HomeMy WebLinkAboutFMC 2015MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of CaliforniaAuthority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations
This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each
monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator.
The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date.
A.General Information
Facility Name:Bldg. No.:
Site Address:City:Zip:
Facility Contact Person: Contact Phone No.:
Make/Model of Monitoring System:Date of Testing/Servicing:
B.Inventory of Equipment Tested/Certified
Check the appropriate boxes to indicate specific equipment inspected/serviced:
Tank ID:Tank ID:
In-Tank Gauging Probe.Model:In-Tank Gauging Probe.Model:
Annular Space or Vault Sensor.Model:Annular Space or Vault Sensor.Model:
Piping Sump / Trench Sensor(s).Model:Piping Sump / Trench Sensor(s).Model:
Fill Sump Sensor(s).Model:Fill Sump Sensor(s).Model:
Mechanical Line Leak Detector.Model:Mechanical Line Leak Detector.Model:
Electronic Line Leak Detector.Model:Electronic LineLeak Detector.Model:
Tank Overfill / High-Level Sensor.Model: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).
Tank ID:Tank ID:
In-Tank Gauging Probe.Model:In-Tank Gauging Probe.Model:
Annular Space or Vault Sensor.Model:Annular Space or Vault Sensor.Model:
Piping Sump / TrenchSensor(s).Model:Piping Sump / Trench Sensor(s).Model:
Fill Sump Sensor(s).Model:Fill Sump Sensor(s).Model:
Mechanical Line Leak Detector.Model:Mechanical Line Leak Detector.Model:
Electronic Line Leak Detector.Model:Electronic Line Leak Detector.Model:
Tank Overfill / High-Level Sensor.Model: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 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).
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).
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 Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also
attached a copy of the report;(check all that apply):System set-up Alarm history report
Technician Name (print):Signature:
Certification No.:License. No.:804904
Testing Company Name:Confidence UST Services, Inc.Phone No.:(800)339-9930
Site Address:Date of Testing/Servicing:
Page 1 of 3
SamcoFoodStore#2
3300WhiteLaneBakersfield93309
SamJouda (661)333-7000
Veeder-RootTLS-350 12/02/2015
12,000gal.Regular
847390-107
794390-420 794390-420
794380-208 794380-208
794380-208 794380-208
FX1V
847390-107
12,000gal.Super
847390-107
FX1V
847390-107
794380-208
1-2
794380-208 794380-208
794380-208
794380-208
3-4
5-6 7-8
9-10
794380-208
11-12
AustinSterling
B45438
3300WhiteLane Bakersfield,CA9330912/02/2015
Monitoring System Certification
D.Results of Testing/Servicing
Software Version Installed:
Complete the following checklist:
Yes No*Isthe 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*
N/A
If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem)
operational?
Yes 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) Sump/Trench Sensors; Dispenser Containment Sensors.
Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; No.
Yes No*
N/A
For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no
mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill point(s) and operating properly? If so, at what percent oftank capacity does the alarm trigger? %
Yes*NoWas any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced
and list the manufacturer name and model for all replacement parts in Section E, below.
Yes*NoWas 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:
Page 2 of 3
329.00
90
Monitoring System Certification
F.In-Tank Gauging / SIR Equipment: 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:
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 of system product level readings tested?
Yes 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 the 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.
Complete the following checklist:
Yes No*
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: 3 g.p.h.; 0.1 g.p.h ; 0.2 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*
N/A
For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
Yes No*
N/A
For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
Yes No*
N/A
For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled
or disconnected?
Yes No*
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*
N/A
For electronic LLDs, have all accessible wiring connections been visually inspected?
Yes No*Were all items on the equipment manufacturer’s maintenance checklist completed?
* In the Section H, below, describe how and when these deficiencies were or will be corrected.
H.Comments:
Page 3 of 3
Leak Detector Test Results Sheet
Customer Address: Work Order: Site Address:
Test Date:
Site Contact: Phone:
Technician: Phone: 800-339-9930 ICC No.:
Product Type LLD Type Model Serial No. Check
Valve
Holding
Pressure
Bleed
Off ML.
Leak
Rate
Tested:
Pass/Fail
3 gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
Technician Name: Technician No.:
Signature: Date:
SamcoFoodStore,Inc.
3817WilsonRoad,SuiteB
Bakersfield,CA93309
35525
12/02/2015
8339953-UT
Regular Mechanical FX1V
AustinSterling
(661)333-7000SamJouda
Bakersfield,CA93309
3300WhiteLane
SamcoFoodStore#2
12 psi65 ml Pass
FX1VMechanicalPremium 11 psi55 ml Pass
AustinSterling 8339953-UT
12/02/2015
Samco food store system setup
Responses Received:
200 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 DEC 2, 2015 12:00 PM TANK PRODUCT GALLONS INCHES WATER DEG F ULLAGE 1 SUPREM 3079 29.15 0.0 67.8 8921 2 UNLEADED 4410 37.93 1.6 66.3 7590 I90500 DEC 2, 2015 12:00 PM SOFTWARE REVISION LEVEL VERSION 329.00 SOFTWARE# 346329-100-A CREATED - 08.10.09.17.08 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD I50500 DEC 2, 2015 12:00 PM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM I50201 DEC 2, 2015 12:00 PM SHIFT TIME 1 : DISABLED I50202 DEC 2, 2015 12:00 PM SHIFT TIME 2 : DISABLED
I50203
DEC 2, 2015 12:00 PM SHIFT TIME 3 : DISABLED I50204 DEC 2, 2015 12:00 PM SHIFT TIME 4 : DISABLED I54600 DEC 2, 2015 12:00 PM TANK PER TST NEEDED WRN: DISABLED I54900 DEC 2, 2015 12:00 PM TANK ANN TST NEEDED WRN: DISABLED I55300 DEC 2, 2015 12:00 PM LINE RE-ENABLE METHOD PASS LINE TEST I55600 DEC 2, 2015 12:00 PM LINE PER TST NEEDED WRN: DISABLED I55900 DEC 2, 2015 12:00 PM
LINE ANN TST NEEDED WRN: DISABLED I50D00 DEC 2, 2015 12:00 PM PRINT TC VOLUMES ENABLED I50E00 DEC 2, 2015 12:00 PM TEMP COMPENSATION VALUE (DEG F ): 60.0
I60B00 DEC 2, 2015 12:00 PM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I51400 DEC 2, 2015 12:01 PM H-PROTOCOL DATA FORMAT HEIGHT I51A01 DEC 2, 2015 12:01 PM DAYLIGHT SAVING TIME ENABLED OFF I51B00 DEC 2, 2015 12:01 PM DAYLIGHT SAVING TIME START DATE MAR WEEK 2 SUN 2:00 AM END DATE NOV WEEK 1 SUN 2:00 AM I51600 DEC 2, 2015 12:01 PM RE-DIRECT LOCAL PRINTOUT DISABLED
I50400 DEC 2, 2015 12:01 PM 232 SECURITY CODE PORT SECURITY CODE STATUS 1 000000 DISABLED 2 000000 DISABLED 3 000000 DISABLED 4 000000 DISABLED 5 000000 DISABLED 6 000000 DISABLED
I21900 DEC 2, 2015 12:01 PM TANK CHART SECURITY DISABLED I5BD00 DEC 2, 2015 12:01 PM CUSTOM ALARM LABELS DISABLED I56000 DEC 2, 2015 12:01 PM MASS/DENSITY DISABLED I88101 DEC 2, 2015 12:01 PM PORT SETTINGS: COMM BOARD : 1 (EDIM ) RS-232 SECURITY CODE : DISABLED I88102 DEC 2, 2015 12:01 PM PORT SETTINGS: COMM BOARD : 2 (RS-232) BAUD RATE : 9600 PARITY : EVEN STOP BIT : 1 STOP DATA LENGTH: 7 DATA
RS-232 SECURITY CODE : DISABLED I88103 DEC 2, 2015 12:01 PM PORT SETTINGS: COMM BOARD : 3 (RS-232) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED
I88104 DEC 2, 2015 12:01 PM I88105 DEC 2, 2015 12:01 PM PORT SETTINGS: COMM BOARD : 5 (S-SAT ) BAUD RATE : 9600 PARITY : NONE STOP BIT : 2 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED DTR NORMAL STATE: HIGH I88106 DEC 2, 2015 12:01 PM I52000 DEC 2, 2015 12:01 PM RECEIVER AUTO DIAL TYPE & START TIME RCVR LOCATION LABEL DIAL TYPE START TIME 1 ON DATE ??? 2, 2015 DISABLED 2 ON DATE ??? 2, 2015 DISABLED 3 ON DATE ??? 2, 2015 DISABLED 4 ON DATE ??? 2, 2015 DISABLED 5 ON DATE ??? 2, 2015 DISABLED 6 ON DATE ??? 2, 2015 DISABLED 7 ON DATE ??? 2, 2015 DISABLED 8 VEEDER ROOT (FMS) WEEKLY TUE 4:33 PM I60100 DEC 2, 2015 12:01 PM
TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 SUPREM ON 2 UNLEADED ON 3 OFF 4 OFF I60200 DEC 2, 2015 12:01 PM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 SUPREM 2 UNLEADED
3 4 I60300 DEC 2, 2015 12:01 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 SUPREM 1 2 UNLEADED 2 3 3 4 4 I60900 DEC 2, 2015 12:01 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 SUPREM 0.000700 2 UNLEADED 0.000700 3 0.000000 4 0.000000 I60700 DEC 2, 2015 12:01 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 SUPREM 96.00 2 UNLEADED 96.00 3 0.00 4 0.00 I60A00 DEC 2, 2015 12:01 PM TANK FULL VOLUME
TANK PRODUCT LABEL TANK PROFILE GALLONS 1 SUPREM 1 PT 12000 2 UNLEADED 1 PT 12000 3 1 PT 0 4 1 PT 0 I60400 DEC 2, 2015 12:01 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREM 12000 2 UNLEADED 12000 3 0 4 0 I60500
DEC 2, 2015 12:01 PM TANK 4 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 SUPREM 12000 0 0 0 2 UNLEADED 12000 0 0 0 3 0 0 0 0 4 0 0 0 0 I60600 DEC 2, 2015 12:01 PM TANK 20 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 SUPREM 12000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 UNLEADED 12000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 I61500 DEC 2, 2015 12:01 PM TANK PRODUCT LABEL METER DATA
1 SUPREM NO 2 UNLEADED NO 3 NO 4 NO I62F00 DEC 2, 2015 12:01 PM MAG PROBE FLOAT SIZE TANK PRODUCT LABEL FLOAT SIZE: 1 SUPREM 4.0 INCHES 2 UNLEADED 4.0 INCHES
I62700 DEC 2, 2015 12:01 PM TANK HIGH WATER WARNING LIMIT TANK PRODUCT LABEL INCHES 1 SUPREM 2.0 2 UNLEADED 2.0 9999FF1B I62400 DEC 2, 2015 12:01 PM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 SUPREM 3.0 2 UNLEADED 3.0 I62800 DEC 2, 2015 12:01 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 12000 2 UNLEADED 12000 3 0 4 0 I62300 DEC 2, 2015 12:01 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 10800 2 UNLEADED 10800 3 0 4 0
I62200 DEC 2, 2015 12:01 PM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 11400 2 UNLEADED 11400 3 0 4 0 I62900 DEC 2, 2015 12:01 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS
1 SUPREM 1200 2 UNLEADED 1200 3 0 4 0 I62100 DEC 2, 2015 12:01 PM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 1200 2 UNLEADED 1200 3 0 4 0 I62600 DEC 2, 2015 12:01 PM TANK LEAK ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 99 2 UNLEADED 99 3 99 4 99 I62500 DEC 2, 2015 12:01 PM TANK SUDDEN LOSS LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 99 2 UNLEADED 99 3 99 4 99 I60800 DEC 2, 2015 12:01 PM
TANK TILT TANK PRODUCT LABEL INCHES 1 SUPREM 0.00 2 UNLEADED 0.00 3 0.00 4 0.00 I60B00 DEC 2, 2015 12:01 PM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I60C00
DEC 2, 2015 12:01 PM TANK STICK HEIGHT OFFSET TANK PRODUCT LABEL INCHES 1 SUPREM 0.00 2 UNLEADED 0.00 3 0.00 4 0.00 I61200 DEC 2, 2015 12:01 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 SUPREM NONE NONE 2 UNLEADED NONE NONE 3 NONE NONE 4 NONE NONE I63600 DEC 2, 2015 12:01 PM PERIODIC LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREM 1200 2 UNLEADED 1200 3 0 4 0 I62A00 DEC 2, 2015 12:01 PM ANNUAL LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREM 1200 2 UNLEADED 1200 3 0 4 0
