Loading...
HomeMy WebLinkAbout2011 RESULTSMONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Wthin the State ofCalifornia Authority Cited- Chapter 6.7, Health and Safety Code; Chapter 16j Division 3, Title 23, California Code ofRegulations This form must be used to document testing and servicing of monitor monitoring system Control panel by the technician who performs the wt The owner /operator must submit a copy ofthis form to the local agency A. General Information Facility Name: ARCO #01960 Site Address: 1701 BRUNDAGE LANE Facility Contact Person: RICH GOSSETT Make/Model of Monitoring System: VEEDER -ROOT TLS -350 B. Inventory of Equipment Tested /Certified cquipmenL A separate certification Or report must be prepared for each A copy Of this form must be provided to the tank system owner /operator. ilating'UST systems within 30 days oftest date. Bldg. No.: BAKERSFIELD Zip: 93304 Contact Phone No.: (714) 670 -3958 Date ofTesting/Servicing: 8/312011 Tank.]D: 87(N) Tank ID: 87(C) In -Tank Gauging Probe. modpi, MAGI in -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor, Model: 409 AtttiularSpace or Vault Sensor, Model: 409 Piping Sump / Trench Sensor(s), Model: 208 piping Sump / Trench Sensor(s). Model: 208 F11I.SumP Sen8or(s), Model :' 208 FrtllSump scnsor(s), M.odel- 208 Mechanical Line Leak Detector. Model: L04600 Mechanical Line Leak Detector_ Model: LD 2000 Electronic Line Leak Detector. Model: Ele Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: MAG / ATG imnie Tank. Overfill / High -Level Sensor. Model: _MAG I ATG Other (spaoify oquipmmtt typetutd.modol In SecfldtiE 6n F4o 2), Gtlier (specify equipment type and model in Section E on Page 2). Tank ID: ;87(S) Tank ID: 91 In -Tank Gauging Probe, Model: MAG IIn -Tank Gauging Probe, MadiL. MAG 1 Annular Space or Vault Sensor. Model: 409 Anouhtr Space or Vault Sensor. Model: 409 Piping Sump / Trench Sensor(s). Model: 208 Piping Sump / Trench Sensor(s). Model: 208. Fill Sump Sensor(s). Model; 208 Fillisutdp scasi*s). M4¢el:.208 Mechanical Line Leak Detector, Model: LO 2000. McChmt.ic tl Ljrte LeakDetector, tvlatlel: LD 2000 Electronic Line Leak Detector, Model: Electronic Unc Lcak Detector. Model: Tank Overfill / High -Level Sensor. Model. MAG l ATG Tadk Overfill / High -Level Sensor. Model: MAGI ATG Other (specify equipment type and model in Section E on Page 2). Otftcr (specify equipment type and model in Section E on Page 2). Dispenser ID: 112 Dispenser ID: 314 Dispenser Containment Sensor(s). Model: 208 bisl )ser Containment 5ensor(s), Model: 208 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s), Dispsnw Containment Float(s) and Chain(s). Diaponser.t 516 Oiapenser ID: 718 Dispenser Containment Sensor(s). Model: 208 Dispenscr Containment Sensor(s), Model: 208 Shear Valve(s), shear Valvgg). Dispenser Containment Float(s) and Chain(s). DispenserContainment Float(s) and Chain(s), Dispenser TD: 9110 Dispenser Ill: 11/12 Disperuet Cotitiiinnient Seneor(s). Model: 206 DispenserContainment Sensor(s). Model: 208 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). 