HomeMy WebLinkAboutFMC 2014MONITORING SYSTEM CERTIFICATION
For Uve By ;lfl Jurisdictions lfli1hi11 1he State <?f'CaNfornio
A11tlwri1y Ci1ed: Chapwr 6. 7, Health and Safety Code: Clrap1er 16, Division 3. Title 23. C(l/ijnrnia Code ufReg11/otio11s
This fonn 1nust be usc<l to d<.l(.;Unu..:nl testing and servicing of 111ooitoring cquiprncnl. A separate <.x-rtilication or rc1lOl'l 11111.;;1 be prepared f(lr cac.;h
1noni1oring svsfe.111 control J)ancl by 1hc tcchnh.:iau \vho 1x=rfi)1'nts the work. A copy of this thrnt ntust be provided H> the lank systc1n
O\v11cr/opcn1101'. l"hc O\vncr/opcrator 111ust subrnit a copy of this fo1·n110 the lrotl agency rcguhuing UST systcn1s \\'ithin 30 days oftc~;;1 <late.
A. General information
Facility Name: -=S..:.h:.:e:.::11'--------------
Site Address: 4700 Coffee Road
Bldg. No.: __ _
City: Bakersfield Zip: :::.93::.:3:.:0:.:::8 __ _
Facility Contact Person: ..:M=a.::tt:.;J:o:e:o:ffc:.r:.:i.::es"------------
Make/Model of Monitoring System: Gilbarco EMC
Contact Phone No.: (661) 496-7006
____ Date orTesting!Servicing: 8/18/2014
B. Inventory of Equipment Tested/Certified
Cl incti, 'fl< . -· --. ··-·· ·----j/scrvkL'<.1
Tank ID: 10000 ljal. Reljular !North) ·rank ID: 10000 ljal. Reljular !South)
181 In-Tank (i:u1g.ing, Pnlhc Model: 847390·107 181 11.,.·1 ~ulk Vauging Prol:M!. MoJd: 847390·107
181 Annular S1)<'1X or Vaull Sc:;n.w1· Model· 794390-420 [8J Annul:1r Sl)\)00 or V;:iult S(.'ftSQr, MoJd: 794390-420
181 Piping Su1n1> • TfCfll;:h Scnsoi1s) Model· 794380·208 r8I Piping Sump· I 1~nch Scn~s) Mixld: 794380·208
181 Fill Sum11 Scnsor1:i.) Model: 794380·208 (81 fill Sump s ..... hllf"I~). M0<ld: 794380-208
181 i\~«:l~ni~I I i11c I ~J.. nc1o;;1l)(. M('odd: FX1V [8J 1\-lochanical Linc L~k Octe<:t()I, Modd: Xf1V
0 F.1¢;;1!'f1nic I ir~ I «"tl.: necce1or. M('l(lcl: 0 Eloctmnic Linc L~1k CA.1..-c1or. Model:
181 T:lnl\ <>vcrlill 'ltigh·l .cvcl Scl\'•(lf'. Model: OPW·61·SO (81 Tank O\'crfill I I ligh-Lt..-vcl s .... 1l)>Of, MO<lcl: OPW·61-SO
0 Other (.specify t.-quipmcnt type and nl<'<lcl in 5<.'Ction Con Page 2). 0 Oth(T(:.p<.'Cif)' u.1uipnl<.'lll type and nx'll.lcl in S.:.-ctmn Eon l';i!,te 2).
T:mk 10: 10000 gal. Super Tank 10: 10000 gal. Diesel
[8J In· I :ink Gnugang Pr«ll'x.-. Model: 847390·107 (81 In· I ::ink Gauging Probe. \fo<lel: 847300·107
[8J 1\nnuh1r Srxicc or Vnull Sensor. Model: 794390-421> ~ Annular Sp;1cc or Vuuh Scn:.or. \fodd: 794300-420
[8J Piping Sump I rl°(_'flCh Scnsoitsl. 1\1odd: 794380·208 [8J Piping Su1111> • I renc:h ~en.•,011:.). \fodcl: 794380-208
(81 E1ll Sump Sc1lSOf1~) Mo<lcl: 794380·208 (8J Fill Suntp S.;.·n:s<..'•1:.>>. M.-lcl: 794380·208
(81 t-itochanical Linc leak DctOOlor. Model: FXW l8J ri.1\..'Chanical line U.'"<lk n ... 1..:..'CIQr. f\11.)(icJ· FX1DV
0 E lcclronic Linc Uak Oett.-ctor. Modd: 0 l;lt."C;tronic Lim: Lo,;ak D•:toctor. 1\1vdcl
® Tank 0\'\..Tfill / I I igh·Lc,·d S1:n.-.or. Modd: OPW-61·50 181 Tank Ovt.Ttill /I ligh¥L1;\•d S..:11M.)r. 1\1(.M.kl OPW·61·SO
0 Otht.T(:tt>l.'Cil)' c~1u1pnll..,111ypc ;)1KI model in Soction tun l\ll-'C 2). 0 O•ht...'1'(~-pctil)· ;.;quipint.'Jll 1ypc ~1od model in So;;tion Eon Pag.c 2}.
Dispenser 10: 1&2 Dispenser I 0: 3&4
[8J Oispet~ <'<•nWinment St't60r(:.). MoJd: 794390-420 181 Oi~);'.(."t"(\lf1lainmcnt S1.~n.~1r(:.). M<'lid: 794390·420
[8J Shear Vah•o(s) (81 Shear V::ilv<.'(.!>I.
0 1)1.,p::n~r CQnt:.ti1lnlCl11 Flo;11~s) and C'hain(s>. 0 Uisp.:~r Conl;iinm.:nl Float~~) and C'ham(s).
