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Home My WebLink AboutFMC 201111000 N. MoPac Expressway, Suite 500 Austin, Texas 78759 Phone: (512) 451 -6334 Fax: (512) 459 -1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR CRAIG PERKINS 1501 TRUXTUN AVE. BAKERSFIELD, CA. 93301 Test Date: 12/12/2011 Order Number: 3188524 Dear Regulator, 5s Date Printed and Mailed: 01/10/2012 Enclosed are the results of recent testing performed at the following facility: CIRCLE K #2708606 1030 OAK ST. BAKERSFIELD, CA. 93304 Testing performed: Leak detector tests Monitor Certification Secondary Containment -Spill Container Sincerely, bowx' KA '` Dawn Kohlmeyer Manager, Field Reporting A TANKNOLOGY CERTIFICATE OF TESTING 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: 12/12111 WORK ORDER NUMBER: 3188524 CUSTOMER PO: Joel Lindquist CLIENT: CIRCLE K STORES SITE: CIRCLE K #2708606 495 E. RINCON, STE. 150 1030 OAK ST. CORONA, CA 92879 BAKERSFIELD, CA 93304 TRISHA YAHNER MANAGER-DONNA 951)270 -5108 (661)861 -1042 TEST TYPE: TLD -1 Prnrlurt Pina Tinhtnacc Tact Racirltc LINE LINE LINE DELIVERY LINE ID MANUFACTURER IMPACT SERIAL # MANUFACTURER isMODEL # NEST RESULT FINAL.LEAK RATE (gph) VALVEIDPRODUCTMATERIALTYpE" A B C; = D Ar B C D T3 -89 2 VAPORLESS LD2000 07111268 FUNCTION T1 -87 1 REG UNLEAD DW FIBERG PRESSURE VAPORLESS LD2000 Y T3 -89 2 PLUS DW FIBERG PRESSURE Y T2 -91 3 SUPER DW FIBERG PRESSURE Y FYictinn I inp I Pak nptprtnr Tpct LINE , , MANIJFiID New Replacement Line Leak Detector T AK°•DETECTOR4111? L# rySERIAL # " ; RESULT m.MAN,UFACTURER owner detailed report information, visit www.tanknology.com and select On -Lin e Tester Name: EDWIN PINEDA t AV I ''SERIAL # J RESULTIII Reports -WRAP, or contact your local Tanknology Technician Certification Number: 8026748 Printed 01/10/2012 07:28 MTUTTLE EXISTING LEAK DifTEUTOR #1 ISTING'LEAK DETECTOR *2 ' LINE ID MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER isMODEL # SERIAL # RESULT T1 -87 1 VAPORLESS LD2000 16476 P T3 -89 2 VAPORLESS LD2000 07111268 P T2 -91 3 VAPORLESS LD2000 16478 P LINE , , MANIJFiID New Replacement Line Leak Detector T AK°•DETECTOR4111? L# rySERIAL # " ; RESULT m.MAN,UFACTURER owner detailed report information, visit www.tanknology.com and select On -Lin e Tester Name: EDWIN PINEDA t AV I ''SERIAL # J RESULTIII Reports -WRAP, or contact your local Tanknology Technician Certification Number: 8026748 Printed 01/10/2012 07:28 MTUTTLE INDIVIDUAL TANK INFORMATION AND TEST RESULTS Tanlmy TEST DATE: 12 /12/11 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3188524 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451 -6334 SITE:CIRCLE K #2708606 Printed 01/10/2012 07:28 5 TANK,INFORMATION Tank ID: T1 -87 1 Tank manifolded: NO Bottom to top fill in inches: Product: REG UNLEAD Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 353 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: -FTA Start (in) End (in) Dipped Water Level: New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: VAPORLESS Ingress Detected: Water Bubble Ullage Model: LD2000 Test time: S /N: 16476 Open time in sec: 3.20 Inclinometer reading: Holding psi: si: zz VacuTect Test Type: NOT Resiliency 6o NOT V8CUT8Ct Probe Entry Point: TESTED Test leak rate ml /m: 189.0 TESTED Pressure Set Point: Metering psi: 1e Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE;TESTRESULTS TesttyperTLD.1 A B C" D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): 120.