HomeMy WebLinkAbout2013 RESULTSMONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of California
Alllhority 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 this date.
A. General Information
Facility Name: California Chevron
Site Address: 4100 California Avenue City: Bakersfield
Bldg. No.: -----
Zip: 93309
Facility Contact Person: Sam Jouda Contact Phone No.: 661-333-0000 ----------------------~~~~~~~------
Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 2/12/2013
Tank 10: 10000 gal. Regular North Tank 10: 10000 gal. Regular South
~ In-Tank Gauging Probe. Model:847390-107 (i] In-Tank Gauging Probe. Model: 847390-107 w Annular Space or Vault Probe. Mode 1: 794390-409 w Annular Space or Vault Sensor. Model: 794390-409 w Piping Sump I Trench Sensor(s). Model: 794380-420 w Piping Sump I Trench Sensor(s). Model: Ronan
0 Fill Sump Sensor(s) Model: 0 Fill Sump Sensor(s). Model:
liJ Mechanical Line Leak Detector. Model:FX1V w Mechanical Line Leak Detector. Model: FX1V
0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: w Tank Overfill / High Level Sensor. Model: OPW 61-SO w Tank Overfill / High Leva! Sensor. Model: OPW61-SO
D Other (specify equip. type and model in Sec. Eon Pg. 2) 0 Other (specify equip. type and model in Sec. E on Pg. 2)
Tank ID: 10000 gal. Regular (Si~hon) Tank 10: 10000 gal. Su~er
[x] In-Tank Gauging Probe. Model :847390-107 w In-Tank Gauging Probe. Model: 847390-107 w Annular Space or Vault Sensor. Model: 794390-409 [xJ Annular Space or Vault Sensor. Model: 794380-409
!il Piping Sump I Trench Sensor(s). Model:Ronan w Piping Sump I Trench Sensor(s). Model: 794380-420
0 Fill Sump Sensors(s). Model: 0 Fill Sump Sensor(s). Model:
0 Mechanical Line Leak Decector. Model: w Mechanical Line Leak Detector. Model: FX1V
0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: w Tank Overfill / High Level Sensor. Model:OPW 61-SO w Tank Overfill / High Level Sensor. Model: OPW 61-SO
0 Other (specify equip. type and model in Sec. E on Pg. 2) 0 Other (specify equip. typs and model in Sec. Eon Pg. 2)
Dispenser 10: 1&2 Dispenser ID: 3&4
0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model:
[X] Shear Valve(s). (i] Shear Valve(s).
W Dispenser Containment Float(s) and Chain(s). W Dispenser Containment Float(s) and Chain(s)
Dispenser ID: 5&6 Dispenser ID: 7&8
0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model:
W Shear Valve(s). W Shear Valve(s).
~ Dispenser Containment Float(s) and Chains(s). W Dispenser Containment Float(s) and Chain(s).
Dispenser ID: 9 & 10 Dispenser ID: 11 & 12
0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model:
W Shear Valve(s). W Shear Valve(s).
[xJ Dispenser Containment Float(s) and Chain(s) W Dispenser Containment Float(s) and Chain(s). . . . . *If the facl11ty contams more tanks or d1spensers, copy th1s form. Include mformahon for every tank and d1spenser at the fac1hty .
C. Certification -1 certify that the equipment identified in this document was inspected/services in accordance with the
manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that
this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating
such reports, I have attached a copy of the report; (check all that apply) 0 System Set-u x Alarm history report
Technician Name (print): Bradley Seykora Signature: ---7"-~::=-l!~-s:::af~~====-----
Certification No: 840738 License No: 8049 ~~~----------------------------~~~---------------------------
Testing Company Name: Confidence UST Services, Inc. Phone No: 800-339-9930
Site Address: 4100 California Avenue , Bakersfield, CA 93309 Date of Testing/Servicing: _2_11_2_12_0_13 ____ _
MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of California
Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations
This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be
prepared for each monitoring system control panel by the technician who perf01ms 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 this date.
