HomeMy WebLinkAbout2011 FMCMONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State ofCalifornia
Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code ofRegulations
This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each
monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner /operator.
The owner /operator must submit a copy ofthis form to the local agency regulating UST systems within 30 days of test date.
A. General Information
Facility Name: EZ STOP MOBIL Bldg. No.:
Site Address: 101 19TM ST. City: BAKERSFIELD Zip:
Facility Contact Person: LEE Contact Phone No.: ( }
Make/Model ofMonitoring System: TLS -360 INSP. ERNIE M Date ofTesting/Servicing: 11/22/2011
B. Inventory of Equipment Tested/Certified
Check the aDarooriate boxes to indicates ecific equipment inspected/serviced:
Tank ID: REGULAR 87 Tank ID: PREMIUM 91
E In -Tank Gauging Probe. Model: MAGAIn -Tank Gauging Probe. Model: MAGA
Annular Space or VaultSensor. Model: 4201463 Annular Space or Vault Sensor. Model: 4201463
Piping Sump / Trench Sensor(s). Model: 2081304 Piping Sump / Trench Sensor(s). Model: 208/304
Fill Sump Sensor(s). Model: 2081304 Fill Sump Sensor(s). Model: 208/304
Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model:
Electronic Line Leak Detector. Model: VEEDER -ROOT E Electronic Line Leak Detector. Model: VEEDER -ROOT
Tank Overfill / High -Level Sensor. Model: EOA Tank Overfill / High -Level Sensor. Model: EOA
Other (specifyequipment type and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2).
Tank ID: DIESEL Tank ID: VENT BOX
In -Tank Gauging Probe. Model: In -Tank Gauging Probe. Model: BRAG
Annular Space orVault Sensor. Model: 4201463 Annular Space or Vault Sensor. Model: 304
Piping Sump / Trench Sensor(s). Model: 2081304 Piping Sump / Trench Sensor(s). Model: 208
Fill Sump Sensor(s). Model: 2081304 Fill Sump Sensor(s). Model:
Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model:
Electronic Line Leak Detector. Model: VEEDER -ROOT Electronic Line Leak Detector. Model:
E Tank Overfill / High -Level Sensor. Model: EOA 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).
DispenserlD: 112 Dispenser ID: 314
Dispenser Containment Sensor(s). Model: 208/304 Dispenser Containment Sensor(s). Model. 2081304
Shear Valve(s). Shear Valve(s).
Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s).
Dispenser ID: 516 Dispenser ID: 718
Dispenser Containment Sensor(s). Model: 2081304 E Dispenser Containment Sensor(s). Model: 2081304
Shear Valve(s). Shear Valve(s).
Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s).
9110 Dispenser ID: 11112
er Containment Sensor(s).
EzoID:
Model: 208/304 Dispenser Containment Sensor(s). Model: 2081304
alve(s). Shear Valve(s).
er Containment Floats) 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 Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also
attached a copy ofthe report; (check all that apply): ® System set -up ® Alarm history report
Technician Name (print): STEVEN OBERT Signature:
Certification No.: A2863118029980 -UT License. No.: C611 D40 809850
Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 326 -8402
Testing Company Address: 6643 BROOKS COURT BAKERSFIELD,CA 93308 Date ofTesting/Servicing: 11/22/2011
Page 1 of 5
UN-036 — I/4 www.unidoes.org Rev. 01/17/08
Monitoring System Certification
A Results of Testing/Servicing
Software Version Installed: 327.04
rmmnlota tha fnllnwine nh"Wict-
Yes I No* Is the audible alarm operational?
Yes No* Is the visual alarm operational?
Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational?
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?
Yes No* If alarrtls are relayed to a remote monitoring station, is all communications equipment (e.g., modem)
N/A operational?
Yes No* For pressurized piping systems, does the turbine automatically shut down ifthe piping secondary containment
N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate
positive shut -down? (Check all that apply) ® Sump/Trench Sensors; ® Dispenser Containment Sensors.
Did you confirm positive shut -down due to leaks and 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
N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill point(s) and operating properly? Ifso, at what percent oftank capacity does the alarm trigger? 90%
Yes* No Was any monitoring equipment replaced? Ifyes, 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? (Check all that apply)
Product; Water. If yes, describe causes in Section E, below.
Yes No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, if applicable
Yes No* Is all monitoring equipment operational per manufacturer's specifications?
In Section E below, describe how and when these deficiencies were or will be corrected.
E. Comments: 1) BRINE SENSOR IN DIESEL STP SUMP FAILED, WAS REPLACED SAME DAY ALL GOOD.
Page 2 of 5
UN -036 — 2/4 www.unidocs.org Rev. 01/17/08
Monitoring System Certification
F. In -Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control.
Check this box ifno tank gauging or SIR equipment is installed.
This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring.
Complete the following checklist:
Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults?
Yes No* Were all tank gauging probes visually inspected for damage and residue buildup?
Yes No* Was accuracy ofsystem product level readings tested?
Yes 1 No* Was accuracy of system water level readings tested?
Yes No* Were all probes reinstalled properly?
Yes No* Were all items on the equipment manufacturer's maintenance checklist completed?
In Section H, below, describe how and when these deficiencies were or will be corrected.
G. Line beak Detectors (LLD):
Complete the followine checklist:
Check this box ifLLDs are not installed.
Yes No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance?
N/A Check all that apply) Simulated leak rate: ® 3 g.p.h.; [3 0.1 g.p.h ; [10.2 g.p.h.
Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements?
Yes No* Was the testing apparatus properly calibrated?
Yes No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
N/A
Yes No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
N/A
Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled
N/A or disconnected?
Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions
N/A or fails a test?
Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected?
N/A
Yes No* Were all items on the equipment manufacturer's maintenance checklist completed?
In Section H, below, describe how and when these deficiencies were or will be corrected.
