diameter: 12.00" 12.00" 12.00" 12.00"
Bucket Depth: 13.50" 13.75" 13.50" 14.00"
Wait time between applying
vacuum /water and start of test:
5 min. 5 min. 5 min. 5 min.
Test Start Time (Ti): 9:15 AM 9:15 AM 9:15 AM 9:15 AM
Initial Reading (111): 9.75" 10.25" 11.001, 11.75"
Test End Time (TO: 10:15 AM 10:15 AM 10:15 AM 10:15 AM
Final Reading (RF): 9.75" 10.25" 11.001, 11.75"
Test Duration (TF — Tj): 1 hour I hour 1 hour 1 hour
Change in Reading (RF - Rj): 0.00" 0.00" 0.00" 0.00"
Pass /Fail Threshold or
Criteria: 0.0625" 0.0625" 0.0625" 0.0625"
Test Result: x Pass Fail 9 Pass Fail x Pass Fail x Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true, accurate, and infull compliance with legal requirements.
Technician's Signature: - ic,t.., Date:_03/26/2012
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
SWRCB, January 2006
Spill Bucket Testing Report Form
Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and
printoutsfrom tests (ifapplicable), should be provided to the facility owner /operator for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: Metro Station Date of Testing: 3/26/2012
Facility Address: 4600 Stine Road
Facility Contact: Mike Phone: 661 -831 -0836
Date Local Agency Was Notified ofTesting : 3/21/2012
Name of Local Agency Inspector (rfpresent during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Kristopher Karns
Credentials: 19 CSLB Contractor x ICC Service Tech. x SWRCB Tank Tester Other (Specify)
License Number(s): CSLB# 804904 ICC# 5264406 -UT TT# 09 -1743
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: x Hydrostatic Vacuum Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank
Number, Stored Product, etc.
1 Regular #1 (Vapor) 2 Regular #2 (Vapor) 3 Super (Vapor) 4 Diesel
Bucket Installation Type: x Direct Bury
Contained in Sump
x Direct Bury
Contained in Sump
x Direct Bury
Contained in Sump
Direct Bury
Contained in Sum
Bucket Diameter: 12.00" 12.00" 12.00"
Bucket Depth: 13.50" 13.75" 13.50"
Wait time between applying
vacuum /water and start of test: 5 min. 5 min. 5 min.
Test Start Time (Ti): 9:15 AM 9:15 AM 9:15 AM
Initial Reading (Rj): 9.50" 10.50" 11.001,
Test End Time (TO: 10:15 AM 10:15 AM 10:15 AM
Final Reading (RF): 9.50" 10.50" 11.00"
Test Duration (TF — Tj): 1 hour 1 hour I hour
Change in Reading (RF - R,): 0.00" 0.00" 0.00"
Pass /Fail Threshold or
Criteria: 0.0625" 0.0625" 0.0625"
Test Result: 121 Pass Fail 0 Pass Fail x Pass Fail 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:ti,. vcn Date:_03/26/2012
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
5,7,11 O
5,7,9 04 13 14 6
5,7,10
0 15 16 O
5,8,12 04 19 0
Metro Station
4600 Stine Road
Bakersfield, CA 93309
3/26/2012
1= Veeder Root TLS 350
9 10 2= External Overfill Alarm
3= ESO Switch
4= Veeder Root ATG Probe
5 5= Veeder Root 208 Sump Sensor
6= Veeder Root 420 Annular Sen.
7= FX1V Line Leak Detector
7 8 8= FX1DV Line Leak Detector
9= Regular 1 STP Sump
5 10= Regualr 2 STP Sump
11= Super STP Sump
12= Diesel STP Sump
5
5
6 13= Regular 1 Spill Bucket
14= Regular 1 Vapor Bucket
15= Regular 2 Spill Bucket
16= Regular 2 Vapor Bucket
17= Super Spill Bucket
34 18= Super Vapor Bucket19= Diesel Spill Bucket
5
1 2
5
0 0
U
Invoice No.: 28971A
Site: Metro Station
4600 Stine Road
Bakersfield, CA 93309
Repairs Requested: Monitoring System Certification, Leak Detector
Testing, and Spill Bucket Testing.
Repairs completed: Monitoring System Certification, Leak Detector
Testing, and Spill Bucket Testing. All Test's passed and no repairs
were required.
Required Repairs, Still Pending: No further repairs are required.
Technician Name: Kristopher Karns
Signature: -.
Date: 3/26/2012