A. General Information
Facility Name: California Chevron Bldg. No.: -----
Site Address: 4100 California Avenue City: Bakersfield Zip: 93309
Facility Contact Person: Sam Jouda Contact Phone No.: 661-333-0 000 -~~~----------------------------~~~~~~---------
Make/Model of Monitoring System: _V;....;e;;...;e;;...;d;;..;e:..;..r....:.-R....:.o=-o=-t;....;T.:...;L=-S=--=3-=5-=0---------____:Date of Testing/Servicing: 2/1 2/2013
Tank ID: 10000 gal. Regular Diesel TankiD:
~ In-Tank Gauging Probe. Model:847390-107 D In-Tank Gauging Probe. Model:
[i] Annular Space or Vault Probe. Model: 794390-409 D Annular Space or Vault Sensor. Model:
[i] Piping Sump I Trench Sensor(s). Model: Ronan D Piping Sump I Trench Sensor(s). Model:
D Fill Swnp Sensor(s) Model: D Fill Sump Sensor(s). Model:
liJ Mechanical Line Leak Detector. Model: FX1 DV D Mechanical Line Leak Detector. Model:
D Electronic Line Leak Detector. Model: D Electronic Line Leak Detector. Model:
[i] Tank Overfill I High Level Sensor. Model: OPW 61-SO D Tank Overfill I High Leval Sensor. Model:
0 Other (specifY equip. type and model in Sec. Eon Pg. 2) D Other (specify equip. type and model in Sec. Eon Pg. 2)
Tank ID: Tank ID:
D In-Tank Gauging Probe. Model: D In-Tank Gauging Probe. Model:
D Annular Space or Vault Sensor. Model: D Annular Space or Vault Sensor. Model:
D Piping Sump I Trench Sensor(s). Model: D Piping Sump I Trench Sensor(s). Model:
D Fill Sump Sensors(s). Model: D Fill Sump Sensor(s). Model:
0 Mechanical Line Leak Decector. Model: 0 Mechanical Line Leak Detector. Model:
D Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model:
D Tank Overfi ll I High Level Sensor. Model: D Tank Overfill I High Level Sensor. Model:
0 Other (specify equip. type and model in Sec. Eon Pg. 2) 0 Other (specify equip. typs and model in Sec. Eon Pg. 2)
Dispenser I D: Dispenser ID:
0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model:
0 Shear Valve(s). 0 Shear Valve(s).
0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containm ent Float(s) and Chain(s)
Dispenser ID: Dispenser I D:
0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containm ent Sensor(s). Model:
0 Shear Valve(s). 0 Shear Valve(s).
O Dispenser Containment Float(s) and Chains(s). D Dispenser Containment Float(s) and Chain(s).
Dispenser ID: Dispenser ID:
0 Dispenser Containment Sensor(s). Model: D Dispenser Containment Sensor(s). Model:
D Shear Valve(s). D Shear Valve(s).
0 Dispenser Containment Float(s) and Chain(s) 0 Dispenser Containment Float(s) and Chain(s).
. . . . *If the fac1llty contams more tanks or d1spensers, copy th1s form. Include mformat1on for every tank and d1spenser at the fac1llty .
C. Certification -I certify that the equipment identified in this document was inspected/services in accordance with the
manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that
this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating
such reports, I have attached a copy of the report; (check all that apply) I!] System Set-up x Alarm history report
Technician Name (print): =B.:.::ra:..:d.:.::le".!..y:..:S:..:e.!_yk:.:..:o:..:..ra=-------------Signature: -....L.~~~o;::::;~!ii:::=::::::::===:=::::...----
Certification No: ..:::84~0:.:7:..:3~8 ________________ _
Testing Company Name: Confidence UST Services, Inc.
Site Address: 4100 California Avenue , Bakersfield, CA 93309
Phone No: 800-339-9930
Date of Testing/Servicing: _2_11_2_12_0_13 ___ _
D. Results ofTesting/Servicing
Software Version Installed: 327.04 -------------------------------
Complete the following checklist:
Iii Yes D No* Is the audible alarm operational?
X Yes r l No* Is the Visual alann operational?
X Yes r l No* Were all sensors visually inspected, functionally tested, and confirmed operational?
~ Yes ONo* Were all sensors installed at the lowest point of secondary containment and positioned so that other
equipment will not interfere with their proper operation?
DYes @No* If alanns are relayed to a remote monitoring station, is all communications equipment (e.g. modem)
N/A operational? lliJ Yes 0No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary
ON/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes:
which sensors initate positive shut-down? ~ Sump/Trench SensorsD Dispenser Containment Sensors
Did you confirm positive shut-down due to leaks and sensor failure/discormected? [iJ Yes; D No;
0 Yes 0No* 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 alann visual and audible at
the tank fill point(s) and operating properly? If so, at what percent oftank capasity does the alann
trigger? l 61 -SO J %
~Yes* 0No Was any monitoring equipment replaced? If Yes, identity specific sensors, probes, or other equipment
replaced and list the manufacturer name and model for all replacement parts in Section E, below.
DYes* ~No Was liquid found inside any secondary containment systems designed as dry systems?
D Product; 0 Water. If yes, describe causes in Section E, below.
IT X YP." r l No* Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable.
[x Yes r l No* Is all monitoring equipment operational per manufacturer's specifications?
* In Section E below, discribe how and when these deficiencies were or will be corrected.
E. Comments: The 91 STP sensor went into alam1 but would not go out of alann during testing. a new 420 sensor was
installed, tested and confirmed operational.