H. Comments:
UN-036 — 314
Page 3 of 5
www.unidoes.org Rev. 01/17/08
Monitoring System Certification Form: Addendum for Vacuum/Pressure Interstitial Sensors
I. Results of Vacuum/Pressure Monitoring Equipment Testing
This page should be used to document testing and servicing of vacuum and pressure interstitial sensors. A copy of
this form must be included with the Monitoring System Certification Form, which must be provided to the tank
system owner /operator. The owner /operator must submit a copy of the Monitoring System Certification Form to the
local agency regulating UST systems within 30 days oftest date.
Manufacturer: VEEDER -ROOT Model: TLS -350 System Type: [] Pressure; ® Vacuum
Sensor ID
Components) Monitored by this Sensor: VAPOR RETURN LINES:1
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: 87 PRODUCT LINE
S:2
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: 87 ANNULARS:3
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: 87 -91 VENT LINES:4
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: 91 PRODUCT LINE
S:5
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: 91 /DIESEL ANNULAR
S:6
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: DIESEL VENT
S:7
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor: DIESEL PRODUCT LINE
S:9
Sensor Functionality Test Result: ® Pass; Fail Interstitial Communication Test Result: ® Pass; Fail
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: Pass; Fail
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: Pass; Fail
How was interstitial communication verified?
Leak Introduced at Far End ofInterstitial Space;' Gauge; ® Visual Inspection; Other (Describe in Sec. J, below)
Was vacuum/pressure restored to operating levels in all interstitial spaces? ® Yes No (Ifno, describe in Sec. J, below)
J. Comments:
Page 4 of 5
If the sensor successfully detects a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the
sensor, vacuum/pressure has been demonstrated to be communicating throughout the interstice.
UN -036A -1 /1 www.unidGes.org Rev. 01/26/06
t4"tll` t IX-1
Monitoring System Certification
UST Monitoring Site-Plan
Site Address: lot /-9 7O—, ST de4 K -Crs'F e )A
T— --
Date map was drawn:
Instructions
If you already have a diagram that shows all required information, you may include it, rather than this page, with your MonitoringSystcTnCertification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following
equipment, if installed: mun4oring system coniml panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill
containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in -tank liquid level probes (if used
for leak detection). In the space proO ded, note the date this Site Plan was prepared.
Page 4 of 4
CN -0Ib -4 4 w•ww.amldocs org Rer.61 /17.MN
4 MII
RICHENVIRONMENTt9L
3305 BRITTAN ST. BAKERSFIELD, CA. 93308
OFFICE (661)326 -8402 FAX (661)326 -8934
PRODUCT LINE LEAK DETECTOR TEST
WORK SHEET
W /0 #:
FACILITY NAME: EZ-STOP MOBIL
FACILITY ADDRESS: 101 19TH ST. BAKERSFIELD, CA.
PRODUCT LINE TYPE: PRESSURE
PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS
BELOW P.S.I. OR
SERIAL NUMBER 3 G.P.H. FAIL
DIESEL L/D TYPE: VEEDER -ROOT
YES 0 PASS
SERIAL # ELLD
UNL -87 LID TYPE: VEEDER -ROOT
YES 0 PASS
SERIAL # ELLD
PREm - 91 LID TYPE: VEEDER -ROOT
YES 0 PASS
SERIAL # ELLD
LID TYPE: YES PASS
SERIAL # NO FA1L
I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS DATE ACCORDING TO RED
JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATIONS.
THE MECHANICAL LEAK DETECTOR TEST PASS / FAIL IS DETERMINED BY USING A
LOW FLOW THRESHOLD TRIP RATE OF 3 GALLONS PER HOUR OR LESS AT 10 P.S.I. I
ACKNOWLEDGE THAT ALL DATA COLLECTED IS TRUE AND CORRECT TO THE BEST
OF MY KNOWLEDGE.
TECHNICIAN: STEVEN OBERT
SIGNATURE: DATE: 11 -22 -11
SWRCB, January 2006
Spill Bucket Testing Report Form
Thuform is intendedfor use by contractors performing annual testing ofUSTspill containment structures. The completedform and
printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: EZ STOP MOBIL I Date of Testing: I1 -22 -11
Facility Address: 101 19'x` ST. BAKERSFIELD, CA.
Facility Contact: LEE Phone:
Date Local Agency Was Notified of Testing: 11/22/11
Name ofLocal Agency Inspector (ifpresent during testing): ERNIE MEDINA
2. TESTING CONTRACTOR INFORMATION
Company Name: RICH ENVIRONMENTAL
Technician Conducting Test: STEVEN OBERT
Credentials: CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Specify)
License Number(s): 8029980 -UT
3. SPELL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic Vacuum Other
Test Equipment Used: VISUAL Equipment Resolution: 0
Identify Spill Bucket (By Tank
Number, StoredProduct, etc.
1
DIESEL
2
UNL-87
3
PREM -91
4
Bucket Installation Type: Direct Bury
X Contained in Sump
Direct Bury
X Contained in Sump
Direct Bury
X Contained in Sump
Direct Bury
Contained in Sum
Bucket Diameter: 12" 12" 12"
Bucket Depth: 14" 14" 14"
Wait time between applying
vacuum/water and start oftest:
30 MIN 30 MIN 30 MIN
Test Start Time (T,): 0900 0900 0900
Initial Reading (RO: 14" 14" 14"
Test End Time (TF): 1000 1000 1000
Final Reading (RF): 14" 14" 14"
Test Duration (TF —T): 1 -HOUR 1 -HOUR 1 -HOUR
Change in Reading (RF - R,): 0 0 0
Pass/Fail Threshold or
Criteria: 0.00 0.00 0.00
Test Result: X Pass Fail X Pass Fail X Pass Fail Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forjailed 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: Date: 11-22-11
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
ki
END ;:XXX*
l is H =STORY REPORT
1ARTSENSOF' ALARM --
91 VENT LINE
UUM ALARM
C'•'
2011 1:::09 PM
N(:' »'
I OU I D ALARM
NO '•,
2011 1,22:08 PM
NC''•.'