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 01/10/2012 07:28 INDIVIDUAL TANK INFORMATION AND r Ten*ry TEST DATE: 12 /12/11 8501 N MOPAC EXPRESSWAY, SUITE 400 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451 -6334 TEST RESPLTS WORK ORDER NUMBER3188524 SITE:CIRCLE K #2708606 Printed 01/10/2012 07:28 TANK INFORMATION Tank ID: T3 -89 2 Tank manifolded: NO Bottom to top fill in inches: Product: PLUS Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESUQTS,Test Method:vacuTe' t s ., LEAK.DETECTOR TEST RESULTS Test method: FTA Start (in) End (in) Dipped Water Level: New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: VAPORLESS Ingress Detected: Water Bubble Ullage Model: LD2000 Test time: S /N: 07111268 Open time in sec: 4.52 Inclinometer reading: Holding psi: psi: 3030 VacuTect Test Type: NOT Resiliency NOT VacuTect Probe Entry Point: TESTED Test leak rate ml /m: 189.0 TESTED Pressure Set Point: Metering psi: 18 Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINESTEST RESULTS ` °. ., Test type:,, TLD- I LINE`s A gip, g;W aC D' Material: DW FIBERG Diameter (in): 2.0 Length (ft): 120.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 01/10/2012 07:28 INDIVIDUAL TANK INFORMATION AND TEST RESULTS r Tangy TEST DATE:12 /12/11 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3188524 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451 -6334 SITE:CIRCLE K #2708606 Printed 01/10/2012 07:28 TANK INFORMATION Tank ID: T2 -91 3 Tank manifolded: NO Bottom to top fill in inches: Product: SUPER Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 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:vacuTeot LEAK DETECTOR TEST RESUL'TS', - $ ' Test'me'th "odFTA' Start (in) End (in) Dipped Water Level: New passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2DippedProductLevel: Probe Water Level: Make: VAPORLESS Ingress Detected: water Bubble Ullage Model: LD2000 Test time: S /N: 16479 Open time in sec: 4.00 Inclinometer reading: Holding psi: 20 VacuTect Test Type: NOT Resiliency cc: so NOT V8CUT0Ct Probe Entry Point: TESTED Test leak rate ml /m: 189.0 TESTED Pressure Set Point: Metering psi: 1e Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE TE$TiRESULTS ;'` TesV pe TIM i LINE A B C " D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): 120.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 01/10/2012 07:28 MONITORING 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: CIRCLE K #2708606 Site Address: 1030 OAK ST. Facility Contact Person: MANAGER - DONNA Make /Model of Monitoring System:TLS 350 B. Inventory of Equipment Tested /Certified Check the appropriate boxes to indicate specific equipment inspected /serviced City: BAKERSFIELD Contact Phone No: 861 -1042 Date of Testing /Service: 12/12/2011 Work Order Number: 3188524 CA Zip: 93304 Tank ID: T1 REGULAR Tank ID: T2 PREMIUM X In -Tank Gauging Probe. Model: MAG PROBE X In -Tank Gauging Probe. Model: MAG PROBE X Annular Space or Vault Sensor. Model: VR -409 Annular Space or Vault Sensor. Model: VR -409 71 Piping SumplTrench Sensor(s). Model: VR -MAG 102 Piping SumplTrench Sensor(s). Model: VR -MAG 102 X Fill Sump Sensor(s). Model: VR -208 Fill Sump Sensor(s). Model: VR -208 X Mechanical Line Leak Detector, Model: LD 2000 X Mechanical Line Leak Detector. Model: LD 2000 Electronic Line Leak Detector, Model: Electronic Line Leak Detector. Model: X Tank Overfill /High -Level