Dispenser ID: 5 & 6 Dispenser I 0: 7 & 8
[81 Oispe1l~' l'ontaimn<."t1l Scnso•1s). Model: 794390-420 (83 1)1.;pi::nscr C'ontninmcnt St.'flS011s>. \lodcl· 794390-420
181 She.ir V<iln.'(s). C8J Shear Val"c(::.)
0 Oi:."f)lilSlT C'onturnmenl l·loot(s) and C'hllin(s). 0 OCspense1· l'om.ainJnent noal(s) and Cf~in(li).
Oispenser IO: Disr,enser 10:
0 l>iSJX.'""-'t ("001ninm(:nt Scn<;.c.•rl:.) ~iudd D Ui:.lX-'llS<.'1' Conllnnmcnl 5>1.'11sor(s). r>.todd:
0 Shear Vah•c.'(s). 0 Sh1.~1r Vulv1.'(s).
0 Di:.p!n:.cr C'ont:umn1..-,1t Ho:u(sl :ind ( 'h:iin(s>. 0 DiSpt'tts(.'f('tu11.<1imncnt Float(~J and C'hain(sl.
•1f the facilicy con1<lins 1nore tao ks or dispensers. oopy this fonn. Include infonnadon tbr every lank and dispenser al the fadlity
C. Certificatio11 -I ce1·tify that the equipotent idcnrificd in this docurnent lvas inspt'l'ted/servicrd in accordance "'ith the
rnanufac.turers' guidelines. Artnched to I his Ce1·1ification is inforn1111ion (e.g. nHutufnclurers' checklists) necessary 10 \'Crify lh11t I his
inforn1ation is correcr and a Plot Plan showing thl' layout of ntonitoring ec1uip1ncnr. For any eciuiprncnt capable of gener:tting such
rt1>01·t!I, I ha,•e also attachrd a copy of the re11or1; (cir eek 111/ that 11pply): [8) Systen~Mup [8J 1\larn1 history re
B!}'._an A Self Signature: ~6:: = '7/ZJ,
License. No.: 0 ~ r
, -_ .. ----
Technician Na1nc
Certification No.: 637501 --''---'-'-------------~ Testing Company Name: Confidence UST Services, Inc.
Site Address: 4700 Coffee road, bakersfield, CA 93308 Date ofTc.stingiScrvicing: 8/18/2014
Page 1 of 3
Monitoring Systcrn Certification
D. Results of Testing/Servicing
Sollwarc Version Installed: 329.00 ....::.::.:..:C:..::.~~~~~~~~~~~~~-
Complete th< ~ •VllV"'" · """'-""""'~••
181 Yes 0 No* Is the audible alann operational'!
181 Yes 0 No* Is the visual alarn1 opcraLional?
181 Yes 0 No* \Vere all sensors visually inspected, func1ionally tested. and con finned operational?
181 Yes 0 No* Were all sensors inslalled at Jo,vest point of secondary co1uain1ncnt and positioned so that other equipn1en1
\viii not interfere v.iith their proper operation?
0 Yes 0 No* If alar111s arc rclayOO lo a rc1no1c n1onitoring station, is all con1nn1nications equipn1cn1 (e.g .. 1nodc1n)
181 NIA operational?
181 Yes 0 No* For pressurized piping systc1ns. docs the turbine auton1atically shut do\vn if the piping secondary containn1cnl
0 NIA 1nonitoring S)'$te1n detects a leak. t1ils to operate. or is electrically disconnected? If yes: \vhich sensors initiate
p(>'itivc shut-down'! (Check al/ that apply) 181 Sumprrrcnch Sensors: 181 Dispenser Containment Sensors.
l)id you confirn1 posilive i<ihut-dO\vn due to leaks and sensor t1ilurc/disconru ... "Ction? 181 Yes: 0 No.
0 Yes 0 No* For tank systerns that utilize tJ1c n1onitoring syste1n as the pri111ary lank overfill \varning device (i.e .• no
181 NIA n1cchanical overfill prevention valve is installed). is the overfill "'arning alarn1 visible and audible at the tank
fill point{s} and operating properly'/ If so. at what percent of tank capacity docs the alarm trigger'/ -61%
0 Yes• 181 No \Vas any 111onitoring equipn1ent replaced'? If )'CS. identify specific sensors. probes. or other equipment
replaced and list the rnanulilcturcr uan1e and 111odel tbr all replacen1ent parts in Section E. belov.'.
O Yes• 181 No \Vas liquid fOund inside any secondary contairuncnt systc1ns designed as dry systen1s? (C./Jeck all that ap1>ly)
0 Product: 0 Water. lfyes. describe causes in Section E. below.
181 Ye" 0 No• \Vas n1onitoring systcn1 set-up rcvic,vcd to ensure proper settings? .l\nach set up reports, if applicable
181 Yes 0 No• Ts all n1onitoring equipn1enl operational per n1anulacturer's specifications?
*In Srction E belo,v, describr hO\\' and \\'hen these drficiencirs \\'rr<' or \\'ill be corrected.
E. Conunents:
Page 2 of 3
i\1onitoriug Systen1 Certifica1ion
f'. In-Tank Gauging I Sil~ Equipment: O Check this box if tank gauging is used only for inventory control.
0 Clu • ..:k this box if no tank gauging or SIR equipment is in,Ulllc'I.
This section must be completed if in-tank gauging equipment is used to pcrfonn lcak detection monitoring.
Complete the follo .. ;ng checklist: -Ill! Ye' 0 No* !las all input wiring b<.-cT1 inspected for proper entry and termination. including testing for ground fault<!
lllJ y C> 0 No* Were all tank gauging probes visually in•pcctc'<l l<>r damage and rc.,,1due buildup'/
Ill! y cs 0 No* \Vas accurncy or sy:,tern product level rcadi ngs tested?
lllJ y C> 0 No* \Vas accurncy Of sy,,tcn1 \Valer level readings 1c~tcd'!
Ill! Ye> 0 No* Were all probes rd11'1alled property·!
@Yo-0 No* \Vere all ih.'111~ t)lt thc equipment rnanuracturef\. 111aintcnancc checkli-;:1 con1plctt..-d?
*In the Section II. below, de>cribe how and when th-.e deficiencies \\ere or "ill be corrected.
G. Linc Leak Detectors (LLD): O Check thi' box 1 f LLDs are not installed.
c, ~ .............. ···-............. _ ~-·~ ...........