DATA WARNING
NC ? "'
2011 G : 16 PM
ki
END ;:XXX*
l is H =STORY REPORT
is END 0:
I., :C4 Fl--STORY REPORT
1ARTSENSOR ALARM --
E;M91 —DSL ANNULAR
C, ., :ILIUM ALARM
2011 12:08 PM
E—'.. EO)TA WARMING
2011 e-:16 PM
AL::i' H::STORY FEPORT
I:IVSOR ALARM - --
G 4L•-87
PL. ::: :HUTDOWN ALARM
N(? 2011 112.:48 PM
L--NE FAIL
N(''.: .', 2011 12:48 PM
HUTDOWN ALARM
NCO 2011 12:32 PM
PI:::- RMFIIJTDOWNALA
NCr,: ?. 2011 11:04 AM
PI:.•::: :HUTDOWN ALARM
NCB'.' ?, 2011 11:02 AM
PI.*:- :HUTDOWN ALARM
NCB': 2011 11:00 AM
HUTDOWN ALARM
N(:-'. ', 2011 10 :59 AM
PI., -.;:: :HUTDOWN ALARM
N(:' 2011 111:57 AM
PI..::..:- :HUTDOWN ALARM
NO'.' 2011 10:52 AM
PI..::..:- :HUTDOWN ALARM
NC''.: :', 2011 10:49 AM
ALi::j,
1ARTSENSOR ALARM --
E;M91 PRODUCT LINE
s
UUM ALARM
C'•' 2011 12-, 10 PM
N(:' »'
IGUID ALARM
NO '•,
2011 12:08 PM
NC''•.'
Eq)TA WARNING
NC ? "'
201 1 (• : 16 PM
is END 0:
I., :C4 Fl--STORY REPORT
1ARTSENSOR ALARM --
E;M91 —DSL ANNULAR
C, ., :ILIUM ALARM
2011 12:08 PM
E—'.. EO)TA WARMING
2011 e-:16 PM
AL::i' H::STORY FEPORT
I:IVSOR ALARM - --
G 4L•-87
PL. ::: :HUTDOWN ALARM
N(? 2011 112.:48 PM
L--NE FAIL
N(''.: .', 2011 12:48 PM
HUTDOWN ALARM
NCO 2011 12:32 PM
PI:::- RMFIIJTDOWNALA
NCr,: ?. 2011 11:04 AM
PI:.•::: :HUTDOWN ALARM
NCB'.' ?, 2011 11:02 AM
PI.*:- :HUTDOWN ALARM
NCB': 2011 11:00 AM
HUTDOWN ALARM
N(:-'. ', 2011 10 :59 AM
PI., -.;:: :HUTDOWN ALARM
N(:' 2011 111:57 AM
PI..::..:- :HUTDOWN ALARM
NO'.' 2011 10:52 AM
PI..::..:- :HUTDOWN ALARM
NC''.: :', 2011 10:49 AM
ALi::j, H -STORY REPORT
IAMENSOR ALARM --
s EBEL VENT LINE
H.. IOIUID ALARM
N(:' »' 2011 12':20 PM
NO '•, LIIJIN ALARM
NC''•.' 2011 12:20 PM.
NC ? "'
DATA WARNING
PI.."
2011 6• :16 PM
NCO '
FI -STORY REPORT
1ARTSENSOR ALARM --
s =' ; EDEL PRODUCT LINE
NO '•• IUM ALARM
N(:-'.' 4 2011 l e- PM
H:'i. IQUID ALARM
N(.,' -' 2011 12:20 PM
J: 'r: )i END 3:
Al.r G' H - STORY REPORT
EJ. :NSOR ALARM - - - --
G i ; EBEL
FIUTDOWN ALARM
N(:,.' :', 2011 12:38 PM
GIP--':H L, -NE FAIL.
N(?;: .', 2011 1.2:38 PM
HUTDOWN ALARM
NC,'„' :'. 2011 12:32 PM
HIJTDOWN ALARM
NCO ' , 2011 1 1:05 AM
PI..::: :;HUTDOWN ALARMN(:O :'. 2011 11:04 AM
PI., -»-: iHUTDOWN FiLARM
NU'.: '. 2011 11:01 AM
PI :.. :HIITDOWN ALARM
NC•'• :. 2011 10:57 AM
HUTDOWN ALARM
N(r•: :'. 2011 10:53 AM
FIUTDOWN ALARM
N( ?' -' :', 2011 10:49 AM
pI•; :•
HIITDOWN ALARM
00' =' 2011 7:13 AM
PI.. -.
H "STORY F:EPORT
H
2011 11:04 AM
TENSOR ALARM - - - --
G
PI..,:::
E•TI -91
FIUTDOWN ALARM
N(:v 2011 1- :43 PM
NC ? "'
L. -NE FAIL,
2011 1':43 PM
pI•; :• FIUTDOWN ALARM
NC'.. 2011 12:32 PM
PI.. -. FIIJTDOWN ALARM
H
2011 11:04 AM
PI..: HIJTDOWN ALARM
N(:'' »' 2011 11:02 AM
PL HUTDOWN ALARM
N( 2011 11:00 AM
PI.." HUTDOWN ALARM
NCO ' 2011 10:59 AM
PI.,::.; 1HU200WN ALARM
10:57 AM1
HU2DOWN CL
NC, 1 R AM
PI... :—," HUTDOWN ALARM
ajrr I gni 1 10:49 AM
AI.•ri
t FI STORY
NG' »'
ALA 'IAPTSENSO
N(i ',•
POR RETURN L I
H I GU I D ALARM
NC'.: 2011 12:04 1
NC '•, LIUM ALARM
2011 12:04 1
X !e : # END 's: x #
AI.j ::.; K.'STORY FEPORT
IARTSENSOP ALAR
s : 1L87 PRODUCT LI
N(, '„ UIJM ALARM
NG' »' 2011 12:05 P
N(i ',• LlUM ALARM
NCO'.. 1. 2011 112:05 P
IOUID ALAJRMNCO.,' 2011 1":.':04 Pi
nE X X END
AL.i"i::; H_STORY FEPORT
1ARTSENSOR ALARM
s "i: iL,E37 ANNULAR
NO !LlUM ALARM
N( »' .', 2011 12:03 Ph
Si:-.-'.. DATA WARNING
0(:'7 . 2011 r-:16 PN
SENSOR ALARM
X-, SUMP
SUMP
1.ARM
2011 11:12 AM
X X END 4: x x x x
Li::i:; H.':STORY REPORT
Ea.:NSOR ALARM -----
WALL
SUMP
1ARM
2011 11:12 AM
H "STORY REPORT
SENSOR ALARM - - - --
4L. • -87
HUTDOWN ALARM
2011 12:48 PM
FAIL.