F. In-Tank Guaging I SIR Equipment: [x] Check this box if tank guaging is used only for inventory control.
D Check this box if tank guaging or SIR equipment is installed.
This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring.
Complete the following checkl ist:
'-~Yes D No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults?
x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
X Yes No* Was accuracy of system product level readings tested?
X Yes No* Was accuracy of system water level readings tested?
_x Yes No* Were all probes reinstalled properly?
~Yes D 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): D Check this box if LLD's are not installed.
c I t th t II h kl" t omp1e e e o owmg c ec IS :
[iJ Yes 0No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance?
(Check all that apply) Simulated leak rate: ~3 g.p.h.: 00.1 g.p.h.; 00.2 g.p.h.;
l,0Yes D No* Were all LLD's confirmed operational and accurate within regulatory requirments?
l.xJ Yes No* Was the testing apparatus properly calibrated?
~Yes No* For machanical LLD's, does the LLD restrict product flow if it detects a leak?
1-N/A
DYes =-= No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak?
[x] N/A
DYes L-JNo* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is
[x] N/A disabled or disconnected?
DYes ~No*
~N/A
For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system
malfunction or fails a test?
DYes 0No* For electronic LLD's, have all accessible wiring connections been visually inspected?
1-F ~N/A
[i] 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:
CALIFORNIA CHEVON
4100 CALIFORNIA AVE BKRSFLD CA 93309 661-336-0263
FEB 12, 2013 9:03 AM
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
INVENTORY REPORT
T 1 :UNLEADED NORTH VOLUME • 3839 GALS ULLAGE • 5845 GALS 90% ULLAGE• 4876 GALS TC VOLUME • 3847 GALS HEIGHT • 37.24 INCHES WATER VOL D 0 GALS
WATER • 0.00 INCHES TEMP M 56.8 DEG F
T 2:SUPREME VOLUME • 3488 GALS ULLAGE • 619b GALS 90% ULLAGE• 5227 GALS TC VOLLI"1E • 3495 GALS HEIGHT • 34.71 INCHES
WATER VOL • 0 GALS WATER • 0.00 INCHES TEMP • 57.0 DEC F
T 3:UNLEADED SIPHON VOLUME • 3559 GALS ULLAGE • 6125 GALS 90% ULLAGE• 5156 GALS
TC VOLUME • 3560 GALS HEIGHT • 35.23 INCHES
WATER VOL • 0 GALS WATER • 0.00 INCHES TEMP • 59.7 DEG F
T 4!UNLEHDED SOUTH VOLLttE • ULLAGE .,
9Cl'o ULLAGE•
TC VOLUME • HEIGHT ..
WATER VOL ..
WATER • TEMP •
T 5:01ESEL
4074 GALS 5610 GALS 4641 GALS 4074 GALS 38.92 INCHES
0 GALS 0.00 INCHES
59.7 DEG F
VOLLtlE • 2236 GALS ULLAGE c 7448 GALS 90% ULLAGE= 64'19 GALS
TC VOLLII'1E • 2221 GALS HEIGHT ... 25. 20 I NCHE.S WATER VOL 0 GALS
WATER • 0.00 INCHES TEMP • 68.9 DEG F
MANIFOLDED TANKS
INVENTORY TOTALS
T t :UNLEADED NORTH T 3:UNLEADED SIPHON T 4:UNLEADED SOUTH
VOLUME • 11472 GALS TC VOLUME • 11481 GALS
SOFTWARE REVISION LEVEL VERSION 327.04
SOFTWARE~ 346327-100-E CREATED -07.02.06.10.28
S-110DULE1i 330160-004 -a SYS~EM FEATURES:
PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS lSD
PMC
SYSTEM SETUP
FEB 12. 2013 9:04 AM
SYSTEM UNITS u.s.
SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM
CALIFORNIA CHEVON 4100 CALIFORNIA AVE
BKRSFLD CA 93309 661-336-0263
SHIFT TIME I
SHIFT TIME 2 SHIFT TIME 3 SHIFT TIME 4
5:00 AM
DISABLED DISABLED DISABLED
TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED
LINE RE-ENABLE METHOD PASS LINE TEST
LINE PER TST NEEDED WRN DISABLED
LINE ANN TST NEEDED WRN DISABLED
i'J\ 1 1 .. 1 1V VV.L..U 11:.0
ENABLED
TEMP COMPEl-sAT I ON
VALUE <DEG F >: 60.0 STICK HEIGHT OFFSET DISABLED
ULLAGE: 90%
H-PROTOCOL DATA FORMAT
HEIGHT DAYLIGHT SAVING TIME
ENABLED START DATE APR l~EEK SUN
S~ART TIME 2:00 Al"l
END DATE OCT WEEK 6 SUN END TIME 2:00 AM
RE-DIRECT LOCAL PRINTOUT DISABLED
EURO PROTOCOL PREFIX s
SYSTEM SECURITY CODE : 000000
MAINTENANCE HISTORY
DISABLED
TANK CHART SECURITY
DISABLED
CUSTOM ALARI"S DISABLED
1"\ASS/DENSITY DISABLED
COMMUNICATIONS SETUP
PORT SETTINGS:
COMM BOARD 1 <RS-232>
BAUD RATE 9600 PARITY NONE STOP BIT : 1 STOP
DATA LEr«;TH: 8 DATA RS-232 SECURITY
CODE : DISABLED
COMM BOARD 2 <RS-232> BAUD RATE 9600 PAR ITY EVEN STOP BIT : I STOP DATA LENGTH: 7 DATA RS-232 SECURITY CODE : DISABLED
COMM BOARD : 3 (EDIM > RS-232 SECURITY CODE : DISABLED
AUTO TRANSMIT SETTINGS:
AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT
DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END
DISABLED AUTO EXTERNAL INPUT ON
DISABLED AUTO EXTERNAL INPUT OFF
DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM
DISABLED AUTO SENSOR OUT ALARM
DISABLED
RS-232 END OF MESSAGE DISABLED
IN-TANK SETUP
T l :UNLEADED NORTH PRODUCT CODE THERMAL COEFF 1 :. 000700 89 .75 4 PTS 9684 7891 4918
1900
TANK DIAI"IETER TANK PROFILE FULL VOL 67.3 lOCH VOL 44.9 lOCH VOL
22.4 INCH VOL
FLOAT SIZE: 4.0 IN .
WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0
HAX OR LABEL VOL: 9684 OVERFILL LIMIT 92% 8909 HIGH PRODUCT 98% 9490 DEL IVERY LIMI T 5%
500
LOW PRODOCT : 500
LEAK ALAR~·LIMJT: 99 SUDDEN LOSS LIMIT: 99
TANK TILT : I. 75 PROBE OFFSET 0.00
SIPHON MANIFOLDED TANKS T#: 03.04 LINE MANIFOLDED TANKS
Til: 03.04
LEAK MIN PERIODIC: 1%
100
LEAK MIN ANNUAL 1% 100
PERIODIC TEST TYPE STI-INDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIOD IC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVER~¥> I NG : OFF
PER TEST AVERACir«;: OFF
TAN~ TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELI VERY DELAY : 1 I'll N
PUMP THRESHOLD : I 0 . 00%
T 2:SUPREME
PRODUCT CODE THERMAL COEFF
TANK DIAMETER TANK PROFILE FULL VOL 67 .3 INCH VOL 44 .9 INCH VOL 22.4 INCH VOL
FLOAT SIZE:
2 : .000700 : 89.75
4 PTS 9684 7891 4918 1900
4.0 IN.
WATER WARNING : 2 .0
HIGH WATER LIM IT: 3 .0
MAX OR LABEL VOL: 9684 OVERFILL LIMIT 92% 8909 HIGH PRODUCT 98%
9490 DELIVERY LIMIT 5% 500
LOW PRODUCT : 500 LEAK ALARM LIM IT: 99 SUDDEN LOSS LIMIT : 99 TANK TILT 3.40
PROAE OFFSET 0.00
SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS T#: NONE
LEAK MIN PERIODIC:
LEAK MIN ANNUAL
1 •• ,,
100
lYe 100
PERIODIC TEST TYPE STANDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARI'1 DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 1 MIN PUMP THRESHOLD : 10 .00%
T 3:UNLEADED SIPHON
PRODUCT CODE : 3 THERMAL COEFF :.000700
TANK D I Al'lETER 89. 75 TANK PROFILE 4 PTS FULL VOL 9684 67.3 INCH VOL 7891 44.9 INCH VOL 4918
22.4 INCH VOL 1900
FLOAT SIZE: 4.0 IN.
WATER WARN! NG :
HIGH WATER LIMIT:
MAX OR LABEL VOL: OVERFILL LIMIT :
HIGH PRODUCT
DELIVERY LIMIT
LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT PROBE OFFSET
2.0 3.0
9684 92% 8909
98% 9490
5%
500
500 99 99 4.70 0.00
SIPHON MANIFOLDED TANKS Til: OL04 LINE MANIFOLDED TANKS Til: 01.04
LEAK !"liN PERIODIC:
LEAK MIN ANNUHL
1% 100
1%
100
PERIODIC TEST TYPE STI-INDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : I MIN PUMP THRESHOLD : 10.00~
T 4:UNLEADED SOUTH
PRODUCT CODE : 4 THERMAL COEFF :.000700 TANK DIAMETER 89.75 TANK PROFILE 4 PTS FULL VOL 9684 67.3 INCH VOL 7891 44.9 INCH VOL 4918 22.4 INCH VOL 1900
FLOAT SIZE: 4.0 IN.