Sensor. Model: PROBE /FLAPPER Tank Overfill /High -Level Sensor. Model: PROBE /FLAPPER 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: In -Tank Gauging Probe. Model: MAG PROBE In -Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: VR-409 Annular Space or Vault Sensor. Model: X Piping Sump/Trench Sensor(s). Model: VR -MAG 112 Piping Sumprrrench Sensor(s). Model: X Fill Sump Sensor(s). Model: VR -208 Fill Sump Sensor(s). Model: X Mechanical Line Leak Detector, Model: LD 2000 Mechanical Line Leak Detector, Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill /High -Level Sensor. Model: PROBE /FLAPPER Tank Overfill /High -Level Sensor. Model: 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 -2 Dispenser ID: Dispenser Containment Sensor(s) Model: BRAVO FLOATS Dispenser Containment Sensor(s) Model: Shear Valve(s). Shear Valve(s) X Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chaln(s). Dispenser ID: 3 -4 Dispenser ID: Dispenser Containment Sensor(s) Model: BRAVO FLOAT Dispenser Containment Sensogs). Model: F1Shear Valve(s). Shear Valve(s). 7XI 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). 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): X System set -up X Alarm history report Technician Name (print): EDWIN PINEDA 1Signature: Certification No.: 8026748 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: 12/12/2011 Monitoring System Certification Page 1 of 3 Based on CA form dated 03/08 Site Address 1030 OAK ST. D. Results of Testing /Servicing Software Version Installed: 329.01 Complete the following checklist: Monitoring System Certification Date of Testing /Service: 12/12/2011 X Yes No Is the audible alarm operational? Yes No Is the visual alarm operational? Q Yes No Were all sensors visually inspected, functionally tested, and confirmed operational? a Yes No Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Ye No' x N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? rYes 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 Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure /disconnection? x Yes 0 No X Yes No' N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanicaloverfillpreventionvalveisinstalled), 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 X Yes* No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. El Yes' X No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) Product; 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. 17-A11 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: T3 LEAK D7ECTOR WAS ADJUSTED IN ORDER TO PASS Page 2 of 3 Based on CA form dated 03/08 Monitoring System Certification Site Address: 1030 OAK ST. F. In -Tank Gauging / SIR Equipment Check this box if no tank gauging or SIR equipment is installed. Date of Testing /Service: 12/12/2011 Check 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: EYes No Has all input wiring been inspected for proper entry and termination, including testing for ground faults? EYes No' Were all tank gauging probes visually inspected for damage and residue buildup? Yes No' Was accuracy of system product level readings tested? QYes No Was accuracy of system water level readings tested? X Yes No Were all probes reinstalled properly? x Yes No Were all items on the equipment manufacturers' maintenance checklist completed? In the Section H, below, describe how and when these deticiencies were or unit be corrected. G. Line Leak Detectors (LLD) : Check