1)i rensorContainment Float(s) and Chain(s). Ifthe tacility contains more tanks or dispensers, copy this Corm. induce intoratatton for every tarot anG Grspenser at me racimy, C. Certification - I certify that the equipment identified in this guidelines. Attached to this Certification is information (e.g. correct and a Plot Plan showing the layout-of monitoring a uipi attached a copy of the report; (check all that apply): Sl Technician Name (print): RICHARD THOMAS Certification No.: B34022 Testing Company Name: TAN) Testing Company Address: 607 UN -036 — TEK ENVIRONMENTAL LMIRA ROAD, PMB 336 ument was inspected/serviced in accordance with the manufacturers' nuraoturors' checklists) necessary to verify that this information is t. For any equipment capable of generating such reports, I have also m set -tip ® Alarm history report License. No.: 803705 I i Page- 1 I of 14 www.umdumorg Phone No.: f707) 446 -6151 95687 Date of Testing/Servicing: 81312011 Rev. 01117/08 I , Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: 330.01 Comolete the following checklist: Yes No* Is the audible alarm operational? Yes No* Is the visual alarm operational? i M vP,z I n Nn* Were al I sensors visuallv insnected_ functionally tested. and confirmed operational? Yes No* Were all sensors installed at lowest point ofsecond uy ta:.nm "t Pnd pas{tinn so that other aniiinmrnt will not interfere with their proper operation? I I Yes No* If alarms are relayed to a remote monitoring ftation, is all communications equipment (e.g., modem) N/A operational? Yee No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment N/A monitoring system detects a leak, fails to oporate, or is electrically disconnected? Ifyes: which sensors initiate positive shut -down? (Check all that apply) Sumo /Trench Sensors; ® Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks an' sensor failure /disconnection? ® Yes; No. Yes No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no I N/A mechanical overfill prevention valve is installed), i the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, allwhat percent of tank capacity does the alarm trigger? 90% Yes* No Was any monitoring equipment replaced? I yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model foi all replacement parts in Section E, below. Yes* No Was liquid found inside any secondary contai ' jsunentystems designed as dry systems? (Check all that apply) I Product; [I Water, If yes, describe causgs inSectionE, below. Yes No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, if applicable Yes No* 1"s all mornitorirg equippc nt operational.per t anufa turer's specifications? In Section E below, describe how and when these deficiencies !were or will be corrected. E. Comments: UN-036 - Page 2 of 4 www.uuldoc&org I I Rev. 01/17/08 Monitoring System Certification F. In -Tank Gauging / SIR Equipment: i 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 equip) ent'is used to perform leak detection monitoring. Complete the following checklist: Yes Noy Has all input wiring been inspected for proper ! entry and. termination, including testing for ground faults? Yes N6* Were all tank gauging probes visually lnspected fbr darnage. and residue ,buildup? Yes p No* Was accuracy of system product level readings tested,? Yes No' Was accuracy of system water level readings tested? Yeg Nos Were all probes reinstalled properly? 0 Yes No* Were all items on the equipment manufaeturer's maintenance checklist - completed? In Section H, below, describe how and when these deficiencies were " or will be corrected. G. Line Leak Detectors (LLD): Check this box If.LLDs"are not installed. tnfo tha rnll.;v,ii;e rhorklictc 1 Yes No For equipment start -up or annual equipment certification, was a leak simulated to verify LLD performance? NIA Check all that apply) Simulated leak rate: ® 3 g:p.k; 0.1 g.p.h ; 0.2 g.p.h. Yes No* Were all LLDs confirmed operational and accurate within regufafory requirements? 