2011 12:48 PM
HUTDOWN ALARM
2011 12:32 Pm
FIUTDOWN ALARM
C. 2011 11:04 AM
I: -f IHMDOWN ALARM
I 2011 11:02 All
HMD(>WN ALARM
2011 111:52 AM
I.....::: 3HUTDOWN ALARM
2011 10:49 AM
H1.11••J." n..mivmy r.arvai
SENSOR ALARM - - - --
L:. : :, : ;1 191 FILL, WALL
P - BUMP
Ft.l:::, Z.ARM
NC-'..:- .. 2011 5:01 AM
X i,:. X x E ND X x x yc A
Al-,:::: H:1' STORY REPORT
HUTDOWN ALARM
L'
2011 11:00 AM
p
3'HUTDOWN ALARM
Ft.(::":.
2011 10:59 AM
I FIUTDOWN ALARM
C"'.. 2011 10:57-AM
HMD(>WN ALARM
2011 111:52 AM
I.....::: 3HUTDOWN ALARM
2011 10:49 AM
H1.11••J." n..mivmy r.arvai
SENSOR ALARM - - - --
L:. : :, : ;1 191 FILL, WALL
P - BUMP
Ft.l:::, Z.ARM
NC-'..:- .. 2011 5:01 AM
X i,:. X x E ND X x x yc A
Al-,:::: H:1' STORY REPORT
SENSOR ALARM - - - --
L' UE FILL SUMP
p Sump
Ft.(::":.
LARM
NO'-, 2011 11:07 AM
X,,:. x X END : x -x x A
Fl::STORY REPORT
SENSOR ALARM
L:, :1 FSEL FILL. WALL
P BLIMP
Flf:..'. LARM
NO'.. 2011 5:30 AM
IIFNSOR ALARM AL,;;C, PI:STORY REPORT
L:.::': 4-67 STP SUMP
S-:: JHP
U'-IL87
SENSOR ALAYR*
FIX: tLJIRM
FI-F;:-
1?191 STP W
NO... 2011 10:62 AM
Fl.l':;::. LARM
N(,'.,' 1, 2011 1:12 AM
Ft.l:::':. iLARM
F1.r2::. iLARM NC,*..' 2011 11.07 AM.
2011 10:42 AM
x !,: is X END
AI..tzL';i H".STORY REPORT
END
AL.i::i-- H:: STORY REPORT
SENSOR ALARM
L;:::.: d:M91 STP SUMP
FLr:.'::'• :iLARM
NOV *1, 2011 10:55 AM
END
AI.i::- FI:STORY REPORT
SENSOR ALARM --
F.SEL STP SUMP
Hp
FtK - ::". ZARM
NOV :'!, 2011 10:53 AN
END
AI-ir; Pl':STORY F!EPORT
SFNSOR ALARM -----
U'-IL87 STP WALL
X)
FI-F;:- A-i)Jal
NC 2011 11:09 AM
Fl.l':;::. LARM
N(,'.,' 1, 2011 1:12 AM
FLC::: 1 LARM
NU..' 51, 2011 1*21 AM
END
AL.i::i-- H:: STORY REPORT
SENSOR ALARM
L;:::.: d:M91 STP SUMP
FLr:.'::'• :iLARM
NOV *1, 2011 10:55 AM
END
AI.i::- FI:STORY REPORT
SENSOR ALARM --
F.SEL STP SUMP
Hp
FtK - ::". ZARM
NOV :'!, 2011 10:53 AN
END
AI-ir; Pl':STORY F!EPORT
SriNSOR ALARM -
EJ"a STP WALL
FU : 7.. A.ARM
NCV 2011 11:31 A
Z.ARM
NO 2011 11:26 A
SENSOR ALARM
L E;1>3-4 WALL
D -SER PAN
F[f;:`-', :jL,61RM
NC."..' '. 2011 11:10 AM
H'..STORY REPORT
E;17NSOR ALARM
L ..c;P5-6 PAN
D- : F-FR PAN
ILARM
2011 11-02 AM
END
STORY REPORT
SENSOR ALARM - - - --
81P5 -6 WALL
Z'ER PAN
LARM
2011 11:11 AM
1 1
rlA.J•0 ri-ijlvXY REPORT
ISENSOR ALARM - - - --
L --*: cl,1)7-8 PAN
D
Lr;I:R PAN
F1. V.: ". l-ARM
W." I"
2011 1,2:32 PM
FU;
ARM
NC, 2011 11:00 AM
K 11:, 0: X END 0: h X x *
AI.A'.:; F1'..'STORY REPORT
c,*IzNSOR ALARM --
L :E;P7-8 WALL
D I.IiR PAN
FlJ';:..;:'. 7L.ARM
NC,. :! , 2011 11'24 AM
NCO., 2011 11:22 AM
X END i: X x X w
H:'.STORY REPORT
t r,..ZDlVxy 1-:1
ENSOR ALARM - --
L E;P9-10 PFA
D 4SER PAN
FLF jLARM
W." I" 2011 11:04 AM
P
ARM
N(-'..' 2011 10:49 AM
t r,..ZDlVxy 1-:1
X 1.: y: ) END X X X X 9
H'-*STORY REPORT
c:FNSOR ALARM ----- SENSOR AL(
L:- 1: c;P9-1 0 WALL L'- ILB7 FILL
D:,. a: ISHR PAN .1 P SUMP
Ft.l'::'." jLARM FU-:'.', 1ARM
NO., 2011 11:09 AM N(,'-' 2011 11
FLI'-':' yL.F)RM FLI':':. ARM
N(',-'.' 2011 10:49 AM N(',',,' 1. 2011 111'
r/
X 1.: y: ) END X X X X 9
H'-*STORY REPORT
END ): X x w
AI.A.' - H.'.STORY REPORT
SENSOR ALARM -----
L:.::':
12 PAN
D':S':: ISHR PAN
FLI': iLARM
N(:-'.' 2011 11 :05 AM
F1.1":: iLARM
NO., 2011 10:49 AM
END ): X x w
AI.A.' - H.'.STORY REPORT
X+.: ),: x END : N
H-STORY F'EP(
cEa:NSOR ALARM -----
L:.::': 51)11 -12 WALL
D:.':::;'.:: 1217R PAN
Ft.1".