I62C00 DEC 2, 2015 12:01 PM TANK PERIODIC TEST TYPE TANK PRODUCT LABEL PERIODIC TEST TYPE 1 SUPREM STANDARD 2 UNLEADED STANDARD 3 STANDARD 4 STANDARD I62D00 DEC 2, 2015 12:01 PM TANK LEAK TEST FAIL ALARMS
TANK PRODUCT LABEL 1 SUPREM GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 2 UNLEADED GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 3 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 4 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED I63100 DEC 2, 2015 12:01 PM TANK LEAK TEST AVERAGING TANK PRODUCT LABEL ANNUAL PERIODIC 1 SUPREM OFF OFF 2 UNLEADED OFF OFF 3 OFF OFF 4 OFF OFF I63000 DEC 2, 2015 12:01 PM IN-TANK LEAK TEST NOTIFY TANK PRODUCT LABEL TANK TEST NOTIFY: 1 SUPREM OFF 2 UNLEADED OFF 3 OFF 4 OFF
I63200 DEC 2, 2015 12:01 PM TANK TEST SIPHON BREAK TANK PRODUCT LABEL SIPHON BREAK 1 SUPREM OFF 2 UNLEADED OFF 3 OFF 4 OFF I61000 DEC 2, 2015 12:01 PM
TANK DELIVERY DELAY TANK PRODUCT LABEL 1 SUPREM 1 2 UNLEADED 1 3 1 4 1 I63A00 DEC 2, 2015 12:01 PM LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD TANK PRODUCT LABEL PUMP THRESHOLD 1 SUPREM 10.00% 2 UNLEADED 10.00% 3 10.00% 4 10.00% I61100 DEC 2, 2015 12:01 PM LEAK TEST METHOD - - - - - - - - - - - - TEST MONTHLY : ALL TANK WEEK 1 MON START TIME : 2:00 AM TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:ENABLED I61300 DEC 2, 2015 12:01 PM CSLD PROBABLITY OF DETECTION I61400
DEC 2, 2015 12:01 PM CSLD CLIMATE FACTOR I61600 DEC 2, 2015 12:01 PM TANK PRODUCT LABEL CAL UPDATE 1 SUPREM IMMEDIATE 2 UNLEADED IMMEDIATE 3 IMMEDIATE 4 IMMEDIATE I61A00
DEC 2, 2015 12:01 PM IN-TANK LEAK TEST EARLY STOP TANK PRODUCT LABEL TST EARLY STOP: 1 SUPREM ENABLED 2 UNLEADED ENABLED 3 ENABLED 4 ENABLED I61B00 DEC 2, 2015 12:01 PM IN-TANK LEAK GROSS TEST AUTO-CONFIRM I61C00 DEC 2, 2015 12:01 PM CSLD REPORT ONLY I62B00 DEC 2, 2015 12:01 PM TANK LAST ANNUAL TEST TANK PRODUCT LABEL DATE 1 SUPREM ??? 0, 0 2 UNLEADED ??? 0, 0 3 ??? 0, 0 4 ??? 0, 0 I63300 DEC 2, 2015 12:01 PM LEAK TEST REPORT FORMAT: NORMAL
I63400 DEC 2, 2015 12:01 PM RECONCILIATION WARNING LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREM 0 2 UNLEADED 0 3 0 4 0 I63500 DEC 2, 2015 12:01 PM RECONCILIATION ALARM LIMIT
TANK PRODUCT LABEL GALLONS 1 SUPREM 1 2 UNLEADED 1 3 1 4 1 I63900 DEC 2, 2015 12:01 PM ACCU CHART END SHAPE FACTOR TANK PRODUCT LABEL 1 SUPREM END FACTOR: NONE 2 UNLEADED END FACTOR: NONE 3 END FACTOR: NONE 4 END FACTOR: NONE I78000 DEC 2, 2015 12:01 PM I77700 DEC 2, 2015 12:01 PM I77800 DEC 2, 2015 12:01 PM
I78C00 DEC 2, 2015 12:01 PM I78300 DEC 2, 2015 12:01 PM I78F00 DEC 2, 2015 12:01 PM
I78700 DEC 2, 2015 12:01 PM I70200 DEC 2, 2015 12:01 PM LIQUID LABEL DEVICE LABEL 1 DISP 1-2 2 DISP 5-6 3 DISP 3-4 4 DISP 7-8 5 DISP 9-10 6 91 FILL 7 DISP 11-12 8 DISP 3-4 9 87 STP 10 87 ANN 11 87 FILL 12 91 ANN 13 91 STP 14 91 FILL 15 DISP 11-12 16 I70300 DEC 2, 2015 12:01 PM LIQUID TYPE SENSOR LOCATION TYPE 1 DISP 1-2 TRI-STATE (SINGLE FLOAT) 2 DISP 5-6 NORMALLY CLOSED 3 DISP 3-4 NORMALLY CLOSED 4 DISP 7-8 TRI-STATE (SINGLE FLOAT) 5 DISP 9-10 TRI-STATE (SINGLE FLOAT) 6 91 FILL TRI-STATE (SINGLE FLOAT) 7 DISP 11-12 TRI-STATE (SINGLE FLOAT) 8 DISP 3-4 TRI-STATE (SINGLE FLOAT) 9 87 STP TRI-STATE (SINGLE FLOAT)
10 87 ANN TRI-STATE (SINGLE FLOAT) 11 87 FILL TRI-STATE (SINGLE FLOAT) 12 91 ANN TRI-STATE (SINGLE FLOAT) 13 91 STP TRI-STATE (SINGLE FLOAT) 14 91 FILL TRI-STATE (SINGLE FLOAT) 15 DISP 11-12 TRI-STATE (SINGLE FLOAT) 16 TRI-STATE (SINGLE FLOAT) I70400 DEC 2, 2015 12:01 PM LIQUID CATEGORY SENSOR LOCATION CATEGORY 1 DISP 1-2 DISPENSER PAN 2 DISP 5-6 DISPENSER PAN
3 DISP 3-4 DISPENSER PAN 4 DISP 7-8 DISPENSER PAN 5 DISP 9-10 DISPENSER PAN 6 91 FILL PIPING SUMP 7 DISP 11-12 DISPENSER PAN 8 DISP 3-4 DISPENSER PAN 9 87 STP STP SUMP 10 87 ANN ANNULAR SPACE 11 87 FILL PIPING SUMP 12 91 ANN ANNULAR SPACE 13 91 STP STP SUMP 14 91 FILL PIPING SUMP 15 DISP 11-12 DISPENSER PAN 16 OTHER SENSORS I74200 DEC 2, 2015 12:01 PM I74300 DEC 2, 2015 12:01 PM I74400 DEC 2, 2015 12:01 PM I74700 DEC 2, 2015 12:01 PM I74800 DEC 2, 2015 12:01 PM I74900 DEC 2, 2015 12:01 PM
I7BC00 DEC 2, 2015 12:01 PM I80200 DEC 2, 2015 12:01 PM I80300 DEC 2, 2015 12:01 PM I80400
DEC 2, 2015 12:01 PM I80700 DEC 2, 2015 12:01 PM RELAY LABEL DEVICE LABEL 1 POSTITIVE SHUT OFF 2 OVERFILL ALARM 3 4 I80900 DEC 2, 2015 12:01 PM RELAY ORIENTATION RELAY DESIGNATION ORIENTATION 1 POSTITIVE SHUT OFF NORMALLY CLOSED 2 OVERFILL ALARM NORMALLY OPEN 3 NORMALLY OPEN 4 NORMALLY OPEN I80B00 DEC 2, 2015 12:01 PM RELAY TANK ASSIGNMENT RELAY DESIGNATION TANK 1 POSTITIVE SHUT OFF 1 2 OVERFILL ALARM NONE 3 NONE 4 NONE I80A00 DEC 2, 2015 12:01 PM
RELAY TYPE RELAY DESIGNATION TYPE 1 POSTITIVE SHUT OFF STANDARD 2 OVERFILL ALARM STANDARD 3 STANDARD 4 STANDARD I80C00 DEC 2, 2015 12:01 PM I80800 DEC 2, 2015 12:01 PM
RELAY SETUP REPORT R 1:POSTITIVE SHUT OFF TYPE: STANDARD NORMALLY CLOSED TANK #: 1 LIQUID SENSOR ALMS L 1:FUEL ALARM L 2:FUEL ALARM L 3:FUEL ALARM L 4:FUEL ALARM L 5:FUEL ALARM L 7:FUEL ALARM L 9:FUEL ALARM L13:FUEL ALARM L 1:SENSOR OUT ALARM L 2:SENSOR OUT ALARM L 3:SENSOR OUT ALARM L 4:SENSOR OUT ALARM L 5:SENSOR OUT ALARM L 7:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L13:SENSOR OUT ALARM L 1:SHORT ALARM L 2:SHORT ALARM L 3:SHORT ALARM L 4:SHORT ALARM L 5:SHORT ALARM L 7:SHORT ALARM L 9:SHORT ALARM L13:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS
ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL R 2:OVERFILL ALARM TYPE: STANDARD NORMALLY OPEN TANK #: NONE IN-TANK ALARMS ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM ALL:MAX PRODUCT ALARM
R 3: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - R 4: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - I79000 DEC 2, 2015 12:02 PM EDIM:1 VR:349634-003-C TD:06.05.11.11.15 I79100 DEC 2, 2015 12:02 PM I72300 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 SMARTSENSOR ASSIGNMENT
DEVICE LABEL CATEGORY 01 FM 1-2 AIR FLOW METER 02 UNKNOWN 03 FM 5-6 AIR FLOW METER 04 FM 7-8 AIR FLOW METER 05 FM 9-10 AIR FLOW METER 06 FM 11-12 AIR FLOW METER 07 FM 3-4 AIR FLOW METER 08 PS 1-2 VAPOR PRESSURE 09 UNKNOWN 10 UNKNOWN 11 UNKNOWN 12 UNKNOWN 13 UNKNOWN 14 UNKNOWN 15 UNKNOWN 16 UNKNOWN 17 UNKNOWN
18 UNKNOWN 19 UNKNOWN 20 UNKNOWN 21 UNKNOWN 22 UNKNOWN 23 UNKNOWN 24 UNKNOWN 25 UNKNOWN 26 UNKNOWN 27 UNKNOWN 28 UNKNOWN 29 UNKNOWN 30 UNKNOWN 31 UNKNOWN 32 UNKNOWN 33 UNKNOWN 34 UNKNOWN 35 UNKNOWN 36 UNKNOWN 37 UNKNOWN 38 UNKNOWN 39 UNKNOWN 40 UNKNOWN I72A00 DEC 2, 2015 12:02 PM VACUUM SENSOR VOLUME DEVICE LABEL VOLUME IV4E00 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 EVR/ISD SETUP TYPE: VACUUM ASSIST
VACUUM ASSIST TYPE: HEALY VAC IV4F00 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 NOZZLE A/L RANGE A/L RATIO: 0.95 - 1.15 IV4000
DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 VAPOR PROCESSOR TYPE NONE IV4700 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 ASSESSMENT TIME START TIME: 10:00 AM TIME DELAY MINUTES: 1 IV5200 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 ACCEPT HIGH ORVR: YES IV4A00 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487
ISD HOSE TABLE HOSE FP FP AFM HOSE ID ID LABEL ID LABEL 01 33 01 01 BLEND3 02 34 02 01 BLEND3 03 35 03 06 BLEND3 04 00 04 06 BLEND3 05 01 05 02 BLEND3 06 02 06 02 BLEND3 07 03 07 03 BLEND3 08 04 08 03 BLEND3 09 05 09 04 BLEND3 10 06 10 04 BLEND3 11 07 11 05 BLEND3 12 08 12 05 BLEND3
IV4B00 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 PRODUCT/HOSE MAP TABLE FP AFID M1/H1 M2/H2 M3/H3 M4/H4 00 06 02/04 09/04 03/04 xx/xx 01 02 02/05 09/05 03/05 xx/xx 02 02 02/06 09/06 03/06 xx/xx 03 03 02/07 09/07 03/07 xx/xx 04 03 02/08 09/08 03/08 xx/xx 05 04 02/09 09/09 03/09 xx/xx 06 04 02/10 09/10 03/10 xx/xx 07 05 02/11 09/11 03/11 xx/xx 08 05 02/12 09/12 03/12 xx/xx 33 01 02/01 09/01 03/01 xx/xx 34 01 02/02 09/02 03/02 xx/xx 35 06 02/03 09/03 03/03 xx/xx IV4900 DEC 2, 2015 12:02 PM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 LABEL TABLE ID LABEL 01 UNASSIGNED 02 BLEND3 03 REGULAR 04 MID GRADE 05 PREMIUM 06 GOLD 07 BRONZE 08 SILVER
09 BLEND2 10 BLEND4 IV1000 DEC 2, 2015 12:02 PM ISD VERSION: 01.02
Samco chevron white lane alrarm history
Responses Received:
I10200 DEC 2, 2015 8:44 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 8SMARTSENSOR BD 39577 39615 2 4 PROBE / G.T. 163488 163654 3 INTERSTITIAL BD 201296 201422 4 INTERSTITIAL BD 201156 201329 5 UNUSED 9946814 9900994 6 UNUSED 9935037 9881813 7 UNUSED 9939537 9883239 8 UNUSED 9933224 9874372 9 UNUSED 9936843 9882946 10 RELAY BOARD 14977 15007 11 UNUSED 9935925 9881966 12 UNUSED 9938567 9876775 13 UNUSED 9934581 9874659 14 UNUSED 9936104 9877889 15 UNUSED 9936977 9873411 16 UNUSED 9928962 9874280 COMM 1 ELEC DISP INT. 101327 101361 COMM 2 RS232 SERIAL BD 14999 15007 COMM 3 RS232 SERIAL BD 14999 15029 COMM 4 UNUSED 9937985 9881543 COMM 5 SERIAL SAT BD 9935320 480077 COMM 6 UNUSED 9935365 9878958 I90200 DEC 2, 2015 8:44 AM SOFTWARE REVISION LEVEL VERSION 329.00 SOFTWARE# 346329-100-A CREATED - 08.10.09.17.08 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD I11100 DEC 2, 2015 8:44 AM 208402 CHVRNSAMCO 2 3300 WHITE LN.
BAKERSFIELD,CA 93309 661-827 0487
PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME T 1 TANK SUPREM LOW PRODUCT ALARM CLEAR 9-05-15 12:46AM T 1 TANK SUPREM LOW PRODUCT ALARM ALARM 9-04-15 11:27PM f 3 OTHER FM 7-8 CHK VAPOR FLOW MTR CLEAR 8-31-15 4:31PM h 8 OTHER FP8: BLEND3 GROSS COLLECT FAIL CLEAR 8-31-15 4:29PM h 8 OTHER FP8: BLEND3 GROSS COLLECT FAIL ALARM 8-31-15 10:01AM f 3 OTHER FM 7-8 CHK VAPOR FLOW MTR ALARM 8-28-15 10:01AM L11 PIPE 87 FILL FUEL ALARM CLEAR 8-21-15 12:54PM L11 PIPE 87 FILL FUEL ALARM ALARM 8-21-15 12:50PM L14 PIPE 91 FILL FUEL ALARM CLEAR 8-21-15 9:36AM L14 PIPE 91 FILL FUEL ALARM ALARM 8-21-15 9:36AM L11 PIPE 87 FILL FUEL ALARM CLEAR 8-21-15 9:05AM L11 PIPE 87 FILL FUEL ALARM ALARM 8-21-15 9:05AM h 7 OTHER FP7: BLEND3 GROSS COLLECT FAIL CLEAR 8-18-15 5:07PM D 8 OTHER VEEDER ROOT (FMS) AUTODIAL FAILURE CLEAR 8-18-15 10:04AM h 7 OTHER FP7: BLEND3 GROSS COLLECT FAIL ALARM 8-18-15 10:02AM f 3 OTHER FM 7-8 CHK VAPOR FLOW MTR CLEAR 8-18-15 10:00AM D 8 OTHER VEEDER ROOT (FMS) AUTODIAL FAILURE ALARM 8-17-15 10:27AM f 3 OTHER FM 7-8 CHK VAPOR FLOW MTR ALARM 8-16-15 10:02AM T 1 TANK SUPREM LOW PRODUCT ALARM CLEAR 7-25-15 11:44PM T 1 TANK SUPREM LOW PRODUCT ALARM ALARM 7-25-15 5:27PM L14 PIPE 91 FILL FUEL ALARM CLEAR 7-20-15 12:36PM L14 PIPE 91 FILL FUEL ALARM ALARM 7-18-15 9:19PM f 3 OTHER FM 7-8 CHK VAPOR FLOW MTR CLEAR 6-22-15 10:00AM f 3 OTHER FM 7-8 CHK VAPOR FLOW MTR ALARM 6-21-15 10:02AM T 1 TANK SUPREM LOW PRODUCT ALARM CLEAR 6-20-15 5:11PM T 1 TANK SUPREM LOW PRODUCT ALARM ALARM 6-20-15 2:19PM E 1 OTHER COMMUNICATION ALARM CLEAR 5-21-15 2:38PM E 1 OTHER COMMUNICATION ALARM ALARM 5-21-15 2:35PM E 1 OTHER COMMUNICATION ALARM CLEAR 4-26-15 9:20AM E 1 OTHER COMMUNICATION ALARM ALARM 4-26-15 9:17AM L 7 DISP PAN DISP 11-12 FUEL ALARM CLEAR 1-21-15 2:32PM L 7 DISP PAN DISP 11-12 FUEL ALARM ALARM 1-21-15 2:32PM T 2 TANK UNLEADED OVERFILL ALARM CLEAR 1-12-15 2:19AM T 2 TANK UNLEADED OVERFILL ALARM ALARM 1-12-15 2:13AM OTHER ISD GROSS PRES FAIL CLEAR 1-11-15 10:56AM OTHER ISD GROSS PRES FAIL ALARM 1-11-15 10:02AM L14 PIPE 91 FILL FUEL ALARM CLEAR 12-17-14 10:15AM L14 PIPE 91 FILL FUEL ALARM ALARM 12-16-14 9:31AM L14 PIPE 91 FILL FUEL ALARM CLEAR 12-16-14 8:37AM L14 PIPE 91 FILL FUEL ALARM ALARM 12-12-14 3:10AM L13 STP SUMP 91 STP FUEL ALARM CLEAR 12-05-14 10:33AM L13 STP SUMP 91 STP FUEL ALARM ALARM 12-05-14 10:33AM L10 ANNULAR 87 ANN FUEL ALARM CLEAR 12-05-14 9:51AM