this box if LLDs are not installed. Complete the following checklist: Yes No' E] 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 hPPY) 9•P• 9•P• 9•P• M Yes No Were all LLDs confirmed operational and accurate within regulatory requirements? Fxj Yes 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' 1!1 N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes No' 0 N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes No' 0 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 ' x N/A For electronic LLDs, have all accessible wiring connections been visually inspected? Yes I 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 SWR ,CB, January 2002 Secondary Containment Testing Report Form Page 1 . Thisform is intendedfor use by contractors performing periodic testing ofUSTsecondary containment systems. Use the appropriate pages ofthis .form to report resultsfor all components tested. The completedform, written test procedures, and printouts F-om tests ( {fapplicable), should be provided to thefacility owner /operator,for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CIRCLE K #2708606 DateofTesting: 12/12/2011 Facility Address: 1030 OAK ST. , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - DONNA Phone: (661) 861 -1042 Date Local Agency Was Notified of Testing: 11/15/2011 Name of Local Agency Inspector (if present during testing): BAKERSFIELD FD 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Pass Technician Conducting Test: EDWIN PINEDA Repairs Made Credentials: El CSLB Licensed Contractor Not Tested SWRCB Licensed Tank Tester Spill Box 1 REG FILL License Type: A —UT License Number: 743160 Manufacturer Manufacturer Training Component(s) Date Training Expires OPW SPILL BUCKET 02/03/2013 Spill Box 2 PLU FILL X 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repair, Made Spill Box 1 REG FILL E Spill Box 2 PLU FILL X Spill Box 3 SUP FILL X E E 1:1 E E 1:1 D 0 El- F7 0 0 7 D 1:1 1:1 El F7 F] El- El El E-1 E E] 1:1 E E F] El 1:1 El El 7 F1 El- El El El El E E] El El 0 If hydrostatic testing was perfonned, describe what was done with the water after completion of tests: WATER WAS PLACE IN FIVE GALLON BUCKETS AND PUT IN TRUCK FOR NEXT SITE 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: r' Date: 12/12/2011 b '. " , SWRCB, January 2006 9. Spill Bucket Vesting Deport Form This form is intendedfor use by contractors performing annual testing of USTspill containment structures. The completed, form and printoutsfrom tests (ifapplicable), should be provided to the facility owner /operator,for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CIRCLE K42708606 DateofTesting: 12/12/2011 Facility Address: 1030 OAK ST. , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - DONNA Phone: (661) 861 -1042 Date Local Agency Was Notified of Testing: 11/15/2011 Name of Local Agency Inspector (if present during testing): BAKERSFIELD FD 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: EDWIN PINEDA Credentials I : CSLB Contractor ICC Service Tech. SWRCB Tank Tester x Other (Specify) A- UT License Number: 743160 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: TAPE MEASURE Equipment Resolution: V I S UAL Identify Spill Bucket(By Tank Number, Stored Product, etc.) 1 1 REG FILL Z 2 PLU FILL 3 3 SUP FILL 4 Bucket Installation Type: Direct Bury Contained in Sump Direct Bury XD Contained in Sump Direct Bury X Contained in Sump E] Direct Bury Contained in Sump Bucket Diameter: 12 " 12 " 12 " Bucket Depth: 12 " 12 " 12 " Wait time between applying vacuum /water and starting test: 10 MIN 10 MIN 10 MIN Test Start Time (TI ): 0900 0900 0900 Initial Reading (RI ): 8 " 81, 7 . 