C8I Yes 0 No* For cquipn1cn1 stnl1·up or annual cquipn1c111 certification. \Vas a lenk s1n1ulntOO lo verify (I.I) pcrl(1nnonce'!
0 NIA (Check a/11/1111 t1/>11l1) Simulated leak rate: 181 3 g.p.h.: O 0.1 g.p.h ; O 0.2 g.p.h.
@Ye> 0 No* Were all l I Ds coo firmed operational and accurate withm regulatory requirement''!
181 y • .,, 0 t\o* Wa< the tc.;tmi; apparatu• properly calihrnt<'<l!
@Ye;. 0 No* For mcchanicnl 11 0-.. does the 1.1.D r<strict product How if it detect• a lea~·!
0 NIA
0 Yes 0 No* For ck..:tro111c I I .Ds. docs the turbine autmnutically shut off if the LLD detects i1 leak·!
181 N//\
0 Ye> 0 No* For electronic 1.1 l)s, docs Lhc turbine nutonu11ically shut offifany portion rifthc 111011itoring systen1 is d1M1hlcd
Ill! NIA or disconncietcd'}
0 Ye, 0 No* For electronic I I )),. docs the turbme automatically shut olT 1f any portion of the monuoring sy,tem
Ill! N•A malfunct1on"-tlr fail-. a tQ.I?
-0 Ye-0 1'o* For clt.-clronic I LD:_... ha\.e all accessible \\·iring connecuous been visually 1n-.::rx.-c1c..-d'?
C8I NIA
181 Yes 0 No* Were all itcn1s on lhc ..:quip1nent 1nanufac1urcr's nu1intcnancc checklist con1plcccd'!
*In the Scceion H, belO\\', des('1'ihf.' hO\\' nnd '''hen tht~sc dt•ficicucies \rcre or '''ill he-corrected.
H. Comments:
Page 3 of 3
S'ISTEH StTUJ>
AUG 10. 2014 9: 11 AH
SYSTD1 Ufll'IS u.o.
S'ISTDt IAllCUllCl! EICLISH S'ISTD1 DATE/TIME FORtlllT HOH DD VYYV llH!rti :SS ><11
BROOlCSIDE !...i<KEI' 4700 COFFIE RO 81\X"I<SF I ELD CA 9330B 661-589-13:10
SHIFT TIHE I : l!OO AM SHIFT TIHE 2 : DISABLED SHIFT TIHE 3 : DISADLEO SHIFT TIME 4 : D SABLED
TAIW. PER '!ST HEEDED WRll DISADLED TAIW. AllN '!ST HEEDED URll
DISAOLED
LltlE RE-ENABLE METllOD PASS LI NE TClT
LltlE PER TST llEEOED WRll DISABLED LlllE Arlll '!ST HEEDED WRll DISABLED
PRIHf TC llOLUl£9 EHABLED
TEMP COMP£1<SATll>ll VALUE IDEC F I: 6D.O STICK HEIC111"10l'mtT DI Sl'll1.£D ~'l.LACE : 90>: •' • II-PROTOCOL l'l\TA•fQRtlllT HEIClll" I
DAYLICIIT SAVIOO TIHE ENABLED START DATE HAR Wl!EK 2 SUI! START TIME 2:DD AH
EflD DATE llOV WEEK I SUll
EflD TIME 2!00 AM
RE-DIRECT LOCAL PRllITOl/T DISABLED
EURO PROTOCOL PREFIX s
SYSTD1 SECURllV CODE : 000000
MAlllTE!IAllCE HISTORY
DISABLED
TA!IY. CHART SECUR I lV DISABLED
CUSTOM AIARl19 DISABLED
SERVICE llOTICE
DISABLED
ISO 3166 COUllTRY CODE:
MASS;OEllSllV • DISABLED
CJ)lflUlllCATIOfS SETUP -... ----.:-:-~· -s--
PORT 8£TTI HCS:
Ct1n1 BOARD : I CB-SAT I
BAUD RATE : 9&oD
PARllV : llOllE STOP BIT : I STOP DATA LEfCrH: 8 DATA
RS·232 SECURllV CODE : DISABLED DTR NORtW. STATE: ltlCH
COtt1 BOARD : 3 <EDIH I RS·232 BECURllV
CODE : DISABLED
COl11 DOARD : G CMODDUSI BAUD RATE : 9600
PARllV : NONE
STOP BIT : I BTOP DATA LENCTH: B DATA RS-232 SECURllV
CODE : DISABLED
COl11 BOARD : 6 IRS-2321 BAUD RATE : 9600 PARITY : 11011£ STOP BIT : I STOP
DATA LEllCTH: 8 DATA RS-232 SECURITY CODE : DISABLED
AUTO TRANSH IT S£TT I HCS:
AUTO LEAK AIA1<11 LIMIT DISABLED AllTO HICH WATER LIMIT DISABLED
AllTO OVERFILi. LIMIT DISABLED AllTO LOW PRODIA."T DISABLED Al/TO THEFT LIMIT DISABLED Al/TO DEL I VERY START
DISABLED AllTO DELIVERY EllD
DISABLED AllTO EXTElWAL I llPllT Ofl DISABLED Al/TO EXTERllAL INPllf OFF
DISABLED AllTO SEllSOR FUEL ALA1<11
DISAllLED
AllTO SENSOR WATER AlARtl
DISABLED AllTO SENSOR OUT AlA1<l1
DISABLED
RECEIVER SETUP:
NONE
AllTO DIAL TINE SETUP:
HOllE
P.S-232 EtlD OF l'\ESSACE
DISABLED
f\UTO DIAL. ALARM SETUP
111-TAllK SETUP
T J :DIESEL PRODUCT CODI! THERMAL COEFP TAtlX DIAMETER TAJIX PROFILE PULL VOL
FLOAT SIZE:
WATER llAP.lllflC : HICH WATER LIMIT:
HAX OR !ABEL VOL:
OVERFILL LIHIT :
HIGH PRODUCT
DELIVER\' LIHIT
LOU PRODUCT : l.£AI: ALARM LIMIT:
I .000045 95,75
I PT 10192
4.0 111.