WATER WARNING :
HIGH WATER LIMIT:
MAX OR LABEL VOL : OVERFILL LIMIT :
HIGH PRODUCT
DELIVERY LIMIT
LOW PRODUCT :
LEAK ALARI"l LIM IT : SUDDEN LOSS LIMIT:
TANK TILT PROBE OFFSET
2 .0
3 .0
9684 92% 8909
98"4 9490
5%
500
500 99
99 4.70 0.00
SIPHON MANIFOLDED TANKS Til: 01.03
LINE MANIFOLDED TANKS
Til: 01.03
LEAK MIN PERIODI C: .
LEAK MIN ANNUAL
1%
100
1%
100
PERIODIC TEST TYPE STANDARD
ANNUAL TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAG I NC: OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELI VERY DELAY PUMP THRESHOLD
I 1"'11 N 10.00%
T 5:DIESEL
PRODUCT CODE THER~1AL COEFF TANK DIAMETER
TANK PROFILE FULL VOL 67.3 INCH VOL
44.9 INCH VOL 22.4 INCH VOL
: 5
: .000700 89 .75
4 PTS 9684
7891 4918 1900
FLOAT SIZE: 4.0 IN.
WATER WARNING : HIGH WATER LIMIT:
~~ OR LABEL VOL: OVERFILL LIMIT
HIGH PRODUCT
DELIVERY Llt11T
LOW PRODUCT : LEAK ALARI"I LIMIT :
SUDDEN LOSS llt1 IT:
TANK TILT PROBE OFFSET
2.0 3.0
9684
92"4 8909
98~
9490
5Y. 500
500 99
99 4.70 0.00
SIPHON MANIFOLDED TANKS
Til: NONE LINE MANIFOLDED TANKS Til: NONE
LEAK MIN PERIODIC:
LEAK MIN ANNUAL
I~ 100
1% 100
PERIODIC TEST TVPE STANDARD
ANNUAL TEST FAIL ALARI1 DISABLED
PERIODIC TEST FAIL ALARM DISABLED
GROSS TEST FAIL ALARM DISABLED
ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON 8REAK:OFF
DELIVERY DELAY : I MIN PU.'1P THRESHOLD : l 0. 0()}•
LEAK TEST METHOD
TEST ON DATE : ALL TANK FEB 6. 2007 START TIME : DISABLED TEST RATE :0.20 CAL/HR DURATION : 2 HOURS
TST EARLY STOP:DISABLED
LEAK TEST REPORT FORMAT NORI1AL
LIQUID SENSOR SETUP
L I :UNLEADED NORTH NORMALLY CLOSED
CATEGORY : OTHER SENSORS
L 2 : SUPRE11E NORI'1ALL Y CLOSED CATEGORY : OTHER SENSORS
L 3:UNLEADED SIPHON NORMALLY CLOSED
CATEGORY : OTHER SENSORS
L 4:UNLEADED SOUTH NORMALLY CLOSED CATEGORY : OTHER SENSORS
L S:DIESEL NORMALLY CLOSED CATEGORY : OTHER SENSORS
L 6:CASPER TRI-STATE <SINGLE FLOAT>
CATEGORY : OTHER SENSORS
L ?:GHOST TRI-STATE (SINGLE FLOAT> CATEGORY : OTHER SENSORS
L s:GHOST
TRI-STATE <SINGLE FLOAT> CATEGORY : OTHER SENSORS
PUMP SENSOR SETUP
OUTPUT RELAY SETUP
R I :POSITIVE-SHUT OFF TYPE:
STANDARD NORMALLY CLOSED
TANK 11: NONE
IN-TANK ALARI'IS ALL:LEAI< ALARM ALL:HICH WATER ALARM
LIQUID SENSOR ALMS ALL:FUEL ALARM
ALL:SENSOR OUT ALARM ALL!SHORT ALARM
lSD SITE ALARMS lSD CROSS PRES FAIL ISO DECRD PRES FAIL lSD VAPOR LEAK FAIL lSD VP PRES FAIL lSD VP STATUS FAIL
I SD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DECRD COLLECT FAIL ALL !FLOW COLLECT FAIL
R 2:UNLEADED NORTH TYPE: STANDARD NORMALLY CLOSED
TANK 11:
LIQUID SENSOR ALI1S ALL!FUEL ALARM ALL:SENSOR OUT ALARM ALL!SHORT ALARM
lSD SITE ALARMS ISO CROSS PRES FAIL lSD DECRD PRES FAIL lSD VAPOR LEAl< FAIL lSD VP PRES FAIL lSD VP STATUS FAIL
lSD HOSE ALARMS ALL :GROSS COLLECT FAIL ALL!DEGRD COLLECT FAIL ALL!FLOW COLLECT FAIL
R 3 :UNLEADED SOUTH TYPE: STANDARD NORMALLY CLOSED
TANK II: 4
LIQUID SENSOR AU1S ALL:FUEL ALARM ALL:SENSOR OUT ALARM