0 Yes No* Was the testing apparatus properly calibrated? Yes No* For mechanical LLDs, does the LLD restrict produc6,tiow if it detects a leak? NIA Yes No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? NIA Yes No* For electronic LLDs, does the turbine automaticattyjshut off if any portion of the monitoring system is disabled NIA or disconnected? Yes No* For electronic LLDs, does the turbine automztically shut off if any portion of the monitoring system malfunctions Njp or fails a test? 0 Yes No* For electronic LLDs, have all accessible wiriti$ cooncdons been visually inspected? NIA Yes No* Were all items on the equipment manulncture`r's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were bi r will be corrected. H. Comments: Page 3 Iof 4 UN -036 — www *idotsmor Rev. 01/17108 I i K. Float and Chain Equipment: ® Check this box iffloats and chains are not present at this site. Check this boX iffloat and chain equipment is installed but only as secondary le.ak detection. This section must be completed if floats and chains are used to perfoin leak detection monitoring. Complete the following checklist: Yes` In the Section M, below, describe how and when these deficioicies.w I re or will be corrected. L. Impact Valves: Cheek .this box cif impact valves are not installed. Complete the followiog.checklist: f Yes No- Were all float and chain equipment properly speated and tested for correct functionality? Yis Io* Were all float and chain equipment certified t be workingproperty? In the Section M, below, describe how and when these deficioicies.w I re or will be corrected. L. Impact Valves: Cheek .this box cif impact valves are not installed. Complete the followiog.checklist: f Yes I No' were all impact valves properly inspected.anditested tor-correct function #liry? YeS- No* Were all impact valves certified to be working properly? Monitoring System Certification I + I I Monitoring System Certification I UST Monitoring Site Flan Site Address: 1701 BRUNDAGE LANE, BAKERSFIELD, CA i. .. ...... ........ . 12 1_• i M .._. ...._.. a ESQ . i a.... .2. C J. j . . , . . . . . :7. H ' , . . . . O. ...... . .8.......6.......... I ...... ..... . VAPOR ANNULAR A MONITOR . M PIPING. , ©, , . _ . , , , . , , . FILL TURBINE 8 _ I VENT. Q . . . . . . ATG . , • . . . . . . , . . . , . Date map was drawn: 1 / I Instructions If you already have a diagram that shows all required informatia:, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tagks and piping. Clearly' identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic Ilse leak detectors; autd In -tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was jprepared, I Page 4 of i 4 i Iflfl A7(. ..._...., .,,1J... ..: r.. _. A I1n Mn 11A, Line Leak Detector Test Data Sheet Station # ARCO #01960 ate 18/3 Address 1701 BRUNDAGE LANE BAKERSFIELD. CA 93304 Test Information. 20 11 Comments: This letter certifies that the annual leak detector according to the equipment manufacturers procedi knowledge true and correct. The mechanical leak flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor TANK -TEK ENVIRO Technician RICHARD THOMAS Signature i i were performed at the above referenced facility and limitations and the results as listed are to my detector test pass /fail is determined using a lowI I AL! CORP. Lic# 803705 1 12 3 4 5 Product 87(N) 87(C) 87(S) 91 Manufacturer VIVII I I VMI VMI Model LD 2000 Lp 2000 I LD 2000 LD 2000 Full Operating