2.0 3.0
10152 ,5::
9644 95.• 9644 5" 507
500
SUOOElt LOSS LIMIT: n TAUK TILT : PROBE OFFSET : o.,o o.oo
SIPHOll HA!llFOLDED TAUXS TO: NOHE LINE HArUFOLDED TANKS TP: NOHE
l.EAK Hiii PERIODIC: :
LEAK H Ill All!IUl\l. :
PERIODIC TEST TYPE
oa
"' IOI
OUICK
AllllUAI. TEST FAIL ALARtt DISABl.EO
PERIODIC TE8T FAIL ALARH DISABLED
CROSS TE8T FAIL ALARtt DISAllLEO
Aini TEST AVEIMClllC: OFF PER TES!' AVERAGlllC! OFF
TAllK TEST NOTIFY: OFF
TtW. TST SIPllOll DRCAl(:OPP
DELIVERY DElAY : 15 Miii PU'IP THRESHOLD : 10.0or.
.. , ,,
~
T 2:UIO.EADED 00\ll'lt PRODUCT COD~ : 2
THEJllW. COCl'F : .DOD70D TAUK 01/IHE'l'ER : 95. 75 TAIU: PROFILE : I PT
FULL VOL : 10152
FLOAT SIZE: 4.0 Ill.
UATER UARNINC : HIGH llATER LIHIT!
HAX OR IJ\Oll. VOL: OVERFILL LIHIT :
lllCll PRODUCT
DELIVERY LIHIT
LW PRODUCT : LEAK AIJ\R/1 Lll'llTI SUDDEtl LOSS LIMIT! TArlX TILT : PROBE OFFSET :
2.0 3.D
10152 95" 9644 95'< 9644 5" 507
500
99 99 o.eo o.oo
SIPHOll HAlllFOLDED TAllKS n: NOllE
LlllE MANIFOLDED TAllKS TO: NOllE
LEAK Miii PERIODIC:
LEAK HIN Atlll\W. j
PERIODIC TEST TYPE
°" 0
IX 101
QUICK
AIUIUAL TEST FAIL ALARH DISABLED
PERIODIC TEST FAIL AL/IRH DISABLED
CROSS TEST FAIL Al.All!1 DISABLED
mm TEST A'/ERt\OlllC: OFF PER TEST AVERACINC: OFF
TAllK TEST llOT I FV: OFF
Tiil: TST SIPHOtl SREl\l::OFF
DELIVERV DEi.AV : 15 HIH PlllP THRESHOLD : IO. 000<
T 3: U11t.£AOED NORTH PRODUCT CODE : 3 TilEllML COEFF : • 000700
Tl\llX Dll'l1ETER : 95. 75 TAIU: PROFILE : I PT FULL VOL : 10152
FLOAT SIZE:
IOITER UAAlllllC : HICH WATER LIMIT:
4.0 Ill.
2.0 3.0
HAX OR IAll£l. VOL: OVERFILL LIMIT j
HICH PRODUCrr
DELIVERY LIMIT
L<llJ PRODUCT : LEAK ALARM LI Ml T: SUODEll LOSS Lll'llT: TANK TILT : PROBE OFFSET :
10162 95'< 9644 95• 9644 5• 507
500 99 99 0.70
0.00
SIPllOll twllFOLDED TANKS TO: NOHli LINE MANIFOLDED TANKS TO: NOllE
L£AX HIH PERIODIC:
LEAK HI H AlllllW. :
PERIODIC TEST TYPE
o" 0
"' IOI
QUICK
AtlllUAL TEST FAIL ~ DISAOLED
P,ERIODIC TEST FAIL
ALARH DlllADLED
CROSS TEST FAIL ALA1'11 DISAllLED
Alltl TEST AVllRACJUQ: OFF PER TEST AVERAOlllO: OFF
TAllK TEST llGT I FV: OFF
Tl<X TST SIPHOll SRl!Al(:OFF
DELIVERY DEi.AV : 15 HUI Pl.t!P THREsltOLD : 10.00. -_ __,
T 4:SUPREHE PRODUCT CODE
THERt1AL COEFF TANK DIAHETER TAllK PROF I LE Fill.I. VOL
Ft.MT SIZE:
LIATER "11\Rtll NC : HIGH UATER LIHIT:
HAX OR LABEL VOL! OVERFILL LIMIT :
HIGH PRODUCT
0
DELIVERY LIHIT
L<llJ PRODUCT : LEA~ Al.ARM LIHIT:
4 .000700
95.75
I PT
10152
4.0 JU.
2.0 3.0
10152 95': 9644 95'1
96•• 5"
507
SUDOEll LOSS LIHIT:
500 99 99
2.30 o.oo TANK TILT : PROBE OFFSET :
SIPHOll HAlllFOLDED TAllKS
T:t: HONE LIUE tWllFOLDED TAUXS n: llGllE
LEAK HIU PERIODIC:
I.EAi( HIN AllNIW. :
o::
0
t>: IOI
PERIODIC TEST TYPE QUICK
A!INUAL TEST FAIL ALARH DISADLED
PF.Ji'IODIC TEST FlflL ALAl;tl DISl\BLEO
CROSS TEST FAIL ALA1'11 DISl\DLED
Ali/I TEST AVEAAGlllC: OFF PER TEST AVERAC lllO: OFF
TAllX TEST ?IGTIFY: OFF
TllX TST SIPHO/I SREAJ::Ofl'
DELIVERY DEi.AV ! 15 Miii PlllP THRESHOLD : 10.00::
LEAK TEST HETHOD
TEST 011 DATE : ALL T/\llK OCT 9. 2009 START TIME : OISADLBD TEST RATE :0.20 Cl\lJllR DURATIOll : 2 llOURS
TST EARLY STOP:OISAOLED
LEAK TEST REPORT FORHAT
llORHAL
LIQUID SEtlSOR SETUP
L I : RECULAR SOUTH TRI •STATE CBlll(ll£ FLOAT> CATECoRV : All!IUlAR SPACE
L 2:RECUIAR SOllTll
TRI -sTATE CBlll(:LE FLOAT> CATECORV : PIPlll(l Sll1P
L 0 :RECUIAR SOUTH TRI ·STATE CBlll(llE FLOAT>
CATECC>RY : BTP Sl.11P
L <I :RECULAR llORTlt TRI-STATE CSlllGLE FLOl\Tl CATECORY : l\llUUL/\R SPACE
L S:RECULAR tlORTlt TRI-STATE CSlll(llE FLOAT> CATECORV : Pl PlllG Sl.t1P
L 6:REClll.AR I/ORTH
TRl•STATE CSlllCLE FLOAT> CATECORV : BTP SLl1P
L 7:SUPR£HE 11!1-sTATE CSlllCLE FLOAT>
CATECORV : AIOIUIAR SPACE
L B:SUPREHE TRI-STATE CSIHCl.E FLOAT) CATECORV : PIPlll(l Bl.HP
L 9:SUPREHE TRI ·STATE CSlllGLE FLOAT> CATECORY : STP Sl.t1P
LJO:DJESEL TRI-STATE CSlllCLE Fl.OAT>
CATECORV : AlllWLAR SPACE
I.I I :DIESEL TRI •STATE CSlllGLE Fl.OAT>
CATECC>RV : PIPlllC Slt1P
LJ2:DIC:SEL TRI ·STATE CSlll(llE FLOAT> CATECORV : BTP SU1l'
LIO:DJSPEISER 1·2
TRI ·STATE CSI llCl.E FLOAT> CATECORV : OISPEHSER PAii
Ll4•DISPENSER 0•4 TRI-STATE (BlllCLE FLOAT>
CATECORV : DISPEllSER PAii
LIS:DISPEllSER 5·6 TRI ·STATE CBltlGLE FLOAT>
CATECORV : DISPENSER PAN
LI 6:01SPEllSER 7-8 TRl-sTATE csumE FLOAT> CATECORV : OISPEllSER PAii
OUTPUT RELAY SETUP
R I :RECULAR SOUTll TYPE: STAllllARD
H01111Al.L Y CLOSED
TAIO: 0: 2
lll•TAll!: AIARl1S T 2:LOU PRODUCT Al.ARl1
LIQUID SEJ<SOR AIJ1S L 3 :FUEL Al.ARl1 Ll:J:FUEL AU\Rt1 L14:FUEL AU\Rt1 L 2:SEllSOR OUT ALARt1 L :J:SEtSOR OUT ALAJlt! LIO:BEISOR OUT ALA!lt1
LI 4 :SENSOR OUT ALA!lt1
ISO SITE ALA"'19 !SD GROSS PRES FAIL !SD DmRD PRES FAIL !SD VAPOR LEAK FAIL !SD VP PRES FAIL !SD VP STATUS FA! L
ISO HOSE ALARt1S ALLlf'LOW COLLECT FA! L
Pt'C Al.ARtS VP EJ11SS!Ot19 FAIL VP PRESSURE FAIL
R 2:REGILAR NORTll TYPE: STAllDARD NORHALLY CLOSED
TAllK •: 0
111-TAllK ALA"'19 T 0 :LO~ PRODUCT ALARt1
LIQUID SEr<SOR AU19 L 6:fUEL ALARt1 LJS:FUEL ALARt1 Ll6:FUEL ALARt1
L s:SENSOR our AlAJa-t L 6:SEllSOR OUT ALARt1 LJS:SEHSOR OUT llLARt1 LI 6:SEHSOR OUT ALARt1
ISO SIT!! ALARt1S !SD GROSS PRES FAIL
ISO Da:RD [RES FAIL ISD VAPOR EAY. FAIL ISD VP PRES FAIL ISO VP STATUS FAIL
ISO HOSE AIARHB ALL :FLOW COLLECT FAIL
PllC Al.ARM3 VP 9115510119 FAIL
--lJP PRESSURE FAIL
R 3:SUPRENE TYPE: STAtiDARO llORt1ALLV CLOSED
TAtt< •: '1
lll·TAIDC ALARHS T 4 :LOU PRODUCT Al.Ml
LIQUID SENSOR AU1S
L 9:FUEL At.Allll Ll:J:FUEL AtARl1 Ll4:FU&. At.AJit1
t.;l S!FUEL Al.A1lt1 L16:FUEL A!J\Rt1 Ll3:6ENSOR OUT AU\lltl Ll4:SE.NSOR our AlAJ\tl LtS:SENSOR OUT A\ARr1 Ll6:SEllSOR OUT ALARl1
ISO SI TE ALAlll19 ISO GROSS PRES FAIL ISO DECRD PRES FAIL ISD VAPOR LEAK FAIL ISO VP PRES FAii. ISD VP STATUS FAIL
ISD !JOSE AlARM9 l\LL:FLOU COLLECT FAIL
Pit:: ALARt1S VP EHISSIOIS FAIL vP PRESSURE FAIL
R 4:DIESEL TYPE: STAllDARD
llOl!HAl.L Y CLOSED
TANK #:
111-TAllX ALA"'19 T I :LOU PRODUCT l\Ll\21
LIQUID SEISOR Al.tG Ll2:FUEL ALARt1 L16:FUEL AtARt1 LI I :sEtSOR our ALARM Ll2:SEllSOR OUT ALARM Ll6:SErlSOR OUT ALARM
ISO SITE ALA"'19 ISD GROSS PRES FAIL ISO DECRD PRES FAIL ISO VAPOR LEAK FAIL ISD vP PRES FAIL ISD VP STATUS FAIL
R S:DISP 1·2 TYPEl
STAllDARO llORHALL Y CLOSED
TAllX ~: llOllE
LIQUID SElSOR A°'9 Ll3!FllEL AtARl1 L I :SEtSOR OUT AlARt1 L 2 :sEtSOR OUT AIARr1
R 6:DISP 0•4
TYPE: STAtlDARD NOR11ALLV CLOSED
TAllK ~: llOllE
LIQUID SEtSOR 111.119 Ll4:FUl:L ALAlll1 ALL :sEISOR OUT Al.ARI'!