L12 ANNULAR 91 ANN FUEL ALARM CLEAR 12-05-14 9:51AM L11 PIPE 87 FILL FUEL ALARM CLEAR 12-05-14 9:51AM L14 PIPE 91 FILL FUEL ALARM CLEAR 12-05-14 9:48AM L12 ANNULAR 91 ANN FUEL ALARM ALARM 12-05-14 9:47AM L10 ANNULAR 87 ANN FUEL ALARM ALARM 12-05-14 9:47AM L14 PIPE 91 FILL FUEL ALARM ALARM 12-05-14 9:44AM L14 PIPE 91 FILL FUEL ALARM CLEAR 12-05-14 9:43AM I11200 DEC 2, 2015 8:44 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487
NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME OTHER ISD GROSS PRES WARN CLEAR 11-25-15 10:51AM SYSTEM PRINTER ERROR CLEAR 11-20-15 11:09AM SYSTEM PAPER OUT CLEAR 11-20-15 11:09AM SYSTEM PRINTER ERROR ALARM 11-20-15 10:51AM SYSTEM PAPER OUT ALARM 11-20-15 10:51AM OTHER ISD GROSS PRES WARN ALARM 11-20-15 10:01AM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN CLEAR 11-15-15 10:00AM OTHER ISD GROSS PRES WARN CLEAR 11-13-15 12:16PM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN ALARM 11-13-15 10:01AM OTHER ISD GROSS PRES WARN ALARM 11-11-15 10:01AM OTHER ISD GROSS PRES WARN CLEAR 11-04-15 3:53PM OTHER ISD GROSS PRES WARN ALARM 11-02-15 10:01AM SYSTEM PRINTER ERROR CLEAR 10-17-15 11:58PM SYSTEM PAPER OUT CLEAR 10-17-15 11:58PM SYSTEM PRINTER ERROR ALARM 10-17-15 11:58PM SYSTEM PAPER OUT ALARM 10-17-15 11:58PM SYSTEM PRINTER ERROR CLEAR 10-17-15 11:57PM SYSTEM PAPER OUT CLEAR 10-17-15 11:57PM SYSTEM PRINTER ERROR ALARM 10-17-15 11:43PM SYSTEM PAPER OUT ALARM 10-17-15 11:43PM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN CLEAR 10-01-15 1:47PM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN ALARM 9-30-15 10:01AM SYSTEM PRINTER ERROR CLEAR 9-27-15 12:10AM SYSTEM PRINTER ERROR ALARM 9-27-15 12:10AM SYSTEM PRINTER ERROR CLEAR 9-16-15 8:11AM SYSTEM PRINTER ERROR ALARM 9-16-15 8:11AM SYSTEM PRINTER ERROR CLEAR 9-16-15 8:11AM SYSTEM PAPER OUT CLEAR 9-16-15 8:11AM SYSTEM PRINTER ERROR ALARM 9-16-15 8:11AM SYSTEM PAPER OUT ALARM 9-16-15 8:11AM SYSTEM PRINTER ERROR CLEAR 9-16-15 8:11AM SYSTEM PAPER OUT CLEAR 9-16-15 8:11AM SYSTEM PRINTER ERROR ALARM 9-16-15 7:56AM SYSTEM PAPER OUT ALARM 9-16-15 7:56AM T 1 TANK SUPREM DELIVERY NEEDED CLEAR 9-05-15 12:46AM T 1 TANK SUPREM DELIVERY NEEDED ALARM 9-04-15 11:26PM OTHER ISD SENSOR OUT WARN CLEAR 8-31-15 4:30PM h 7 OTHER FP7: BLEND3 GROSS COLLECT WARN CLEAR 8-31-15 4:29PM h 8 OTHER FP8: BLEND3 GROSS COLLECT WARN CLEAR 8-31-15 10:00AM h 8 OTHER FP8: BLEND3 GROSS COLLECT WARN ALARM 8-30-15 10:01AM h 7 OTHER FP7: BLEND3 GROSS COLLECT WARN ALARM 8-29-15 10:01AM OTHER ISD SENSOR OUT WARN ALARM 8-28-15 10:01AM h 8 OTHER FP8: BLEND3 GROSS COLLECT WARN CLEAR 8-18-15 5:07PM
OTHER ISD SENSOR OUT WARN CLEAR 8-18-15 10:02AM h 8 OTHER FP8: BLEND3 GROSS COLLECT WARN ALARM 8-18-15 10:02AM h 7 OTHER FP7: BLEND3 GROSS COLLECT WARN CLEAR 8-18-15 10:00AM h 7 OTHER FP7: BLEND3 GROSS COLLECT WARN ALARM 8-17-15 10:02AM OTHER ISD SENSOR OUT WARN ALARM 8-16-15 10:02AM SYSTEM PRINTER ERROR CLEAR 8-14-15 9:26AM SYSTEM PAPER OUT CLEAR 8-14-15 9:26AM I20600 DEC 2, 2015 8:44 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487
TANK ALARM HISTORY TANK 1 SUPREM OVERFILL ALARM DEC 5, 2014 9:26 AM LOW PRODUCT ALARM SEP 4, 2015 11:27 PM JUL 25, 2015 5:27 PM JUN 20, 2015 2:19 PM HIGH PRODUCT ALARM DEC 9, 2013 10:33 AM INVALID FUEL LEVEL DEC 5, 2014 9:27 AM DEC 9, 2013 10:34 AM DEC 9, 2013 9:11 AM PROBE OUT DEC 5, 2014 9:27 AM DEC 5, 2014 9:22 AM DEC 9, 2013 10:33 AM DELIVERY NEEDED SEP 4, 2015 11:26 PM JUL 25, 2015 5:27 PM JUN 20, 2015 2:19 PM LOW TEMP WARNING DEC 5, 2014 9:23 AM TANK 2 UNLEADED OVERFILL ALARM JAN 12, 2015 2:13 AM DEC 5, 2014 9:25 AM AUG 24, 2014 11:52 AM LOW PRODUCT ALARM DEC 5, 2014 9:20 AM DEC 9, 2013 9:08 AM NOV 27, 2013 3:55 PM HIGH PRODUCT ALARM JAN 12, 2015 2:15 AM INVALID FUEL LEVEL DEC 5, 2014 9:26 AM DEC 5, 2014 9:20 AM DEC 9, 2013 9:09 AM PROBE OUT DEC 5, 2014 9:25 AM DEC 5, 2014 9:21 AM
DEC 9, 2013 10:32 AM DELIVERY NEEDED DEC 5, 2014 9:20 AM DEC 9, 2013 9:08 AM NOV 27, 2013 3:55 PM LOW TEMP WARNING DEC 5, 2014 9:22 AM DEC 9, 2013 10:33 AM I38200 DEC 2, 2015 8:44 AM I30200
DEC 2, 2015 8:44 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 DISP 1-2 DEC 5, 2014 9:35 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM DEC 9, 2013 10:14 AM FUEL ALARM 2 DISP 5-6 DEC 5, 2014 9:36 AM FUEL ALARM DEC 5, 2014 9:31 AM FUEL ALARM DEC 9, 2013 10:18 AM FUEL ALARM 3 DISP 3-4 DEC 5, 2014 9:35 AM FUEL ALARM DEC 5, 2014 9:31 AM FUEL ALARM DEC 9, 2013 10:16 AM FUEL ALARM 4 DISP 7-8 DEC 5, 2014 9:36 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM DEC 9, 2013 10:19 AM FUEL ALARM 5 DISP 9-10 DEC 5, 2014 9:37 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM DEC 9, 2013 10:20 AM FUEL ALARM 7 DISP 11-12 JAN 21, 2015 2:32 PM FUEL ALARM DEC 5, 2014 9:37 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM 9 87 STP DEC 5, 2014 9:33 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM DEC 9, 2013 9:44 AM FUEL ALARM 10 87 ANN DEC 5, 2014 9:47 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM DEC 9, 2013 9:56 AM FUEL ALARM 11 87 FILL AUG 21, 2015 12:50 PM FUEL ALARM AUG 21, 2015 9:05 AM FUEL ALARM