Pressure (psi) 28 PSI 21l PSI i I 28 PSI 28 PSI Line Bleed Back (ml) 85 ML 90 ML 90 ML 145 ML Trip Time (sec) 3 SEC 3 SEC 1 3 SEC 3 SEC Metering Pressure (psi) 10 PSI 10 PSI i 10 PSI 10 PSI F/E Holding Pressure (psi) 22 PSI 22 PSI' i 22 PSI 22 PSI Test Leak Rate (ml /min)(gph) 3 GPH 3 GPH 3 GPH 3 GPH PASS or FAIL PASS PASS PAS3 PASS Comments: This letter certifies that the annual leak detector according to the equipment manufacturers procedi knowledge true and correct. The mechanical leak flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor TANK -TEK ENVIRO Technician RICHARD THOMAS Signature i i were performed at the above referenced facility and limitations and the results as listed are to my detector test pass /fail is determined using a lowI I AL! CORP. Lic# 803705 Facility #: ARCO #01960 p Impact Va Ive Testing Contractor: TANK -TEK ENVIRONMENTAL CORP. Address: 1701 BRUNDAGE LANE Address: 607 ELMIRA ROAD, PMD 336 City, State: BAKERFIELD, CA City,_ State: VACAVILLE, CA 95687 Test Date: 8/3/2011 Phone: 707) 446 -6151 Type of test: FACILITY INSPECTION Technician: RICHARD THOMAS Test erformed Burin .line test? Yes No Disp# Grade Impact Make Secure Mount? a ve Lock? I Pass/ Fail Comment Disp# Grade mpa Make Secure Mount? Valve Lock? Pass/ Fad Comment 112 87 DPW YES YES PASS 1/2 91 DPW YES YES PASS 314 87 DPW YES YES PASS 314 91 DPW YES YES PASS 5/6 87 DPW YES YES PASS 516 91 DPW YES YES PASS 718 87 DPW YES YES PASS 718 91 OPW YES YES PASS 9/10 87 DPW YES YES PASS 9110 91 DPW YES YES PASS 11/12 87 DPW YES YES PASS 11/12 91 DPW YES YES PASS SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual restuigiuf USTspill containment structures. The completedform and printoutsfrom tests (ifapplicable) should beprovided to thefa Iillty owner /operatorfor submittal to the local regulatory agency. 1. FACILITY pWOP NUTION Facility Name: ARCO #01960 I I Date of Testing: 81312011 Facility Address: 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93.304 Facility Contact: RICH GOSSETT Phones (714) 670 -3868 Date Local Agency Was Notified ofTesting: I 7/26!2091 Name of Local Agency Inspector (rfpresent during testing): f NONE PRESENT 2_ TESTING rnW TR kCTOR INFORMATION Company Name: TANK -TEK ENVIRONMENTAL CORPORATION Technician Conducting Test: RICHARD THOMAS Credentials': ®CSLB Contractor ®ICC Service Tech. I S", CB Tank Tester 0 Other (Spec) License Number(s): 803705 (CSLB Contractor) — 5207376-i!T (ICC Service Tech) — 06 -1672 (SWRCB Tank Tester) L 3. SPILL BUCKED' TESTING INFORMATION Test Method Used: ® Hydrostatic 0 Vacuum 0 Other (Specify) Test Equipment Used: VISUAL / TAPE MEASURE Equipment Resolution: + OR -.0021, yIdentify Spill Bucket (By Tank Number, Stored Product, etc.) 87(N) FILL 87(M) VAPOR 87(C) FILL 87(C) VAPOR 3ucket lnstatlaton Type: Direct Bury Contained in Sump pi[ect Bury Cgnt$inrdifn Sump Direct $ury Contained in Sump 0 Direct Bury . Contained in Sump Bucket Diatn'eier: 16" 1fi" I 16" 16" Bucket Depth: 12" 12" 1 12" 12" Wait time between applying vacuum/water and start oftest: 10 MIN 10 MIN 10 MIN 10 MIN Test Start Time (Tj): 11:00 AM 11:00 AM ' 11:00 AM 11•:00,AM thitial Readiiig.