R 7:DISP 5-6 TYPE: STA HOARD llORmU.V CLOSED
TAHK P: NOllE
LIQUID SEHSOR 1\1.t'S L15:FUEI. ALARl1
R 8:DISP ?-8 TYPE: STANDARD H0"11Al.l.V CLOSED
TAllX d: llOllE
LIQUID SEllSOR Al.119 Lt6:FUEL AU\Rl1
R 9:
TVPI!: STANDARD llORl'\l\LLV CLOSED
TAllX II: llOllE
LIQUID SEllSOR Al.MS Au.!FUEL ALARl1
RIO:VST CONTROL OPEN TYPE: VAPOR PROCE!SOR llORmu.Y CLOSED
-no AlARl1 ASSIOttl.Etll'S -
RI I :VST COlnROL CLOSED TYPE: STA~"OARD NOR11ALLY CLOSD>
TAHK o: UOHE
IN-TAil~ ALARt19 ALL:OVERFILL ALARl1 ALL:tllCll PRODUCT ALAAH
StlA!!TBEllSOR SETUI'
s I :DISP 1-2 FLOll 11ETER
CATEOORV AUi Fl.Oii HETER
s 2:Dl9P 3-4 Fl.Oii ttETl!l!
CATEOORV AIR Fl.Oii HETER
s 3:DISP 5-6 Fl.OU t1ETER CATEOORV AIR Fl.OU HETER
• 4 :DISP '1-B FLOW t1ETER CATECORV AIR FLOU HETER
• 7:PRESsUR6 SENSOR • --
CATECORV VAPOR PRESsURE
EVR/ISD SETUP
EVR TYPE: UAIAllCE
BALAllCE 1102ZLE TYPE
VST
VAPOR PROCESSOR TYPE
VST VAPOR PROCESSOR
Al~LVSIS TIHES TIHE: 10!00 AM DELAY MlllllTES:
ACCEPT HIGH ORVR:
DISABLED
I SD llOSE TAD LE ID FP FL HL AA RR ------------------------01 01 01 02 01 uu 02 02 02 02 OI uu
03 03 03 02 02 uu D4 04 04 02 02 uu 05 OS OS 02 03 uu 06 06 06 02 03 uu 07 07 07 02 04 uu DB DB OB 02 04 uu
ISO AIRFLOU HETER HAP ID SERIAL llU1 LABEi.
I 2BDB2 :? 2~945 3 25313 4 24957
DISP 1-2 F
DISP 3-4 F DISP 5-6 F
DISP 7-8 F
ISO FU£L GRADE HOOE MAP I 2 3 4 FP HHH HHll HHH HHH M ------------------------01 IOI no1 201 9 u I 02 102 302 202 9 U I
03 ID3 303 203 u u 2 04 104 304 204 u u 2 OS IDS 30S 205 U U 3 06 106 306 206 u u 3 07 107 307 207 4 u 4 00 IOB 30B 209 4 u 4
LABEL TABLE -----------------1 : Ul:ASSICllED 2: BLEND3 3: RECUIAR 4: HID GRADE 5: PREHIU1
6: GOUl 7: BRONZE B: SILVER 9: BLEH02 10! BLEllD4
PtC SETUP
PtC VERSIOU: 01 .02
VAPOR PROCESSOR TYPE VST VAPOR PROCESSOR
PROCESSOR COllTROL LEVEL: FULL
1W< RUllflt!E 111NtlTCS: 30 om 0.200 INCHES OFF: -0.200 lllCHES
ALARl1 IUSTORV REPORT
-----SVSTEH ALARM ----PAPER OUT AUG 9. 2014 7:49 AM
PRI NTEll ERROR AUG 9. 2014 7!49 AM
M X X X M EffD X X X M X
ALARM HISTORY REPORT
---Ill-TANK ALARM -----
T I :DIESEL
OVERFILL ALARM AIJG 18. 2009 11!00 AM
HIGH PRODUCT ALARt1 AIJG 18. 2009 10!59 AM
lloVALID FUil. LEVEi. AUG 18. 2009 9!42 AM
PROBE OllT
AIJC IB. 2009 11 !02 AM
LOW TEMP IJARlll llO
AUG IB. 2009 11!03 AM
M )( M )( )( EtlD M M M X M
AU\P.1:1 HISTORY REPORT
--I N-TA!IX AU\Rt1
T 2:UtlLEAOEO SOUTH
OVERF I LI. AU\Rt1 JUH 27. 2014 9:27 Hi JU:I 5. 2014 6:52 Ht FEB 14. 2014 9:00 1Y1
HIGH PRODUCT AlARH JUN 27-. 20t4 9:27 P11 JU!I S. 2014 6:52 Ht FEB 14. 2014 9:00 Ht
PROBE OUT AUG t8. 2009 tt:o7 AH
HAX PRODUCT AIARH
JAii 12. 2012 9:33 Ht JlL s. 201 l 9:50 Ht
x x M M x EflD x M x M ><
AI.ARN HISTORY REPORT
----Ill-TANK AU\Rt1 -----
T 3:urn.EADED llORTH
OllERFIU. AlARH 11AV 9. 2014 9:20 AH
11AV S. 2014 5:06 Ht JUL 10. 2013 6:5o 1'11
HIGH PRODUCT ALARt1 11AV 9. 2014 9120 Hi 11AV 9. 2014 5106 Hi
JUL to. 2013 6150 Hi
I hVAL ID FUEL LEVEL AUG 19. 2009 9:49 Hi
PROBE OUT AUG 18. 2009 tt:lt Ht AUG 18. 2009 9:47 AH
LOY Ta1P lJl\Rlll UC AUG 18. 2009 11:12 Hi
W M >< X K EUD >< X M M M
ALAllt1 HISTORY REPORT
----IH•TA!llC ALARN -----
T 4:SIJPREl1E
OVERFILL ALARH JUN 6. 2012 5:55 Pt1 DEC 22. 2011 6:39 Hi AUG 18. 2009 11:14 Hi
HICH PRODUCT ALARH .JUH 6. 2012 5:55 Pl'I
DEX: 22. 2011 6:39 Al1 AUG 10. 2009 It: 13 Al1