ALL !SHORT ALARM
lSD SITE ALARMS ISO GROSS PRES FAIL ISO DEGRD PRES FAIL ISO VAPOR LEAK FAIL ISO VP PRES FAIL
lSD VP STATUS FAIL
ISO HOSE ALARMS ALL:GROSS COLLECT FAIL ALL :OEGRO COLLECT FAIL ALL :FLOW COLLEC~ FAIL
~1ARTSENSOR SETUP
s I :PS 7-B CATEGORY VAPOR PRESSURE
s 2!FM 1-2 CATEGORY AIR FLOW METER
s 3:FH 3-4 CATEGORY AIR FLOW 11ETER
s 4 :FM 5-6 CATEGORY AIR FLOW METER
s 5:FI1 7-8
CATEGORY AIR FLOW I"'ETER
s 6:FM 9-10
CATEGORY AIR FLOW METER
s 7:FM 11-12 CATEGORY AIR FLOW METER
EVR/ I SD SETUP
EVR TYPE: VACUUM ASS IST VACUUM ASSIST TYPE
HEALY VAC
NOZZLE A/L RANGE MAX: 1.15 MIN: 0.95
VAPOR PROCESSOR TYPE
NO VAPOR PROCESSOR
ANALYSIS TIMES TIME: 10:00 AM DELAY 1'1 I NUTES :
ACCEPT HIGH ORVR: DISABLED
ISO HOSE TABLE
10 FP FL HL AA RR ------------------------01 33 01 02 01 uu 02 34 02 02 01 uu 03 35 03 02 02 uu 04 02 04 02 02 uu 05 08 05 02 03 uu
06 01 06 02 03 uu 07 00 07 02 04 uu
08 04 08 02 04 uu 09 05 09 02 05 uu 10 06 10 02 05 uu
11 07 11 02 06 uu
12 03 12 02 06 uu
I SO A I RFLOW 11ETER MAP ID SERIAL NUM LABEL -----------------------1 18422 FM 1-2
2 18424 FM 3-4 3 18415 FM 5-6
4 12370 FM 7-8
5 19032 FM 9-10
6 18433 FM 11-12
ISO FUEL GRADE HOSE MAP
I 2 3 4
FP MHH MHH MHH MHH AA
00 207 307 907 5 u 4
01 206 306 906 5 u 3 02 204 304 904 5 u 2
03 212 312 912 u u 6 04 208 308 908 u u 4
05 209 309 909 u u 5 06 210 310 910 u u 5 07 211 311 911 u u 6
08 205 305 905 u u 3 33 201 301 901 5 U I 34 202 302 902 5 u 1
35 203 303 903 5 u 2
LABEL TABLE
1: UNASSIGNED 2: BLEND3 3: REGULAR
4: MID GRADE 5: PREMIUM 6: GOLD
7: BRONZE 9: SILVER
9: BLEND2
10: BLEND4
PMC SETUP
PROCESSOR CONTROL LEVEL:
NONE
ALARM HISTORY REPORT
----SENSOR ALARM L I :UNLEADED NORTH
OTHER SENSORS FUEL ALARM FEB 14. 2012 9:33 AM
FUEL ALARM FEB 14. 2012 9:32AM
FUEL ALARM
FEB 14. 2012 9:26 AM
ALARM HISTORY REPORT
-----SENSOR ALARM L 2:SUPREME
OTHER SENSORS SETUP DATA WARNING DEC 13. 2012 9 :58 AM
FUEL ALARM
DEC 12. 201 2 10:15 PM
SENSOR OUT ALARI'I
AUG 28. 2012 7:10AM
ALARM HISTORY REPORT
-----SENSOR ALARM -----
L 3:UNLEADED SIPHON OTHER SENSORS SENSOR OUT ALARM
NOV 10. 2012 2:33AM
SENSOR OUT ALARM
NOV 10. 2012 2:31 AM
SENSOR OUT ALA~1 NOV 10, 2012 2:25AM
ALARM HISTORY REPORT
-----SENSOR ALARM L 4:UNLEADED SOUTH OTHER SENSORS
SENSOR OUT ALARM
DEC 3. 2012 5:01 PH
SENSOR OUT ALARM
DEC 3. 20 12 5:00PM
SENSOR OUT ALARM
DEC 3. 2012 4:58PM
ALARM HISTORY REPORT
-----SENSOR ALARM L 5:DIESEL
OTHER SENSORS FUEL ALARM FEB lq, 2012 9:38 ~1
FUEL ALARM FEB 14. 2012 9:29 AM
FUEL ALARM
FEB 14, 2012 9:21 AM
ALARJ•l HISTORY REPORT
-----SENSOR ALARM L 6:CASPER OTHER SEI'SORS
SENSOR OlJf ALARI1
FEB 14. 2012 9:21 AM
SENSOR OUT ALARM
FEB 14. 2011 II :03 AM
ALARM HISTORY REPORT
-----SENSOR ALARM L 7 :GHOST
OTHER SENSORS SENSOR OUT ALARM FEB 14. 2012 9:21 AM
SENSOR OUT ALARM
FEB 14. 2011 II :03 AM
ALARM HISTORY REPORT
-----SENSOR ALARI'I L 8:GHOST OTHER SENSORS
SENSOR OUT ALARM FEB 14. 2012 9:21 Af'l