(R}: 12" 42" I 12" 12' Test End Time (TF): 12:00 PM 12:00 PM 12:00 PM 12:00 PM Final !reading (RR): 6" 12" j 12" 12" Test Duration (TF — Tj): 1 HR 1 HRj 1 HR 1 HR Change in Reading (91;- N: 6" 0`' 0" 0" Pass/Fail Threshold or Criteria: NO LOSS NO L;oSS kOLOSS NO LOSS 0,0' lh Pass — 0 Fail Pp. Comments — (include information on repairs made prior to testing, qnd recommendedfollow -upforfailed tests) 87(N) FILL BUCKET NEEDS A NEW PHIL -TITS DRAIN VALVF INSTALLED AND RETESTED. CERTIFICATION OF TECHNICIAN RE I hereby certify that all the information contained in this Technician's Signature: t---- RBIJE FOR CONDUCTING THIS TESTING Is, trite, accurate, and infull compliance with legal requirements. Date: 8/3 /2011 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. Spill Bucket Test Thisform is intendedfor use by contractors performing annual printoutsfrom tests (ifapplicable) should beprovided to thefig 4. FACILITY SWRCB, January 2006 ort Form spill containment structures. The completedform and eratorfor submittal to the local regulatory agency. Facility Name: ARCO 401960 I CORPORATION Technician Conducting Test: RICHARD THOMAS Date ofTesting: 81312011 Facilityy Address: 1701 BRUNDAGE LANE, BAKERSF(ELD, CA 93304 Facility Contact: RICHGOSSETT I U,t ( /CC Service Tech.) - 06 -1672 (S WRCB Tank Tester) Phone: (714) 6703958 Date Local Agency Was Notified ofTesting: 7f26/2011 Name of Local Agency Inspector (fpresent during tOfrtg): NONE PRESENT 5. TESTING CONTR C-TOR- INFORMATION Company Name: TANK- TEKENVIRONMENTAL CORPORATION Technician Conducting Test: RICHARD THOMAS Direct Bury g Contained In Sump Credentials': ® CSLB Contractor ® ICC Service Tech. S CB Tank Tester Other (Specify) License Number(s): 803705 (CSLB Contractor) - 5254736 U,t ( /CC Service Tech.) - 06 -1672 (S WRCB Tank Tester) 6. SPILL BUCKET TESTING INFORMATION Test Method Used: ® Hydrostatic Vacuum Other (Specify) Test Equipment Used: VISUAL / TAPE MEASURE Equipment Resolution: + OR -.002" Identify Spill Bucket (By Tank Number, Stored Product, etc.) 87(S) FILL 87(S VAPOR 91 FILL 81 VAPOR Bucket Installation Type: Direct Bury Contained in Sump El D rcct,Bury Ct ntained!in Sump Direct Bury g Contained In Sump El Direct Bury Contained in Sump Bucket Diameter 16" 16" 16" 16" Bucket Depth: 12" 12" I I 12" 12" Wait time between applying vacuum/water and start oftest: 10 MIN 10' MIN 10 MIN 10 MIN Test Start Time (T1): 11:60 AM 11:00 AM 11•:00 AM 11:00 AM Initial Reading (R'O 12" 12" I 12" 12" Test End Time (TF): 12:00 PM 12:Od PM j 12:00 PM 12:00 PM Final Reading (RF): 5" 12" 12" 12" Test Duration (TF - TI): 1 HR 1 HR; 1 HR 1 HR' Change in Reading (RF - RO: T" 0'. i 0" 0" PassfFail Threshold or Criteria:. NO LOSS NO LOSS NO LOSS NO LOSS l - - — a ;Piis;; Fail f >ss ;1 q'ail y?ss` ,np i3iL Pass Fail j Comments - (include information on repairs madeprior to tasting; ,and recommendedfollow -up forfailed tests) 87(S) FILL BUCKET NEEDS A NEWPHIL -TITS DRAIN VALVE INST41LLED AND RETESTED. CERTIFICATION OF TECHNICIAN RESPO SLBIJE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report Lr true, accurate, and infull compliance with legal requirements. Technician's Signature: - j Date: 81312011 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. 246722 ARCO alr Fpl 1 1701 Brundage Lane Bakersfield CA 93304 AUG 3, 2011 12:02 PM SYSTEM STATUS REPORT ALL FUNCTIONS 19OR11AL INVENTORY REPORT T 1 :.UNLEADED R VoLum..E 4.400 GALS ULLAGE 0 5284 GALS 9C* ULLAGE- 43.15 GALS TC' VOLUME. - 4328 t ALS HEIGHT . 41 .30 .twiliEs WATER VOL - 0 GALS WATER = 0..00 INCHES TEMP ° 8? -:9 DEG F T ,2: UNLEADED R VOLUME - 4407 'GALS ULLAGE - 52,17'. GALS 90% LLLAGE= 4.3018 GALS Ti VOLUME - 4341 GALS HE l GHT - 41 .:36 I W3 -'lES WATER VOL - 0 CALi WATER = 0.00 INCHES TEKP . 