DEC 5, 2014 9:41 AM FUEL ALARM 12 91 ANN DEC 5, 2014 9:47 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM DEC 9, 2013 10:00 AM FUEL ALARM 13 91 STP DEC 5, 2014 10:33 AM FUEL ALARM DEC 5, 2014 9:34 AM FUEL ALARM DEC 5, 2014 9:31 AM SENSOR OUT ALARM 14 91 FILL AUG 21, 2015 9:36 AM FUEL ALARM JUL 18, 2015 9:19 PM FUEL ALARM DEC 16, 2014 9:31 AM FUEL ALARM I31600 DEC 2, 2015 8:44 AM
208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 FM 1-2 3 FM 5-6 4 FM 7-8 5 FM 9-10 6 FM 11-12 7 FM 3-4 8 PS 1-2 I40200 DEC 2, 2015 8:44 AM I40300 DEC 2, 2015 8:44 AM I34200 DEC 2, 2015 8:44 AM I34700 DEC 2, 2015 8:44 AM IV0100 DEC 2, 2015 8:44 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309
661-827 0487 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.02 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME :100% STAGE I TRANSFERS: 0 of 0 NOTEST EVR/ISD PASS TIME :100% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 15-11-25 10:02:16 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.47 15-11-24 10:02:02 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.55 15-11-23 10:01:37 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.53
15-11-22 10:01:40 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.49 15-11-21 10:02:02 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.52 15-11-20 10:01:46 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.58 15-11-14 10:01:33 A/L RATIO DEGRADATION FP11 BLEND3 0.80 15-11-13 10:01:48 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.51 15-11-13 10:01:48 A/L RATIO DEGRADATION FP11 BLEND3 0.80 15-11-12 10:01:55 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.49 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-08-31 10:01:15 A/L RATIO GROSS BLOCKAGE FP 8 BLEND3 BLKD 15-08-18 10:02:34 A/L RATIO GROSS BLOCKAGE FP 7 BLEND3 BLKD 15-01-11 10:02:31 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.26 13-11-01 07:53:35 A/L RATIO GROSS BLOCKAGE FP10 BLEND3 BLKD 13-11-01 07:53:35 A/L RATIO GROSS BLOCKAGE FP 5 BLEND3 BLKD 13-10-31 08:32:20 A/L RATIO GROSS BLOCKAGE FP10 BLEND3 BLKD 13-10-31 08:32:20 A/L RATIO GROSS BLOCKAGE FP 7 BLEND3 BLKD 13-10-31 08:32:20 A/L RATIO GROSS BLOCKAGE FP 5 BLEND3 BLKD 13-10-30 08:32:00 A/L RATIO GROSS BLOCKAGE FP10 BLEND3 BLKD 13-10-30 08:32:00 A/L RATIO GROSS BLOCKAGE FP 5 BLEND3 BLKD SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 15-11-25 10:51:56 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-11-13 12:16:59 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-11-04 15:53:25 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-11-01 01:00:00 TIME CHANGE DETECTED AT: 15-11-01 02:00:13 15-10-01 13:47:41 COLLECTION TEST HH01 GRADE TEST MANUALLY CLEARED 15-08-31 16:30:21 SENSOR OUT TEST MANUALLY CLEARED 15-08-31 16:30:16 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-08-31 16:29:57 COLLECTION TEST HH07 GRADE TEST MANUALLY CLEARED 15-08-31 16:29:50 COLLECTION TEST HH08 GRADE TEST MANUALLY CLEARED 15-08-31 11:11:54 PUMPS MANUALLY RE-ENABLED
Samco food store white lane alarm history after
Responses Received:
I10200 DEC 2, 2015 11:58 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 8SMARTSENSOR BD 39577 39574 2 4 PROBE / G.T. 163488 163518 3 INTERSTITIAL BD 201296 201454 4 INTERSTITIAL BD 201156 201267 5 UNUSED 9946814 9849167 6 UNUSED 9935037 9837442 7 UNUSED 9939537 9837196 8 UNUSED 9933224 9840836 9 UNUSED 9936843 9833037 10 RELAY BOARD 14977 14992 11 UNUSED 9935925 9839893 12 UNUSED 9938567 9836208 13 UNUSED 9934581 9838307 14 UNUSED 9936104 9834823 15 UNUSED 9936977 9841010 16 UNUSED 9928962 9835292 COMM 1 ELEC DISP INT. 101327 101338 COMM 2 RS232 SERIAL BD 14999 15014 COMM 3 RS232 SERIAL BD 14999 15037 COMM 4 UNUSED 9937985 9846303 COMM 5 SERIAL SAT BD 9935320 480893 COMM 6 UNUSED 9935365 9844047 I90200 DEC 2, 2015 11:59 AM SOFTWARE REVISION LEVEL VERSION 329.00 SOFTWARE# 346329-100-A CREATED - 08.10.09.17.08 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD I11100 DEC 2, 2015 11:59 AM 208402 CHVRNSAMCO 2 3300 WHITE LN.
BAKERSFIELD,CA 93309 661-827 0487
PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME L 2 DISP PAN DISP 5-6 FUEL ALARM CLEAR 12-02-15 10:17AM L 7 DISP PAN DISP 11-12 SENSOR OUT ALARM CLEAR 12-02-15 10:17AM L 4 DISP PAN DISP 7-8 SENSOR OUT ALARM CLEAR 12-02-15 10:17AM L 3 DISP PAN DISP 3-4 FUEL ALARM CLEAR 12-02-15 10:17AM L 1 DISP PAN DISP 1-2 SENSOR OUT ALARM CLEAR 12-02-15 10:17AM L 5 DISP PAN DISP 9-10 SENSOR OUT ALARM CLEAR 12-02-15 10:17AM L12 ANNULAR 91 ANN SENSOR OUT ALARM CLEAR 12-02-15 10:17AM L11 PIPE 87 FILL SENSOR OUT ALARM CLEAR 12-02-15 10:17AM L14 PIPE 91 FILL SENSOR OUT ALARM CLEAR 12-02-15 10:16AM L10 ANNULAR 87 ANN SENSOR OUT ALARM CLEAR 12-02-15 10:16AM L13 STP SUMP 91 STP SENSOR OUT ALARM CLEAR 12-02-15 10:16AM L 9 STP SUMP 87 STP SENSOR OUT ALARM CLEAR 12-02-15 10:16AM L 4 DISP PAN DISP 7-8 SENSOR OUT ALARM ALARM 12-02-15 10:16AM L 3 DISP PAN DISP 3-4 FUEL ALARM ALARM 12-02-15 10:16AM L 2 DISP PAN DISP 5-6 FUEL ALARM ALARM 12-02-15 10:16AM L 7 DISP PAN DISP 11-12 SENSOR OUT ALARM ALARM 12-02-15 10:16AM L 5 DISP PAN DISP 9-10 SENSOR OUT ALARM ALARM 12-02-15 10:16AM L14 PIPE 91 FILL SENSOR OUT ALARM ALARM 12-02-15 10:16AM L12 ANNULAR 91 ANN SENSOR OUT ALARM ALARM 12-02-15 10:16AM L11 PIPE 87 FILL SENSOR OUT ALARM ALARM 12-02-15 10:16AM L10 ANNULAR 87 ANN SENSOR OUT ALARM ALARM 12-02-15 10:16AM L 1 DISP PAN DISP 1-2 SENSOR OUT ALARM ALARM 12-02-15 10:16AM L13 STP SUMP 91 STP SENSOR OUT ALARM ALARM 12-02-15 10:16AM L 9 STP SUMP 87 STP SENSOR OUT ALARM ALARM 12-02-15 