AARM
N(-'.'
2011 1 1.'21 AM
FCl'::
L iRm
NO'.. 2011 10:49 AM
Sl:"+.; OUT ALARM
NC,.'
2011 10:15 AM
X+.: ),: x END : N
H-STORY F'EP(
END
AI.A'-, H-STORY REPORT
UHNSOR ALARP
L:.
11-07 FILL WAL
V
SUMP
Ft.1".
AARM
N(-'.' 1. 2011 11:1C
FCl':: HARM
N(:-',.' 1, 2011 9:14
SI:.' *-(!;; OUT ALARM
NC,.' 1. 2011 9:14
END
AI.A'-, H-STORY REPORT
E:17NSOR ALARM -
L:. Tri91 FILL. SUMP
V 13 UMP
Ft.1". ARM
N(-;-,"' 1.. 2011 11:08 A
N( 2011 10:49 A
E;FNSOR ALARM -----
3;1-2 PAN
LSER PAN
If_ 'jLARM
2011 10:57 AM
END":
X E ND x x x x x
JJ:s`i I•L STORY REPORT
12ENSOR ALARM -----
SP3-4 PAN
41SER PAN
lf:- :jLJ)RM
2011 10:59 AM
T -IL.--87
PF',-,
J-I_-STORY REPORT
1.02ENSORALARM -----
1, COEFF :.000700
E:I; I — 2 WALL
Th'-f.:
4SER PAN
114.00
Th'•f-:
C 2011 11:10 AM
X E ND x x x x x
JJ:s`i I•L STORY REPORT
12ENSOR ALARM -----
SP3-4 PAN
41SER PAN
lf:- :jLJ)RM
2011 10:59 AM
T -IL.--87
PF',-, 1' CODE
1.0
TI,I`::':; 1, COEFF :.000700
3.0
Th'-f.: IAMETER 114.00
Th'•f-: FOFILE 20 PTS
CC..-)-.:*:
FULL VOL, 15022
H
NCH VOL, 14765
G NCH VOL. 14269
DE--'.'.
NCH VOL, 13645
D:: '&:':'
NCH VOL, 12924
L(',I.i
VOL 12122
AU'-
VOL, 11282
VOL. 10381
Tfv.P
NCH VOL, 9450
PF!,*.:.*::,
NCH VOL. 8516
i': NCH VOL, 7553
NCH VOL 6611
NCH VOL. 5657
NCH VOL 4735
NCH VOL. 3837
INCH VOL. 2973
NCH VOL 2183
NCH VOL. 1446
NCH VOL. 012
NCH VOL 303
FL, ::ti:: E; " ZE, 4.0 IN
Wf:i'-'_'-' WARN I NG 1.0
H JA ER LIMIT: 3.0
MiriX LABEL VOL: 15022
OV'!.::° LJ_ LIMIT 90%
CC..-)-.:*: I)1 SABLED
13519
H RODUCT 900/0
Alf" ELIVERY END
13519
DE--'.'. 7W LIMIT 15%
D:: '&:':' E 3")
2253
L(',I.i ODUCT 1000
AU'-
iL.ARM LIMIT: 8
I LOSS LIMIT' 65
Tfv.P I LT 3.00
PF!,*.:.*::, OFFSET 0.00
A I ' SETURC61"11" 11C TIONS SETUP
NO'..' 2011
WS:
C(41' 10ARD : I (RS-232)
FATE3:6 E1600
Pi::O 7Y : NONE
S- B.". T : I STOP
I ' U NGTH: El DATA
R.8 SECURITY
CC..-)-.:*: I)1 SABLED
Alf"."..' :'FY NSMIT SETTINGS.'
Ali EAK ALARM LIMIT
D.': w: 2:1)
All""C -11(3H WATER LIMIT
D '. 184,: XD
ALI LIMIT
D El)
AU".'--- kW PRODUCT
D:: :4,- 11)
At.r_"-*' HEFT L I M I T
D -: :'i- E:I)
ALr':'-- ELIVERY :TART
D.- XI)
Alf" ELIVERY END
D.-. !::;,:: 23)
AU':"- ERNAL I NPUT ON
D:: '&:':' E 3")
ALI"• 7ERNAL I NPUT OFF
D ED
AU'- CENSOR FUEL ALARM
AL17,_" E:NSOR WATER ALARM
D "4 4- 23)
At.r. -" i-ENSOR OLrI' ALARM
D -_ &- 3)
S.*. I hANIFOLDED TANKS END OF MESSAGETP: MR,
L': 1ANIFOLDED TANKS
TV 'Iqlz
r.
LL::,:•: '1114 PER IOE, I C: I
150
LE,::I**• IIN ANNUAL. 5%
751
PF `_ )IC TEST 1"YPE
STANDARD
A •4
TA E.:
TW::
DF
EST FAIL
ALARM DISABLED
11C TEST FAIL
ALARM DISABLED
TEST FAIL.