3 / 8 " Test End Time (TF ): 1000 1000 1000 Final Reading (RF ): 81, 8 " 7. 3 / 8 " Test Duration: 1 hr 1 hr 1 hr Change in Reading (R I: - RI ): 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 Test Result: X Pass Fail F Pass Fail... X 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 information contained in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature: - .; , , r, :. ? Date: 12/12/2011 cf,. . 1.,....- —A --I..+;— A, --f --;— +—f;— +- t— .. ..F...... A 1.., ., .,..,.17471o.7 ---- LJ....,o.— I......1 .n..••7........,..t Work Order: 3188524 ESO) & (ESV) Tegling Fnrm - Vernion 1- 12/8/2010 Emergency Shut Off (ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCATIONS AND TEST DATA Testing if No, Provide Company: TANKNOLOGY Date: 7Y Location Name: 99 rC E Z- 0 OQ 6 Store #: State ID #: Address: SOT City: State: Emergency Shut Off ES® Testing Results On \Z Z I I in accordance with "ESO Vendor Letter (3- 21- 05).doc ", from Retail Compliance Departmen , as a part ofannual compliance testing, this representative tested the Emergency Shut Off ESO) switches indicated on this sketch. Findings listed below: Emcrgcncy Shut Off (ESO) if No, Provide Operational'? 7Y Maintenance Log # Date Called: On l m accordance with NFPA 30A this representative tested the automatic - closing feature of the ispenser 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. Emcrgency Shut Off If No, Provide Valve (ESV) Operational! Maintenance Log # Date Called: Site Map 0i" Location and PlaccmcM of Devices Tested: o Signature Of Representative E L 1, -o '(1 J1 Tanknology Inc. 11000 N. MoPac Expressway, Suite 500, Austin, Texas 78759 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 512) 451 -6334 FAX (512) 459 -1459 TEST DATE:12 /12/11 WORK ORDER NUMBEF3188524 CLIENT:CIRCLE K STORES SITE:CIRCLE K #2708606 COMMENTS Conducted Witness Annual Monitor Certification Testing with Inspector Ernie Medina Bakersfield Fire Dept confirmed on 11/15/11. Site contacted and e- mailed regarding testing with "ALEX ". Replaced 93) Veeder -root light bulbs. Tank# 3 Leak detector had to be adjusted to pass. All tests passed. Cleared a ISD gross pressure warning per the CARB advisory. PARTS REPLACED QUANTITY DESCRIPTION m r 3 LAMP- TLS350 HF- LIUIVI PINPOINT TEST RE5ULT5 (IF APPLICABLE) W ITEMS TESTED s L . F fr .t^, , . 'a „+ r ,,K 7S vs gsR a'e. — HELIUM PINPOINT LEAK RESULTS, Printed 01/10/2012 07:28 MTUTTLE TE DIAGRAM ar'IrnokVy 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 512) 451 -6334 FAX (512) 459 -1459 TEST DATE: 12/12/11 WORK ORDER NUMBER3188524 CLIENT:CIRCLE K STORES SITE: CIRCLE K #2708606 PROPANE breaker ESO 0 TLS Nei Circle K #2708606 RI S 0 V pv zero 0 cas T 2 #1 s s AIR/ H2O s Printed 01/10/2012 07:28 MTUTTLE ATG Information Work Order# 3188524 110100 DEC 12, 2011 12:49 PM CIRCL K 1030 OAK ST 661 - 861 -8048 BA KERSFIELD, CA.93304 SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL 150301 DEC 12, 2011 12:49 PM 1:CIRCL K II 150302 DEC 12, 2011 12:49 PM 2:1030 OAK ST 150303 DEC 12, 2011 12:49 PM 4 3:661 - 861 -8048 150304 DEC 12, 2011 12:49 PM 4:BAKERSFIELD,CA.93304 f1 151700 DEC 12, 2011 12:49 PM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM t II 150F00 DEC 12, 2011 12:49 PM MON DD YYYY HH:MM:SS xM 160100 DEC 12, 2011 12:49 PM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 UNL -REG ON 2 UNL -PREM ON 3 UNL -MID ON 4 OFF 160200 DEC 12, 2011 12:49 PM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 UNL -REG 2 UNL -PREM 3 UNL -MID 160300 DEC 12, 2011 12:49 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 UNL -REG ! 