10:16AM T 1 TANK SUPREM PROBE OUT CLEAR 12-02-15 10:10AM T 1 TANK SUPREM PROBE OUT ALARM 12-02-15 10:09AM T 1 TANK SUPREM LOW PRODUCT ALARM CLEAR 12-02-15 10:08AM T 1 TANK SUPREM PROBE OUT CLEAR 12-02-15 10:08AM T 1 TANK SUPREM PROBE OUT ALARM 12-02-15 10:08AM T 1 TANK SUPREM LOW PRODUCT ALARM ALARM 12-02-15 10:07AM T 2 TANK UNLEADED LOW PRODUCT ALARM CLEAR 12-02-15 10:06AM T 2 TANK UNLEADED LOW PRODUCT ALARM ALARM 12-02-15 10:06AM T 2 TANK UNLEADED PROBE OUT CLEAR 12-02-15 10:06AM T 2 TANK UNLEADED OVERFILL ALARM CLEAR 12-02-15 10:05AM T 2 TANK UNLEADED PROBE OUT ALARM 12-02-15 10:05AM T 2 TANK UNLEADED OVERFILL ALARM ALARM 12-02-15 10:05AM T 2 TANK UNLEADED PROBE OUT CLEAR 12-02-15 10:04AM T 2 TANK UNLEADED PROBE OUT ALARM 12-02-15 10:00AM L10 ANNULAR 87 ANN FUEL ALARM CLEAR 12-02-15 9:54AM L10 ANNULAR 87 ANN FUEL ALARM ALARM 12-02-15 9:54AM L12 ANNULAR 91 ANN FUEL ALARM CLEAR 12-02-15 9:50AM L12 ANNULAR 91 ANN FUEL ALARM ALARM 12-02-15 9:50AM L 2 DISP PAN DISP 5-6 FUEL ALARM CLEAR 12-02-15 9:47AM
L 2 DISP PAN DISP 5-6 FUEL ALARM ALARM 12-02-15 9:47AM L 4 DISP PAN DISP 7-8 FUEL ALARM CLEAR 12-02-15 9:46AM L 4 DISP PAN DISP 7-8 FUEL ALARM ALARM 12-02-15 9:45AM L 5 DISP PAN DISP 9-10 FUEL ALARM CLEAR 12-02-15 9:44AM L 5 DISP PAN DISP 9-10 FUEL ALARM ALARM 12-02-15 9:43AM L 7 DISP PAN DISP 11-12 FUEL ALARM CLEAR 12-02-15 9:38AM L 7 DISP PAN DISP 11-12 FUEL ALARM ALARM 12-02-15 9:38AM I11200 DEC 2, 2015 11:59 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487
NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME OTHER ISD GROSS PRES WARN CLEAR 12-02-15 10:24AM OTHER ISD SENSOR OUT WARN CLEAR 12-02-15 10:23AM T 1 TANK SUPREM HIGH PRODUCT ALARM CLEAR 12-02-15 10:10AM T 1 TANK SUPREM HIGH PRODUCT ALARM ALARM 12-02-15 10:08AM T 1 TANK SUPREM DELIVERY NEEDED CLEAR 12-02-15 10:08AM T 1 TANK SUPREM DELIVERY NEEDED ALARM 12-02-15 10:07AM T 2 TANK UNLEADED DELIVERY NEEDED CLEAR 12-02-15 10:06AM T 2 TANK UNLEADED DELIVERY NEEDED ALARM 12-02-15 10:06AM T 2 TANK UNLEADED INVALID FUEL LEVEL CLEAR 12-02-15 10:06AM T 2 TANK UNLEADED INVALID FUEL LEVEL ALARM 12-02-15 10:06AM T 2 TANK UNLEADED HIGH PRODUCT ALARM CLEAR 12-02-15 10:05AM T 2 TANK UNLEADED HIGH PRODUCT ALARM ALARM 12-02-15 10:05AM OTHER ISD SENSOR OUT WARN ALARM 12-02-15 10:02AM OTHER ISD GROSS PRES WARN ALARM 12-02-15 10:02AM OTHER ISD GROSS PRES WARN CLEAR 11-25-15 10:51AM SYSTEM PRINTER ERROR CLEAR 11-20-15 11:09AM SYSTEM PAPER OUT CLEAR 11-20-15 11:09AM SYSTEM PRINTER ERROR ALARM 11-20-15 10:51AM SYSTEM PAPER OUT ALARM 11-20-15 10:51AM OTHER ISD GROSS PRES WARN ALARM 11-20-15 10:01AM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN CLEAR 11-15-15 10:00AM OTHER ISD GROSS PRES WARN CLEAR 11-13-15 12:16PM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN ALARM 11-13-15 10:01AM OTHER ISD GROSS PRES WARN ALARM 11-11-15 10:01AM OTHER ISD GROSS PRES WARN CLEAR 11-04-15 3:53PM OTHER ISD GROSS PRES WARN ALARM 11-02-15 10:01AM SYSTEM PRINTER ERROR CLEAR 10-17-15 11:58PM SYSTEM PAPER OUT CLEAR 10-17-15 11:58PM SYSTEM PRINTER ERROR ALARM 10-17-15 11:58PM SYSTEM PAPER OUT ALARM 10-17-15 11:58PM SYSTEM PRINTER ERROR CLEAR 10-17-15 11:57PM SYSTEM PAPER OUT CLEAR 10-17-15 11:57PM SYSTEM PRINTER ERROR ALARM 10-17-15 11:43PM SYSTEM PAPER OUT ALARM 10-17-15 11:43PM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN CLEAR 10-01-15 1:47PM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN ALARM 9-30-15 10:01AM SYSTEM PRINTER ERROR CLEAR 9-27-15 12:10AM SYSTEM PRINTER ERROR ALARM 9-27-15 12:10AM SYSTEM PRINTER ERROR CLEAR 9-16-15 8:11AM SYSTEM PRINTER ERROR ALARM 9-16-15 8:11AM SYSTEM PRINTER ERROR CLEAR 9-16-15 8:11AM SYSTEM PAPER OUT CLEAR 9-16-15 8:11AM SYSTEM PRINTER ERROR ALARM 9-16-15 8:11AM
SYSTEM PAPER OUT ALARM 9-16-15 8:11AM SYSTEM PRINTER ERROR CLEAR 9-16-15 8:11AM SYSTEM PAPER OUT CLEAR 9-16-15 8:11AM SYSTEM PRINTER ERROR ALARM 9-16-15 7:56AM SYSTEM PAPER OUT ALARM 9-16-15 7:56AM T 1 TANK SUPREM DELIVERY NEEDED CLEAR 9-05-15 12:46AM T 1 TANK SUPREM DELIVERY NEEDED ALARM 9-04-15 11:26PM I20600 DEC 2, 2015 11:59 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487
TANK ALARM HISTORY TANK 1 SUPREM OVERFILL ALARM DEC 5, 2014 9:26 AM LOW PRODUCT ALARM DEC 2, 2015 10:07 AM SEP 4, 2015 11:27 PM JUL 25, 2015 5:27 PM HIGH PRODUCT ALARM DEC 2, 2015 10:08 AM DEC 9, 2013 10:33 AM INVALID FUEL LEVEL DEC 5, 2014 9:27 AM DEC 9, 2013 10:34 AM DEC 9, 2013 9:11 AM PROBE OUT DEC 2, 2015 10:09 AM DEC 2, 2015 10:08 AM DEC 5, 2014 9:27 AM DELIVERY NEEDED DEC 2, 2015 10:07 AM SEP 4, 2015 11:26 PM JUL 25, 2015 5:27 PM LOW TEMP WARNING DEC 5, 2014 9:23 AM TANK 2 UNLEADED OVERFILL ALARM DEC 2, 2015 10:05 AM JAN 12, 2015 2:13 AM DEC 5, 2014 9:25 AM LOW PRODUCT ALARM DEC 2, 2015 10:06 AM DEC 5, 2014 9:20 AM DEC 9, 2013 9:08 AM HIGH PRODUCT ALARM DEC 2, 2015 10:05 AM JAN 12, 2015 2:15 AM INVALID FUEL LEVEL DEC 2, 2015 10:06 AM DEC 5, 2014 9:26 AM DEC 5, 2014 9:20 AM
PROBE OUT DEC 2, 2015 10:05 AM DEC 2, 2015 10:00 AM DEC 5, 2014 9:25 AM DELIVERY NEEDED DEC 2, 2015 10:06 AM DEC 5, 2014 9:20 AM DEC 9, 2013 9:08 AM LOW TEMP WARNING DEC 5, 2014 9:22 AM DEC 9, 2013 10:33 AM I38200 DEC 2, 2015 11:59 AM