ALARM DISABLED
27. AVERk-;ING: OFF
S7 AVERAGING: OFF
EST NOTIFY: OFF
11' SIPHON BREAK :OFF
RY DELAY I MIN
RESHOLD 10-00%
I UNITS
9:51 AM
TE,11.'- '-*P1PENSATION
VF11. -
1 IANGUAGE:
Sill— T' ME 2 : 8:00
sj•I::,-_
I DATE/TIME FORM
MC, 1 VYYY HH:MM:SS
EZ' MOBIL
10- 1TH ST
Th'•f.:
F'1'ELD,CA 93301
TE,11.'- '-*P1PENSATION
VF11. -
I I : 12*00
Sill— T' ME 2 : 8:00
sj•I::,-_ T "ME 3 : DI SABL
T-ME 4 : D I SABL
Tf4'•I*: 1:12 TST NEEDED w
D *'E:,:: 13)
Th'•f.: 4NN TST NEEDED to
D *:::-;1:: 11)
L '-I: E:•-EfqABLE IIIETHOE
Pic1:::k":: I NE TEST
L 4:: E:R TST NEEDED 6
EI)
L" '-I*-- IN TST NEEDED L
ED
PR"'- TC VOLUMES
EI-4 :!1::: 11
TE,11.'- '-*P1PENSATION
VF11. - DEG F ) : 60
S"' ": I': F117IGHT OFFSET
D 15
9001.
H•-::5 XCOL DATA FORME
Pfi` ION TEST DURAT
H(' X; 2
DA'::'_ 1-17 SAVINC: TIME
D i:: XD
R1.7 1:0T LOCAL PRIN'
XI)
F'OTOCOL PREFIX
I SECURITY
000000
NANCE HISTORY
D 1:1)
HART SECURITY
XI)
ALARMS
MR:: )EIGITY
S;,: ZE: 3.0 IN.
v:
ll.'.-::
l WARNING 110
Tff*'::: 1' CODE 2
Trc:f:
L COEFF :.000700
8042
Tf-, A: I AMETER 114.00
T ":
FIOF I LE 20 PTS
H j:';
FULL VOL 8042
SE
VOL 7904
D E_'..
NCH VOL. 7638
NCH VOL 7304
i(Cl
NCH VOL. 691B
Lb:n -:
NCH VOL. 6489
SLID-
I INCH VOL 6040
TA
NCH VOL 5557
PF--'_::
NCH VOL, 5064
NCH VOL : 4559
VOL. : 4043
I ::NCH VQL : 2539
NCH VOL, 3028
j
VOL 2533
NCH VOL 2054
NCH VOL. 1592
NCH VOL, 1168
NCH VOL 774
NCH VOL : 434
NCH VOL, : 162
S;,: ZE: 3.0 IN.
v:
ll.'.-::
l WARNING 110
Tff*':::
JA7ER LIMIT: 3.0
Trc:f:
I-ABEL VOL: 8042
Tf-, A:
LL LIMIT 90%
T ":
FULL VOL
7237
H j:'; RODUCT 95%
SE
VOL
7639
D E_'.. i"RY LIMIT 15%
VOL.
1206
i(Cl t.'ODUCT 500
Lb:n -: tLARM LIMIT: a
SLID- I LOSS LIMIT. 65
TA 7 1 LT 3.00
PF--'_:: OFFSET 0.00
S_:; :'•• I MANIFOLDED TANKS
Tl::: "PIE
L" A.- IIANIFOLDED TANKS
Tl::: ."PIE
Lip ::,'-: qIN PERIODIC: oya
0
1114 ANNUAL oy.
0
PEI::!- "IC TEST TYPE
STANDARD
AW-1- .. "EST FAIL
ALARM DISABLED
PE*?'_' '110 TEST FAIL
ALARM DISABLED
Gf--`1X': TEST FA 11.
ALARM DISABLED
A14',( :877 AVERAC41NG: OFF
PL..71. '1117 AVEW,ING: OFF
Th+: 'EST NOTIFY: OFF
Tk-:' ;T SIPHON BREAK:OFF
DIT :2V DELAY I MIN
PLVG -IrIRESHOLD 10.00%
FL-_M-- El-.ZE: 4.0 IN.
CODE 3
Tff*'::: Z. COEFF 0001450
Trc:f: IIAMETEK 114.ob
Tf-, A: F*OF I LE 20 PTS
T ":
FULL VOL 7070
P. VOL, 6949
SE
VOL 6715
DE'%::
NCH VOL. 6420
VOL. 6082
LOW
NCH VOL. 5705
Lb:n -:
I :NCH VOL 5309
SLI-C
NCH VOL, 4885
Tiv•.•:
NCH VOL. 4450
PF--'_::
VOL. 4008
NCH VOL. 3555
NCH VOL, 3111
NCH VOL, 2662
NCH VOL. 2228
j NCH VOL, 1806
NCH VOL 1399
NCH VOL. 1027
NCH VOL 681
NCH -VOL 381
NCH VOL. 143
FL-_M-- El-.ZE: 4.0 IN.
S I MANIFOLDED TANKS
Tr: A4E
L':',F 'ViNIFOLDED TANKS
Tr: ',NE
1114 PERIODIC: 0%
0
Llii= -: illil ANNUAL. ox
0
PI: " ?_ ?IC TEST TYPE
STANDARD
AN',L . "EST FAIL
ALARM DISABLED
PE'. __ '11C TEST FAIL
ALARM DISABLED
Gl;'.-':" TEST FA I L.
ALARM DISABLED
AN 1-C AVERAG I NG: OFF
PE;, Z- AVERAC-1 I NG * OFF
Tri'4': 'FBT NOT I FY: OFF
Tt.l':: :;T SIPHON BREAK :OFF
DI:'.:: -:S!V DELAY 1 M I N
Pt. ff-_- "IrlIZESHOLD 10.00%
FT-1 L I Nt L.tMr, orm 1 -r
14E D I SABLE BE'
IL-87 IL•-87
T%..'-" , Cv3.0IN FIBERGLASS
21:).-, EC"A LEN: 200 FEET
3. El'A LEN: 0 FEET
SH-C. 'WI4 RATE: 3.0 GPH
L(:-I..l ;IESSURE SFlUTOFF: NO
L(A.1 dloSURE 0 PSI
T 4L.• -87
ASE MODE.