8.3 DEC F T 3:0LEADED R VOLUME 4545 GALS ULLAQE n 513.9 GALS 90?:" ULLAGE- 4170 GALS TC VOLUP18' = 4474 GALS HEIGHT - 42.34 I433HES WATER VOL = 0 GALS WATER 0.00 INCHES TEMP 0 62.1 DEG F T 4':UL PREMIUM VOLUME 287.2 GHLS ULLAGE 6012 GALS 909 ULJ -AGE= 5_6A3 GALS TG VO1 UIhE 2623 GALS HEIGHT 3Q..66 INCHES WATER VOL 0 GALS WATER 0.00 INCHES TEMP 84.1 DEC F MANIFOLDED TANKS INVENTORY TOTALS T ]:UNLEADED R T 2 :UNLEADED R T 3:UNLEADED R f VOLUME - 13352 GALS TO VOLUME = 13144 GALS Xx))- END Xe' *** SOFTWARE REV151GN'LEVE VERSION 330.01 SOFTWARE# :346330 - -100 -8 CREATED - 10.07.23.17.2 ' S- MODULE0 330160- 104 -a SYSTEM FEATURES: PERIODIC 1 N —TANK- .TEST: ANNUAL IN-TANK tS-AT ;' BIR iSD ALARM HISTORY REPORT SYSTEM :ALAW, - PAPER OUT AUG 3. 2011 12:02 PMI PRINTER ERROR AUG 3. 2011 12:02.PM r END A rK I ALARM H I STORY REPORT I -N -TANK ALARM - T I:UNLEADED R END I ALARM HISTORY REPORT IN -TANK ALARM - - - -- C 2: UNLEADED R x x i* END A) x x 1r: ALARM Hl TORY REPORT IN -TANK ALARM - - - -- T 3:UNLEADED R x* x x) END X x x x A ALARM HISTORY REPORT IN-TANK ALARI °I - - - -- T 4 :UL PREMIUM x x x X X END X A x k ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT SE14SOR ALARM - - - -- L 1:87 NORTH STP SUMP STP SUMP FUEL ALARM MAY.31, 2011 9 :18 AM FUEL ALARM MAY 31, 2011 9:10 AM FUEL ALARM MAY 31, 2011 9:09 AM x x x A E14D x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L 2:91 ANNULAR ANNULAR SPACE FUEL ALARM MAY 31, 2011 9 :23 AM x x x x x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L 3:91 F ILL SUMP PIPING SUMP FUEL ALARM MAY 31, 2011 9:20 AM k 4 4* 4 FNTI x* k X X SENSOR ALARM - ----- L 4:91 UNL STP SUMP STP SUMP FUEL ALARM JUL 2, 2011 10:37 PM FUEL ALARM MAY 31. 2011 9:11 AM XAXxx END xxxx, ALARM HISTORY REPORT SENSOR ALARM -' -- -- L 5:DISP.1 -2 UDC? j I DISPENSER PAN FUEL ALARM MAY 31, 2011 9:34 41 I I i i i I ii iE ±E ii 3% EJAD I J i I I I i ALARM HISTORY REPORT SENSOR ALARM - -- -- L 6:DI'SP.'3 -4 UDC DISPENSER -PAN FUEL ALAR11 MAY 3l. 2011 9:35 Ali I I X xi x x END f I- i SENSOR ALARM - - - -- L 7:DISP.5 -6 UDC: DISPENSER PAN FUEL ALARM MAY 31, 2011 9:33 AM x x x x x END x* A x A ALARM HISTORY REPORT SENSOR ALARM - - - -- L e :DISP.7 -6 UDC DISPENSER PAN FUEL ALARM MAY 31. 2011 9:21 AM FUEL ALARM MAY 31, 2011 9:21 AIM x x x x x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L 9:87 SOUTH ANNULAR ANNULAR SPACE FUEL ALARM MAIL' 31. 201 I 9 :3U At -1 FUEL ALARM MAY 31, 2011 9:29 Al °1 x x x x x END x x n x x ALARM HISTORY REPORT ALARM H1STORY.REPORT ALARM H19TORY REPORT SENSOR :ALARM ----- LIO:B7 SOUTH FILL SUMP. P I P 1 NG SUPIF FUEL ALARM MAY 31. 2011 9:14 AM ALARM HISTORY REPORT SENSOR ALARM ----- 1-10:87 SOUTH FILL SUMP PIPING SUMP FUEL ALARM MAY 31, 2011 9:14 AM x x A* x END X* A x ALARM HISTORY REPORT SENSOR. ALARM - - - -- 1-11:87 SOUTH STP SUMP STP SUMP FUEL ALARM JUL 15. 2011 12:40 All FUEL ALARM MAY 31, 2011 9:13 AM A** x x END A* x x A SENSOR ALARM - - - -- L12:67 :ENTER ANNULAR ANNULAR SPACE iFUELALARM MAY 31, 2011 9:26 AM w* x x x END x x x x X1 ALARM HISTORY R-EPO?T SENSOR ALARM - - - -}— L13:07 CENTER FILL! SUIlP, PIPING SUMP x ENV ALARM HISTORY REPORT SENSOR ALARM - -+- L 14:67 CENTER STP,' SUMS} STP SUMP FUEL ALARM AUG 2, 2011 9:08 AM FUEL ALARM MAY 31, 2011 9:12-1 AM i x *xAi* END x * xAI SENSOR HLi-,Rm - - -- L15:87 NORTH ANNULAR ANAIULAR SPACE FUEL ALARM MAY 31. 