I30200 DEC 2, 2015 11:59 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 DISP 1-2 DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:36 AM FUEL ALARM DEC 5, 2014 9:35 AM FUEL ALARM 2 DISP 5-6 DEC 2, 2015 10:16 AM FUEL ALARM DEC 2, 2015 9:47 AM FUEL ALARM DEC 5, 2014 9:36 AM FUEL ALARM 3 DISP 3-4 DEC 2, 2015 10:16 AM FUEL ALARM DEC 2, 2015 9:35 AM FUEL ALARM DEC 5, 2014 9:35 AM FUEL ALARM 4 DISP 7-8 DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:45 AM FUEL ALARM DEC 5, 2014 9:36 AM FUEL ALARM 5 DISP 9-10 DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:43 AM FUEL ALARM DEC 5, 2014 9:37 AM FUEL ALARM 7 DISP 11-12 DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:38 AM FUEL ALARM JAN 21, 2015 2:32 PM FUEL ALARM 9 87 STP DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:31 AM FUEL ALARM DEC 2, 2015 9:21 AM FUEL ALARM 10 87 ANN DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:54 AM FUEL ALARM DEC 5, 2014 9:47 AM FUEL ALARM 11 87 FILL
DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:30 AM FUEL ALARM AUG 21, 2015 12:50 PM FUEL ALARM 12 91 ANN DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:50 AM FUEL ALARM DEC 5, 2014 9:47 AM FUEL ALARM 13 91 STP DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:33 AM FUEL ALARM DEC 5, 2014 10:33 AM FUEL ALARM 14 91 FILL DEC 2, 2015 10:16 AM SENSOR OUT ALARM DEC 2, 2015 9:30 AM FUEL ALARM AUG 21, 2015 9:36 AM FUEL ALARM
I31600 DEC 2, 2015 11:59 AM 208402 CHVRNSAMCO 2 3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 FM 1-2 3 FM 5-6 4 FM 7-8 5 FM 9-10 6 FM 11-12 7 FM 3-4 8 PS 1-2 I40200 DEC 2, 2015 11:59 AM I40300 DEC 2, 2015 11:59 AM I34200 DEC 2, 2015 11:59 AM I34700 DEC 2, 2015 11:59 AM IV0100 DEC 2, 2015 11:59 AM 208402 CHVRNSAMCO 2
3300 WHITE LN. BAKERSFIELD,CA 93309 661-827 0487 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.02 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :WARN EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :WARN ISD MONITOR UP-TIME :100% STAGE I TRANSFERS: 0 of 0 NOTEST EVR/ISD PASS TIME : 0% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 15-12-02 10:02:33 SENSOR OUT SELFTEST T 2
15-12-02 10:02:33 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.47 15-11-25 10:02:16 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.47 15-11-24 10:02:02 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.55 15-11-23 10:01:37 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.53 15-11-22 10:01:40 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.49 15-11-21 10:02:02 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.52 15-11-20 10:01:46 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.58 15-11-14 10:01:33 A/L RATIO DEGRADATION FP11 BLEND3 0.80 15-11-13 10:01:48 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.51 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-08-31 10:01:15 A/L RATIO GROSS BLOCKAGE FP 8 BLEND3 BLKD 15-08-18 10:02:34 A/L RATIO GROSS BLOCKAGE FP 7 BLEND3 BLKD 15-01-11 10:02:31 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.26 13-11-01 07:53:35 A/L RATIO GROSS BLOCKAGE FP10 BLEND3 BLKD 13-11-01 07:53:35 A/L RATIO GROSS BLOCKAGE FP 5 BLEND3 BLKD 13-10-31 08:32:20 A/L RATIO GROSS BLOCKAGE FP10 BLEND3 BLKD 13-10-31 08:32:20 A/L RATIO GROSS BLOCKAGE FP 7 BLEND3 BLKD 13-10-31 08:32:20 A/L RATIO GROSS BLOCKAGE FP 5 BLEND3 BLKD 13-10-30 08:32:00 A/L RATIO GROSS BLOCKAGE FP10 BLEND3 BLKD 13-10-30 08:32:00 A/L RATIO GROSS BLOCKAGE FP 5 BLEND3 BLKD SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 15-12-02 10:24:11 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-12-02 10:23:40 SENSOR OUT TEST MANUALLY CLEARED 15-12-02 10:15:25 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS 15-12-02 10:15:25 ISD STARTUP 15-12-02 10:14:41 ISD SHUTDOWN 15-11-25 10:51:56 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-11-13 12:16:59 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-11-04 15:53:25 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-11-01 01:00:00 TIME CHANGE DETECTED AT: 15-11-01 02:00:13 15-10-01 13:47:41 COLLECTION TEST HH01 GRADE TEST MANUALLY CLEARED
SWRCB, January 2006
Spill Bucket Testing Report Form
This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and
printouts from tests (if applicable), should be provided to the facility owner/operator forsubmittal to the local regulatory agency.
1.FACILITY INFORMATION
Facility Name:Date of Testing:
Facility Address:
Facility Contact:Phone:
Date Local Agency Was Notified of Testing :
Name of Local Agency Inspector (if present during testing):
2.TESTING CONTRACTOR INFORMATION
Company Name:Confidence UST Services, Inc.
Technician Conducting Test:
Credentials1:CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Specify)
License Number(s):CSLB#804904 ICC#
3.SPILL BUCKET TESTING INFORMATION
Test Method Used:Hydrostatic Vacuum Other
Test Equipment Used:Lake TestEquipment Resolution:0.0625”
Identify Spill Bucket (By Tank
Number, Stored Product, etc.)
1234
Bucket Installation Type: Direct Bury
Contained in Sump
Direct Bury
Contained in Sump
Direct Bury
Contained in Sump
Direct Bury
Contained in Sump
Bucket Diameter:
Bucket Depth:
Wait time between applying
vacuum/water and start of test:
Test Start Time (TI):
Initial Reading (RI):
Test End Time (TF):
Final Reading (RF):
Test Duration (TF – TI):
Change in Reading (RF -RI):
Pass/Fail Threshold or
Criteria:
Test Result: Pass Fail Pass Fail Pass Fail Pass Fail
Comments –(include information on repairs made prior to testing, and recommended follow-up for failed 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:________________________________________________ Date:_________
1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
SamcoFoodStore#2 12/02/2015
3300WhiteLane Bakersfield,CA93309
SamJouda(661)333-7000
11/11/2015
AustinSterling
8339953-UT
Regular
12.00"
10.50"
5min.
9:25 am
9.50"
10:25 am
9.50"
1hour
0.00"
0.0625"
Super
12.00"
10.00"
5min.
9:25 am
9.00"
10:25 am
9.00"
1hour
0.00"
0.0625"
12/02/2015