4DARD -
SE: Li: :': NON-VEPITED
pl;!:' JRF OFFSET: O-OPSI
Q. 2: 1.101-91
T":""P:
WARN I NG 1.0
H-C-.;: IA-.`ER LIMIT: 310
llk- °: LABEL VOL: 7070
E.13SURE SHUTOFF: NO
1-1. LIMIT 90%
T ": Fli-91
6363
H'.(!'t - RODUCT 95%
SE NON-VENTED
6716
DE'%:: R? L I M I T 15%
1060
LOW C,I)UCT 500
Lb:n -: LARM LIMIT: a
SLI-C 4 LOSS LIMIT: 65
Tiv•.•: I LT 3.00
PF--'_:: OFFSET 0.00
S I MANIFOLDED TANKS
Tr: A4E
L':',F 'ViNIFOLDED TANKS
Tr: ',NE
1114 PERIODIC: 0%
0
Llii= -: illil ANNUAL. ox
0
PI: " ?_ ?IC TEST TYPE
STANDARD
AN',L . "EST FAIL
ALARM DISABLED
PE'. __ '11C TEST FAIL
ALARM DISABLED
Gl;'.-':" TEST FA I L.
ALARM DISABLED
AN 1-C AVERAG I NG: OFF
PE;, Z- AVERAC-1 I NG * OFF
Tri'4': 'FBT NOT I FY: OFF
Tt.l':: :;T SIPHON BREAK :OFF
DI:'.:: -:S!V DELAY 1 M I N
Pt. ff-_- "IrlIZESHOLD 10.00%
FT-1 L I Nt L.tMr, orm 1 -r
14E D I SABLE BE'
IL-87 IL•-87
T%..'-" , Cv3.0IN FIBERGLASS
21:).-, EC"A LEN: 200 FEET
3. El'A LEN: 0 FEET
SH-C. 'WI4 RATE: 3.0 GPH
L(:-I..l ;IESSURE SFlUTOFF: NO
L(A.1 dloSURE 0 PSI
T 4L.• -87
ASE MODE.
4DARD -
SE: Li: :': NON-VEPITED
pl;!:' JRF OFFSET: O-OPSI
Q. 2: 1.101-91
T":""P: 0V3. 01 N F I BERGLASS
C - 2. . D-. A LEN: 200 FEET
3. ICA LEN: 0 FEET
SHJ- WN RATE: 3.0 GPH
LC4•J E.13SURE SHUTOFF: NO
LW E:.c3SURE 0 PSI
T ": Fli-91
121: MODE:
IDARD
SE NON-VENTED
PTC::_: IFT; OFFSET: 0 - CPS I
0 -':1*. :FSEL
Cl,'3.0 I N F I BERGLASS
2. EC LEN: 150 FEET
3. D'_'A LEN*. 0 FEET
SH -C. '-W(4 RATE. 3.0 GPH
LCLI :,ES"sURE SHUTOFF :N0
L('A.1 1 !El3SURE 0 PSI
T ':I: 'ESEL
D :: i::;-.z: LRE MODE
1::;,:: 4DARD
SE t: NON-VENTEDt
py., 512. OFFSET: O-OPSI
qX ALARMS
iIGH WATER' ALAR
L 1;4.. ') SENSOR Pd-MS
L :ZHSOR OUT ALAF
L w :;EISOR OUT ALAF
EI4SOR OUT ALAF
1134SOR OUT ALAI
214SOR OUT ALAI
214SOR OUT ALAI
11E`I4SOR OUT ALAI
L '1ENSOR OUT ALA.
L = ';F.14SOR OUT ALA
1EI4SOR OUT ALA
TENSOR OUT ALA
04SOR OUT ALP
L,2:: *,'04SOR OUT ALP
L;.!;; '-EWSOR OUT ALF
L .:;HORT ALAW
L X)RT ALARM
I., ;HURT ALARM
L :;IrIORT ALARM
L ::HORT ALARM
L `::HURT ALAT'll
L SHORT ALARM
L 3WRT ALARM
SHORT ALARM
L:.'.: :iHORT ALARM
FK)RT ALARM
7 ;.'&K)RT ALARM
HORT ALARM
L -, -' - :;HORT ALARM
L 2" "HURT ALARM
1'. - v.!;: "HURT ALARM
METHOD
TES-_ 41 DATE : ALL
FE,11 2007
T- Mir - DISAI
Ty -, itA'7E :0.20
014 : 2 H(
T ci1 jpj.y STOP :DI(l
LEj-, EST REPORT
N
spik., WqBox Sh I ur EM91 FILL. SUMP LN 1_t
1-7. 4 ALARMS TV` A-E (SINGLE FLOAT)
11GH WATER ALARM 5 OR RETURN LINE IRV : PIPING SUMP L SPI-2 PAN
EilGHWATU! ALARM VAC SENSOR T-.- K A- GSINLE FLOf
PL4 DIS; ENSER I
11' d SENSOR PLMS 0 4L.--87 ET191 FILL, WALL
E:tQOR OUT ALARM V(* 41.4 GALLONS TV.. - A7E (SINGLE FLOAT)
EJ6OR OUT ALARM
VeOR RE: VALVE: : NO RV . PIPING SUMP
L 8111-2 WALLOUTALARM
ENBOR OUT ALARM
ENSOR OUT ALARM 4L87 PRODUCT LINE
L FILL, SUMP
TR - A- E (S I NGLE FLOC
DISPENSER I
104SOR OUT ALARM1
cA,:
PLI-V
Fn/ VAC SENSOR
1 : TR
E13EL
A-E (SINGLE FLOAT)
VSOR OUT ALARM Q IL-87 PIPING SUMP
El6OR OUT ALARM
04SOR OUT' ALARM 46.0 GALLONS L c,:;1)3-4 PAN
04BOR OUT ALARM RE:_:: VALVE: ; NO
L:. EBEL FILL WALL Tl:!:* - A'-'E (S I NGLE FLOC
ENSOR OUT ALARM 4L.87 ANNULAR A.-E (SINGLE FLOAT) CAI:-: F%4! : DISPENSER I
ZNSOR OUT ALARM Ch -= RV VAC SENSOR A!V : PIPING SUMP