SENSOR OUT ALARM FEB 14, 201 1 II :03 AM
ARCHIVE l1f ILl TY ----
SAVE SETUP DATA: START TIME:
FEB 12. 2013 9:08:14 AM
ARCHIVE UTILITY
-1-----------sAVE SETUP DATA: END TIME: FEB 12. 2013 9:11:15 AM
BYTES : 23168
-----SENSOR ALARM
L ?:GHOST
C'THER SENSORS SENSOR OUT ALARM FEB 12, 2013 10:09 AM
-----SENSOR ALARM
L I :UNLEADED NORTH OTHER SENSORS FUEL ALARM FEB 12. 201 3 10:09 AM
-----SENSOR f\LARI'I
L S:GHOST OTHER SENSORS
SENSOR OUT ALARM FEB 12. 2013 10:09 AM
\
-----SENSOR ALARI'l L 2 :SUPREME
OTHER SENSORS FUEL ALARM FEB 12. 2013 10:09 AM
-----~ENSOR ALARM -----L 3:UNLEADED SIPHON OTHER SENSORS FUEL ALARM
FEB 12, 2013 10:09 AM
-----SENSOR ALARM -----L 4:UNLEADED SOUTH OTHER SENSORS
FUEL ALARM
FEB 12, 2013 10:09 AM
-----SENSOR ALARM
L 5:DIESEL
OTHER SENSORS FUEL ALARM
FEB 12. 2013 10:09 AM
-----SENSOR ALARM L 6!CASPER
OTHER SENSORS
SENSOR OUT ALARM
FEB 12. 2013 10:09 AM
CALIFORNIA CHEVON
4100 CALIFORNIA AVE BXRSFLD CA 93309 661-336-0263
FEB 12, 2013 IO:t~AM
S'/STEM STATUS REPORT ------------ALL FUNCTIONS NORI•tAL
-----SENSOK ALARM
L 5:DIESEL
OTHER SENSORS
FUEL ALARM FEB 12, 2013 10!14 AM
-----SENSOR ALARM L 4:UNLEADED SOUTH OTHER SENSORS
FUEL ftLARM
FEB 12. 2013 10:16 AM
-----SE .~OR ALARM -----L 3:UNLE~l·ED SIPHON
OTHER SENSORS
FUEL ALARM FEB 12, 2013 10:18 AM
-----SENSOR ALARM L 2:SUPREME
OTHER SENSORS
FUEL ALARf"l FEB 12. 2013 10:2u AM
-----SENSOR ALARM
L 1 :UNLEADED NORTH
OTHER SENSORS FUEL ALARM
FEB 12. 2013 10:21 AM
CALIFORNIA CHEVON
4100 CALIFORNIA AVE BKRSFLD CA 93309 661-336-0263
FEB 12, 2013 10:22 AM
SYSTEM STATUS REPORT -----------
ALL FUNCTIONS NOR1'1AL
---SENSOR ALARM L I : l.INLEAOE[• NORTH OTHER SENSORS
FUEL ALARM
FEB 12. 2013 10:26 AM
--SENSOR ALARt-1 -----L 2!SUPREME
OTHER SENSORS FUEL ALARM FEB 12. 2013 10:34 AM
-·---SENSOR ALARM L 3:UNLEADED SIPHON OTHER SENSORS -FUEL ALA~M
FEB 12, 2013 10:35 AM
-----SENSOR ALARM
L 4:UNLEADED SOUTH OTHER SENSORS
FUEL ALARI1
FEB 12, 2013 10!41 AM
-----SENSOR ALARM
L 4 : UtlLEADED SOUTH OTHER SENSORS FUEL ALARM
FEB 12. 2013 10:44 AM
I
-----SENSOR ALARM L 5:DIESEL
OTHER SENSORS FUEL ALARM FEB 12. 2013 10:45 AM
CALIFORNIA CHEVON 4100 CALIFORNIA AVE BKRSFLD CA 93309 66!-336-0263
FEB 12. 2013 10:46 AM
SYSTEM STATUS REPORT
L 4:FUEL ALARM
-----SENSOR ALARM
L 5:DIESEL OTHER SENSORS FUEL ALARM
FEB 12. 2013 10:46 AM
-----SENSOR ALARM L 4:UNLEADED SOUTH OTHER SENSORS FUEL ALARM
FEB 12, 2013 10:47 AM
CALIFORNIA CHEVON/
4100 CALIFORNIA AVE 1BKRSFLD CA 93309 66i-336-0263
FEB 12, 2013 10:49 AM
SYSTEM STATUS REPORT
L 4:FUEL AlARM
CALIFORNIA CHEVON 4100 CALIFORNIA AVE BKRSFLD CA 93309
661-336-0263
. ., 12. 2013 10:49 AM
.,., oq QF'PORT
SWRCB, January 2006
Spill Bucket Testing Report Form
This form is intended for use by contractors pelforming annual testing of UST spill containment structures. The completed form and
printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regwacory agency.