21011 9 :?5 AM ie * x X A END A x* A is ALARM HISTORY REPORT SENSOR ALARM - - - -- L16:87 NORTH FILL SUMP PIPING SU1 °1P FUEL ALARM MAY 31, 2011 9:17 AM x* A x x END x x x X x ALARM HISTORY REPORT SENSOR ALARM - - - -- L17:DiSP.9 -10 UDC IiISPENSER PAN FUEL ALARM MAY 31. '2011 9:36 AM xxxxx END 9x*xx ALARM HISTORY REPORT SENSOR ALARM - - - -- L18:DISP,11 -12 UDC DISPENSER PAN FUEL ALARM MAY 31, 2011 9:37 AM A x x x' x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L19: OTHER SENSORS x x x x x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L20: OTHER SENSORS A x x A x END x x x x x i I ALARM HISTORY REPORT SENSOR ALARM -_I - -- L21: OTHER SENSORS END * * x I I ALARM HISTORY REPORT+ SENSOR ALAN,-, - I - -- L'= 2: f OTHER SENSORS i i x* x x x END i ALARM HISTORY REPORTI SENSOR ALARM -; - -- L13: OTHER SENSORS X x x x x END t ALARM HISTORY REPORT SENSOR ALARM - - - -- L24: OTHER SENSORS ALARM HISTORY REPORT SENSOR ALARM - - - -- L 1:87 NORTH STP SUMP STP SUMP FUEL ALARM MAY 31, 2011 9:18 AM FUEL ALARM MAY 31, 2011 9:10 AM FUEL ALARM MAY 31. 2011 9:09 AM xxx.;xENDxxxxx ALARM HISTORY REPORT SENSOR ALARM -- -- 9 1 OTHER SENSORS x A x x ;k END * x x x x Emergency Shut -Off (ESO) Testing Results & Checklist Facility Information Contractor Information Test Results - -- 7 Site # c.v Wr3l C, C-co Co. Name: f 4.. - T h I Date: __ I Cj'-- I , k Address: one: I PASS or FAIL (Next Day Repair Required) City f St: Lead Technician: it, L,, L aMaint. W.O. # Or7-X4-7 sic i NBmE: " I Passport #: -7-4jL4Cc:) %k t- I Si nature: j The objective of this test is to provide assurance thatwhen the ESO switch Is activated, all the fueling system circuits (turbines, and dispensers) are de -energized, and remain de -0norgized until they are ra -set manually. The test procedures and guidellrres shall be in accordance with the ESO Tosting Process. 4 The following information is tobe completed. ` xT. Stled Yes I No 1 SITE DATA - — - - Number of ESO switches: 2 Type of Switch: Push Pull _Momentary Plain light /Toggle I Other:( ) if Momentary type, locate and identify re -set button): 3 Type of Turbine Control Relay System (Electrical Distribution Center): Brown Box _Power Solution _Custom Fabricated _Carolina Box Other 4 Type of Turbine Control Relays: Make Modell 5 Type of Line Leak Detection: Mechanical ELDICPT I _PLED PERFORMANCE TEST 6 Does the ESO shutdown power to the DISPENSERS? I 7 jDoes the ESO shutdown power to the TURBINES? I 1 S Its the 220 voltage to the turbine relay removed (either the line side or the motor side of the contacts or the coil)? 9 Are the DISPENSER BREAKERS clearly identified / labeled? 10 Are the TURBINE BREAKERS clearly identified / labeled? I 11 Are all the ESOs accessible and clearly identified / labeled? I 12 Did the ESO(s) function correctly (de- energized from either the line side or the motor side of the contacts or the coil)? 12A If #12 is NO, briefly describe what was wrong: i 128 How was it corrected: i 12C Ifrepair or ESO funclionalily cannot be corrected same day (prior to leaving the site), The technician MUST notify the Site Manager of the problem, place an "Out of Service" Tag on the ESO(s), and identify an alternate mean (i.e ", locate circuit panel , dearly identify turbine and dispenser breakers for shut -off in the event of an emergency). 12D Elite Customer Solution Center has been contacted for the repair. eMaint. W.O. Ticket # ; FPOSTTEST 11 Site's fueling system is fully operational. 12 All equipment secured and any access ports, lids, enclosures are closed. 13 All safety barricades, and any debris was been removed" I I COMMENTS „. — - — • - — I Submitcompleted copy with other documentation In E- Mainlenance.