2 UNL -PREM 3 UNL -MID B 3188524 ATG Information Work Order# 3188529 160400 DEC 12, 2011 12:49 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 UNL -REG 9684 2 UNL -PREM 9684 3 UNL -MID 9684 4 0 160700 DEC 12, 2011 12:49 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 UNL -REG 89.75 2 UNL -PREM 98.75 3 UNL -MID 8935 4 0.00 160900 DEC 12, 2011 12:49 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 UNL -REG 0.000700 2 UNL -PREM 0.000700 3 UNL -MID 0.000700 4 0.000000 161200 DEC 12. 2011 12:49 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 UNL -REG NONE NONE 2 UNL -PREM NONE NONE 3 UNL -MID NONE NONE 4 NONE NONE 162100 DEC 12, 2011 12:49 PM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 UNL -REG 1000 2 UNL -PREM 1000 3 UNL -MID 490 4 0 11 162200 DEC 12, 2011 12:49 PM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 UNL -REG 9325 2 UNL -PREM 9325 3 UNL -MID 9325 4 0 162300 DEC 12, 2011 12:49 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 UNL -REG 8834 2 UNL -PREM 8834 3 UNL -MID 8834 4 0 162400 DEC 12, 2011 12:49 PM 3188524 ATG Information Work Order# 3188529 TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 UNL -REG 3.0 2 UNL -PREM 3.0 3 UNL -MID 10 162800 DEC 12, 2011 12:49 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 UNL -REG 9684 2 UNL -PREM 9684 3 UNL -MID 9684 4 0 162900 DEC 12, 2011 12:49 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 UNL -REG 490 2 UNL -PREM 490 3 UNL -MID 490 4 0 170300 DEC 12, 2011 12:49 PM LIQUID TYPE SMART SENSOR CONFIGURATION SENSOR LOCATION TYPE 1 87 ANNULAR TRI -STATE (SINGLE FLOAT) 2 91 ANNULAR TRI -STATE (SINGLE FLOAT) 3 89 ANNULAR TRI -STATE (SINGLE FLOAT) 4 TRI -STATE (SINGLE FLOAT) 5 TRI -STATE (SINGLE FLOAT) 6 TRI -STATE (SINGLE FLOAT) 7 87 FILL TRI -STATE (SINGLE FLOAT) 8 91 FILL TRI -STATE (SINGLE FLOAT) 9 89 FILL TRI -STATE (SINGLE FLOAT) 10 TRI -STATE (SINGLE FLOAT) 11 TRI -STATE (SINGLE FLOAT) 12 TRI -STATE (SINGLE FLOAT) 13 TRI -STATE (SINGLE FLOAT) 14 TRI -STATE (SINGLE FLOAT) 15 TRI -STATE (SINGLE FLOAT) 16 TRI -STATE (SINGLE FLOAT) 172100 DEC 12, 2011 12:49 PM SMART SENSOR CONFIGURATION DEVICE LABEL CONFIGURED 1 87 TURBINE ON 2 91 TURBINE ON 3 89 TURBINE ON 4 OFF 5 OFF 6 OFF 7 OFF 8 OFF 9 UDC 3-4 ON 10 UDC 1 -2 ON 11 UDC 1 -2 PRESS SENSOR ON 12 OFF 13 OFF 14 OFF 15 OFF 16 OFF r1 172200 DEC 12, 2011 12:49 PM SMART SENSOR LABEL DEVICE LABEL 3188524 ATG Information 1 87 TURBINE 2 91 TURBINE 3 89 TURBINE 4 5 6 7 8 9 UDC 3-4 10 UDC 1 -2 11 UDC 1 -2 PRESS SENSOR 12 13 14 15 16 120600 DEC 12, 2011 12:50 PM CIRCL K 1030 OAK ST 661- 861 -8048 BAKERSFIELD,CA.93304 TANK ALARM HISTORY TANK 1 UNL -REG HIGH WATER ALARM DEC 12, 2011 11:38 AM DEC 21, 2010 10:28 AM OVERFILL ALARM DEC 12, 2011 11:30 AM DEC 4, 2011 8:22 AM NOV 5, 2011 9:09 AM LOW PRODUCT ALARM DEC 12, 2011 11:27 AM OCT 15, 2011 12:23 PM MAY 2, 2011 10:30 AM HIGH PRODUCT ALARM DEC 12, 2011 11:30 AM MAY 3, 2011 8:53 PM INVALID FUEL LEVEL DEC 12, 2011 11:27 AM DEC 21, 2010 10:13 AM PROBE OUT DEC 12, 2011 11:40 AM DEC 12, 2011 11:26 AM DEC 21, 2010 10:36 AM HIGH WATER WARNING DEC 12, 2011 11:38 AM DEC 21, 2010 10:17 AM DELIVERY NEEDED DEC 21, 2010 10:13 AM MAX PRODUCT ALARM DEC 12, 2011 11:30 AM LOW TEMP WARNING DEC 12, 2011 11:41 AM DEC 21, 2010 10:37 AM TANK 2 UNL -PREM HIGH WATER ALARM DEC 12. 