trNALID FUEL LEVEL AUG 10. 2009 9:49 Al1
PROD!l OUT AUG ID. 2009 11:16 Ht AUG 18. 2009 tt:t3 1'11 AUG 18. 2009 9:49 "'1
XX1CNXEtCDAKXXM
ALARll HISTORY REPORT
---SEIGOR ALARM -----L I :REOULAR SOUTll AllNULAR SPACE
SEIGOR OUT ALARl1 AUG 13. 2013 12:34 Pt1
SEISOR OUT llLARH AUG 13. 2013 12:32 P11
FUEL AIARH AUG 13. 2013 12:14 Pl1
)( )( )( )( )( £HD )( x )( )( )(
Al.ARI! HISTORY REPORT
-----SENSOR ALARl1 -----L 21RECULAR SOUTH PIPtrlG Bl.tlP FU!ll. ALARH llOV 22. 2013 12:00 Pt1
FUEL ALARl1 HOV 21. 2013 7:04 Pt1
SEIGOR OUT ALARH AUG 13· 2013 12:34 Pt1
XMKMXE:flDXXXMX
ALAllH HISTORY REPORT
-----SEISOR ALllRll -----L 3:REGULAR SOUTH
STP SUMP SEtlSOR OUT ALARH AUG 13. 2Dl3 12:34 Pt1
BEllSOR OUT ALARl1 AUC 13. 2013 12:32 Pl1
FUEL ALARN AUG 13. 2Dl3 12:01 Pt1
X K K )( )( EUD X M M M X
AlARl1 HISTORY REPORT
-----SEtlSOR AU\llH --L 4:RECUU\R NORTH AtltlULAR SPACS
BEtlSOR OUT AU\Rl1 AUO 13. 2013 12:34 PH
SEH90R OUT ALA!i11 AUG 13. 2013 12:32 Pl1
FUEL ALAJ<H AUG 13. 2013 12:14 PH
M M X M )( END M )( X K M
ll1.AAt1 HISTORY REPORT
---SEllSOR ALARH --L S:RECUU\R NORTH PlPlllCl SUMP SENSOR OUT ALARM AUi) 13. 2013 12:34 PH
BEllSOR OUT ALARM AUC 13. 2013 12:32 Pl1
FUEL ALAR!1 AUC 13. 2013 12:22 PH
MMMMX£tl0MXMMX
AlARl1 HISTORY REPORT
----BEllSOR ALAR!1 -----L G:Rl:CULAR llORTH BTP SUMP SEllSOR OUT ALAR!1 AUC 10. 2013 12:34 Pl1
SEllSOR OUT ALARM AUC 13. 2013 12:32 1'11
FUEL ALARM AUC 13. 2013 11:59 AH
M M )( M M END M X M X X
AU\Rt1 HISTORY REPORT
--SENSOR ALARM ----L 7:9UPRE!1E
AllHUL.AR SPACE
SENSOR OUT ALARM AUG 10. 2013 12>35 PH
SEtlSOR OUT Al.ARK AUC 13. 2013 12:32 P11
FUEL AlARl1 . AUC 13. 2013 12:14 PH
x X X X ~ END X X X X X
ALARH HISTORY REPORT
----SEtlSOR ALARH -----L O:SUPREl1S PIPING BlJ1P SEtlSOR OUT AlARl1 AUG 13. 2013 12:34 PH
SEHSOR OUT Al.ARl1 AUG 13. 2013 12:32 1'11
FUEL ALARM AUG 13. 2013 12:10 PH
M X X )( M END X ~ M M M
ALARH HISTORY REPORT
-----SEllSOR ALARH -----L 9:SUPREJ1E STP Sl.tfl' SEllSOR OUT ALARM AUG 13. 2013 12:34 PH
SEllSOR OUT Al.ARM AUG 13. 2013 12:32 Pl1
FUEi. ALARM AUG 13. 2013 11:50 AH
x M )( M M END x >< M M X
ALARl1 ttlSTORV REPORT
-----BtllSOR ALARM -----LI O:Dl ESEL. AHllULAR SPACE SENSOR our ALARH AUG 13. 2013 12:34 PM
SEllSOR our ALARl1 AUG 13. 2013 12!32 PM
FUEL ALAR11 AUG 13. 2013 12:15 Pl1
M )( Jlf M )( EtID )( X )( X )(
ALARl1 HISTORY REPORT
-----SEllSOR ALARl1 ----LI I !DIESEL
PI P lllG SltlP SENSOR our ALARl1 AUG 13, 2013 12:34 Pt1
SEtlSOR our ALARl1 AUG 13. 2013 12:32 Pl1
FU£t. ALARM AUG 13. 2013 12:27 Pl1
M X X M >c: EHD )( X N >< x
AL.AAl't IJJSTORV REPORT
-----SENSOR AtAJlii :: ••• Lt2:01ESEL STP SU1P FUEL ALARl1 ~ 29. 2014 ,,37 Ali
BEllSOR our AL.AAl't
AUG 13. 2013 12:34 Pl1
SEtlSOR our ALARM AUG 13. 2013 12:32 PH
M )( M X M EUD X X >c: >< M
ALAl!tl IHSTORV REPORT
---SENSOR ALARH ----LI 3: DISPENSER 1·2 DISPENSER PAii SEllSOR our ALARM AUG 13, 2013 12!34 PM
SEUSOR our ALARl1 AOO 13. 20l3 12!32 I'll
FUEL ALARH AUG 13. 2013 12!04 PM
XMMXXEIU>MMMXX
ALARM HISTORY REPORT
-----SEllSOR AL.AAl't ---· L14!DISPENSEll 3·4
DISPEllSER PAN SEllSOR our ALARH AUO 13. 2013 12:34 PH
SEllSOR our ALARM AUG 13. 2013 12:32 PH
FUEL ALARM AOO 13. 2013 12!06 Pl1
x X x x x END >< M x x x
ALARH HISTORY REPORT
---SEllSOR ALARH ---LI 5 :DISPENSER 5·6 DISPEtlSER PAii
SEllSOR our AL.AAl't AUC: 13. 2010 12!34 Pl1 . ~ ..