iENSOR OUT ALARM
XNSOR OUT' ALARM Q 4L--87E:IeOR OUT' ALARM V(:'::.... 17.0 GALLONS L_:- 4LA7 STP SUMP L EJ>3 -4 WALL
HORT ALAFtl RE:..'..' VALVE: NO I . TY. A-E SINGLE FLOAT) Tl;':'-- A-E (SINGLE FLOi
RVHORTALAP" STP SUMP C4: 17' DISPENSER I
HORT ALAR11 91 VENT LINEIHORTALARMFVVACSENSORHORTALARMPLK: L'2"i IL87 STP WALL
HORT ALAFT1 Q :,: EM-91 TR: - Yj-E (SINGLE FLOAT) L SP5-6 PAN
HORT ALARM VC,':-,. 40.0 GALLONS R! : STP SUMP TR Pt-E (SINGLE FLO,
3FIORT AL*tl RF-'.:: VALVE: ; NO DISPENSER
AT ALAH1
HORT ALAF11 i'E:N9l PRODUCT LINE L2:.: E.M91 STP SUMP
HORT ALAFTI
HORT F' VAC SENSOR TP A-E (SINGLE FLOAT)
ALARM 1 STP SUMP L E;1>5-6 WALL
HORT ALARM Q M-91 TR A -E (SINGLE FLOC
n! FlORT ALARM Vc,- 46.0 GALLONS c4Y7 DISPENSER
FlORT ALAFIM RE.... VALVE: NO iT:Plgl STP WALL
FIORT ALAFtl TJ?_- A7E (S I NGLE FLOAT)
rBEL s S; ET191 -DSL ANNULAR STP SUMP
L E!1>7-8 PANDRVACSENSORA_E (SINGLE FLQ
1 1K ALARMS ESEL STP SUMP Cfi_-_:: RV : DISPENSER
lIGH WATER ALARM Vc 17.0 GALLONS SINGLE FLOAT)
13ENSOR ALMS RF_ VALVE: : NO
c6l- RV : STP SUiMp
LIE ALARI'l E: M5 VENT L I NE L ED: SP7-8 WALL
A'-'EENSOROUTALARMVACSENSOREBELSTPWALLTl;':: - SINGLE FLO
IENSOR OUT ALARM pltrr
W TI; - A"E (SINGLE FLOAT) CA RY '. DISPENSER
Z16OR OUT ALARM Q 'D: EBEL F:`! : STP SUMP
14SOR OUT ALARM V(."'-.. 14.0 GALLONS1114BOROUT' ALARM
X14BOR OUT' ALARM VALVE: : NO
L'.:' 5, 7tIr SUMP L 2:1>9-10 PAN
XNSOR OUT ALARM PRES Tlj. A E (SINGLE FLOAT) TV: A_E (SINGLE FLO
L ENSOR OUT ALARM C* 4;"? ATM P SENSOR C(: R! : PIPING SUMP Cfi':: R? : DISPENSER
L 11FNBOR OUT ALARM
I.:.:. OLCCOR OUT ALARM ESEL PRODUCT LINEL:.': 1:14SOR OUT ALARM
XIIISOR RY SVACENSOR L,:.: Pr.' WALL
L OUT ALARM T)*,.:: - K., 'E (SINGLE FLOAT) L-:"I: SP9-10 WILLL;'': 4ENWR OUT' ALARM Q EBEL RV PIPING SUMP TR Yi-E (SINGLE FLO1. ENSOR OUT ALARM C. V".'.. 39.0 GALLONS CA DISPENSERL;:1 iEASOR OUT ALARM Rlr_ VALVE: NOJ. HORT ALAF11
IL HORT AL*!M
L' HORT ALAFM L:. - E31 11 -12 PAN
L HORT ALARM TR -- A-E (SINGLE FLO1.- :1 iFIORT ALARM C44"' IF' : DISPENSER
L ii FlORT AL*!M
L IHORT ALARM pj REVISION LEVELILSHORT " RT ALAP N 327.04L. 3FI0RT ALARM FIF# 346327-100-E L:. 2: SP I I -12 61ALLL:.:, 3FlORT ALAFtl Cp, . jy° 07. 0".. 06. 10. 28 TR - - A -E (S I NGLE FLO
I.:_ isHORT ALARM Ch'::: F:!! : DISPENSERI.. - r HORT AL*!M I'UARE MODULEL' i &IORT ALARM i FEATURES`- l.:..- HURT ALQM ic'Dic IN-TANK TESTSL;: - I i FK)RT ALARM I N -TANK TESTS L:.3: IL(37 FILL SUMP
AORT ALAFM Tl;!:: - A-E <SINGLE FLC
I FIORT ALARM PY PIPING sut"
L:. E.87 FILL WALL
tj;,.. A.-E (81 NGLE FLC
PIPING SUll'
qLM-1 Ix
MONITOR CERT. FAILURE REPORT
SITE NAME: EZ -STOP MOBIL DATE: 11 -22 -11
ADDRESS: 101 19' ST. TECHNICIAN: STEVEN OBERT
CITY: BAKERSFIELD SIGNATURE:
REPAIRS: REPLACED DIESEL STP BRINE SENSOR.
PARTS INSTALLED: VEEDER -ROOT 420 SENSOR
THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING
THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR
THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMENTAL FOR
ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL, OF
ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE.
A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR
CONVIENENCE.