2011 11:32 AM DEC 21, 2010 10:23 AM OVERFILL ALARM DEC 12, 2011 11:37 AM DEC 21, 2010 10:56 AM LOW PRODUCT ALARM DEC 12, 2011 11:29 AM DEC 21, 2010 10:11 AM HIGH PRODUCT ALARM DEC 12, 2011 11:38 AM DEC 12, 2011 11:35 AM INVALID FUEL LEVEL DEC 12, 2011 11:44 AM DEC 12, 2011 11:29 AM DEC 21, 2010 10:12 AM PROBE OUT DEC 12, 2011 11:44 AM DEC 12, 2011 11:28 AM SEP 5, 2011 6:56 PM HIGH WATER WARNING DEC 12, 2011 11:32 AM DEC 21, 2010 10:23 AM DELIVERY NEEDED DEC 21, 2010 10:12 AM TANK 3 UNL -MID HIGH WATER ALARM DEC 12, 2011 11:31 AM DEC 21, 2010 10:28 AM OVERFILL ALARM DEC 12, 2011 11:32 AM DEC 21, 2010 10:30 AM 3188524 Work Order# 3188524 ATG Information Work Order# 3188529 LOW PRODUCT ALARM DEC 7, 2010 10:45 AM DEC 7, 2010 10:32 AM HIGH PRODUCT ALARM DEC 12, 2011 11:32 AM INVALID FUEL LEVEL DEC 12, 2011 11:43 AM DEC 12. 2011 11:28 AM DEC 21, 2010 10:32 AM PROBE OUT DEC 12, 2011 11:42 AM DEC 12, 2011 11:27 AM DEC 21, 2010 10:32 AM HIGH WATER WARNING DEC 12. 2011 11:31 AM DEC 21, 2010 10:28 AM DELIVERY NEEDED DEC 7, 2010 10:45 AM DEC 7, 2010 10:32 AM MAX PRODUCT ALARM DEC 12, 2011 11:32 AM 130200 DEC 12, 2011 12:50 PM CIRCL K 1030 OAK ST 661 - 861 -8048 BAKERSFIELD, CA.93304 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 87 ANNULAR DEC 12, 2011 9:28 AM SENSOR OUT ALARM DEC 12, 2011 9:20 AM FUEL ALARM DEC 21, 2010 9:11 AM FUEL ALARM 2 91 ANNULAR DEC 12, 2011 9:28 AM SENSOR OUT ALARM DEC 12, 2011 9:26 AM FUEL ALARM DEC 21, 2010 9:38 AM FUEL ALARM 3 89 ANNULAR DEC 12, 2011 9:28 AM SENSOR OUT ALARM DEC 12, 2011 9:23 AM FUEL ALARM DEC 21, 2010 9:30 AM FUEL ALARM 7 87 FILL DEC 12, 2011 9:28 AM SENSOR OUT ALARM DEC 12, 2011 9:18 AM FUEL ALARM DEC 21, 2010 9:09 AM FUEL ALARM 8 91 FILL DEC 12. 2011 9:28 AM SENSOR OUT ALARM DEC 12, 2011 9:25 AM FUEL ALARM DEC 21, 2010 9:36 AM FUEL ALARM 9 89 FILL DEC 12, 2011 9:27 AM SENSOR OUT ALARM DEC 12. 2011 9:22 AM FUEL ALARM MAR 23. 2011 7:04 PM FUEL ALARM Ii 131600 DEC 12, 2011 12:50 PM CIRCL K 1030 OAK ST 661- 861 -8048 BAKERSFIELD, CA.93304 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 87 TURBINE DEC 12, 2011 12:01 PM INSTALL ALARM DEC 12, 2011 9:17 AM WATER ALARM DEC 12, 2011 9:16 AM WATER ALARM 2 91 TURBINE DEC 12, 2011 11:51 AM INSTALL ALARM DEC 12, 2011 9:24 AM WATER ALARM DEC 12, 2011 9:24 AM INSTALL ALARM 3 89 TURBINE DEC 12, 2011 9:21 AM WATER ALARM DEC 12, 2011 9:20 AM INSTALL ALARM DEC 21, 2010 9:34 AM INSTALL ALARM 9 UDC 3-4 10 UDC 1 -2 11 UDC 1 -2 PRESS SENSOR 3188529 ATG Information IA0100 DEC 12. 2011 12:51 PM TYPE CODE LENGTH SERIAL N0, DICODE TANK 1 UNL -REG MAG C000 96.00 243412 1984 TANK 2 UNL -PREM MAG C000 96.00 244273 2084 TANK 3 UNL -MID MAG C000 96.00 244272 2084 IA0200 DEC 12, 2011 12:51 PM TANK 1 UNL -REG MAG GRADIENT= 351.0000 TANK 2 UNL -PREM MAG GRADIENT= 350.3400 TANK 3 UNL -MID MAG GRADIENT= 350.3100 190200 DEC 12. 2011 12:52 PM SOFTWARE REVISION LEVEL VERSION 329.01 SOFTWARE# 346329 -100 -B CREATED - 09.01.29.15.44 S- MODULE# 330160 -004 -a SYSTEM FEATURES: PERIODIC IN -TANK TESTS ANNUAL IN -TANK TESTS ISD 110100 DEC 12. 2011 12:53 PM CIRCL K 1030 OAK ST 661- 861 -8048 BAKERSFIELD,CA.93304 SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL 3188524 Work Order# 3188524