SEllSOR our ALAR11 AUG 13. 2013 12:32 PM
FUEL ALARM AUG 13. 2013 12:07 PM
M x M' M x EtlD x x M x x
SWRCB . .January 2006
Spill Bucket Testing Report Form
'/Jlif.. /011u i~ i11te11tlet/_/(1r tMe In• l'ontrf1ctar\ 11eifonni11g cuuuul/ 1e,1ing of UST spill conla111nu•11f \ll't1cl11re•\. Tire cn111plett'd/nru1111ul
1n'i111out\_/ron1 tests (it a11plicuhlt•), .•:lun1/tl be [JrOl'ided u' tlu..· jat·ilil)· o"?Jer/operatnr for {11hu1l11a/ U> the local regulaton• e1ge1rt·~·.
facilit) Name: Shell
L FACILITY INFORMATION
;:.;.;.;...;;.;"""-;..;....'-'---Tl-o-a1-c-o-rT-c-·,1-i1-,g-:---R.-·1-8.-.201.i
I ac1ht} Addre«s: 4700 C'offc-c Road. Baker<field. ('A 9H08
l'aciliiy Contact: Mall .lcfli'ies ----~1-P-h-01-1e-:--<:-,6-l-4%-7006
---712812014 Dale I ocal Agency Was Notified ofTc•Mg: _
Nun1c of Local Agency Inspector (~'lprese111 during testing): Shane G•rdnc1·
2. TESTING CONTRACTOR INFOR!VlATION
£ompany Name: C:on fi<lcncc UST Services. Inc.
l'c..:hn1cian Conducung l'<'>t: Bryan A S.:Jr
Credentials': X CSLB Cootroct(>( X ICC Service Tc-ch. X SWRCB Tank Tester Other (Sf'<'df)·J -'---'-'-----
l 1ccn.;c Number(s): C'SI B: 80490.t ICC': 8022R04 U I SWRCB: I 1-1756
--------------~-----~
3. SPILL BUCKET TESTING TN FORMATION
l'c•l Method Used: ,_ X llydrostaiic I Yncuun1 IOihcr
I c<t l'quip111c111 Usc-d: I.akc Tcsi Fquip111l11i Resolution: 0.0625"
ldcnlify Spill Bucket (Ry 7i111k I Regular (North) 2 Hc~11l11r (South) 3 Supcr 4 Diesel
,.,,..,,,,.,rn_.r, Storetl Pr{){/11c1. etc. J -
Uuckct ln<Ullation T)JX. l)1rcc1 Bury Oir.i;t Bury Ducci Bury J Dmx:t Bury
'-_X Contained in Swnp X Contained in Swnn X C'tlt113mc-d m Sumo X Contamc'<l 1n Sumi!_
Bucket D1omc1cr: I 2.0<1" 12.00" 12.00·· 12.00··
Bucket Depth: 12.50" 13.00" 13.50" 13.00" ~ ----
W:111 1imc bc1wccn applying 5 111in. 5 rn1n. 5 111in. 5 n1i11. vncuun1/"1atcr and start of lc~t:
I est Sl!lrt rime (T1): '-I I :30am I I :30ttrn 11 :JOam I 1:30am
lniunl Reading (R1): 10.75" 11.50" I 1.00" I f.50" -I e't Lnd I imc [fr): 12:30pm I 2:30ptn 12:J0pm 12:30pm
--
h1wl Reading (Rr): 10.75" I I .50" 11 00" I 1.50" ---I CM Duration (Ir T,): I hour 1 hour I hour I hour
Change in Reading (R, -R1): 0.00" 0.00" 0.00" o.oo··
Pass/l'all l'hrcshold or ~
l'ritcrin: 0.0625" 0.0625" 0.0625" 0.0625"
Tcsl Result: X Pass OFail X Pnss 0 Fail X Pnss D F•il X Pass 0 Fnll ._ .
_f..01n111c11ts -(incllul~ in{t.Jr1n<11ion on rl'pail:'i nuu/e priur to lt!'""S· (Ind reco111111e11ded /(J/lou··up forfailetl te.'its)
CERTIFICATION or TECHNICIAN 1u:sPONSIIII,E FOR CONDUCTING TlllS TF.STIN\.
I ltcrt•hy certify that t1ll the r'11.fi1r111~11fl1i11eJ in tlris report i,\ true~. ~ul iyfull ('tJ111plit111ce H"ilh legal req11ire111t!11t~
I c-chnician ·, Signatur~~L.--:-• ; 2 ::;;> -¥-o..·,,_/ ___ _ Oatc: 8'18'2014
-------./
Stale faw, and regulations do not currc'lltefrequire lcsung to be pcrk>nncd by a quahfic'<l wntrnctor. llm<e\·er. local rc'<(Ull'cmc'lll'
n111y be rnorc srringent.
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Toll Free#: 1-800-33&-9930
Confidence UST
16250 Mcachon1 Ruud
Job Order/ Invoice#: ~Z.102..
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S•teName: <:J'..C/ ~ ( .To~1 "7 ~ • ..,~~ ~.,.-.-)
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TRAVEL and LABOR (0 !t 1-b# l.4;f'ldl.lm LaborCtW'gej OVERTIME (5:00 PM· 7,00AM)
Date Toc:hnottn{&) Name Start End T-OT Start OTEnd OTT°""
c..11 ... ltJ l~ 111~. "' .... L. ,t-Travel A.r/,LL . Labor I ~I.I-
Tra\o'OI AdA
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SUPPLIES -MATERIALS· RENTALS Check Ono
Qly. UST Par1e Siio Por1s
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COMMENTS
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