1 FACILITY INFORMATION
Facility Name: California Chevron I Date ofTesting: 2112/2013
Facility Address: 4100 California A venue , Bakersfield, CA 93309
Facility Contact: Sam Jouda I Phone: 661-333-0000
Date Local Agency Was Notified of Testing : 1/14/2013
Name of Local Agency Inspector (if present during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bradley Seykora
Credentials': X CSLB Contractor X ICC Service Tech. 0 SWRCB Tank Tester 0 Other (Specify)
License Number(s): 804904 ICC# 811 1231-UT
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic 0 Vacuum 0 Other
Test Equipment Used: Lake Test Equipment Resolution:0.0625"
Identify Spill Bucket (By Tank I Regular (North) 2 Regular (South) 3 Regular (Siphon) 4 Super
Number, Slored Product, etc.)
Bucket Installation Type: Direct Bury Direct Bury 0 Direct Bury 0 Direct Bury
X Contained in Sump X Contained in Sump X Contained in Sump X Contained in Sump
Bucket Diameter: 12.00" 12.00" 12.00" 12.00"
Bucket Depth: 13.75" 14.25" 14.00" 13.75"
Wait time between applying 5 min. 5 min. 5 min. 5 min. vacuum/water and start of test:
Test Start Time (T1): 9:30AM 9:30AM 1:00PM 9:30AM
Initial Reading (R1): 9.50" 9.50" 9.00" 9.25"
Test End Time (TF): 10:30 AM 10:30 AM 2:00PM l0:30AM
Final Reading (RF): 9.50" 9.50" 9.00" 9.25"
Test Duration (T F-T,): I hour I hour I hour I hour
Change in Reading (RF-R1): 0.0" 0.0" 0.0" 0.0"
Pass/Fail Threshold or 0.0625" 0.0625" 0.0625" 0.0625" Criteria: -Test Result: X Pass 0 Fail X Pass 0 Fail X Pass 0 Fail X Pass O Fail
Comments-(include information on repairs made prior to testing, and recommended[ollow-upfor failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTrNG THIS TESTING
I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements.
Techn-ic_i_an_'_s_s_ig_n_aru __ re_:~~~~~~o~~~2~~~~--~~~~~------------------Date: 2/12/2013
1 State laws and regulations do not currently req uire testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
SWRCB, January 2006
Spill Bucket Testing Report Form
Thisform is intended for use by contractors performing annual testing ofUSTspi/1 containment structures. The completed form and
printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency.
1 FACILITY INFORMATION .
Facility Name: Cali fo rnia Chevron I Date ofTesting: 2/12/2013
Facility Address: 4 100 Californ ia Avenue, Bakersfield, CA 93309
Facility Contact: Sam Jouda I Phone: 661 -333-0000
Date Local Agency Was Notified of Testing: 1/14/2013
Name of Local Agency Inspector (if present during testing): Ernie Medina
2 TESTING CONTRACTOR INFORMATION .
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bradley Seykora
Credentials 1: X CSLB Contractor X ICC Service Tech. 0 SWRCB Tank Tester 0 Other (Specify)
License Number(s): 804904 ICC # 811 1231-UT
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic 0 Vacuum 0 Other
Test Equipment Used: Lake Test Equipment Reso1ution:0.0625"
Identify Spill Bucket (By Tank 1 Diesel 2 3 4
Number, Stored Product, etc.)
Bucket Installation Type: C Direct Bury [] Direct Bury 0 Direct Bury 0 Direct Bury
X Contained in Sump OContained in Sump IJContained in Sump UContained in Sump
Bucket Diameter: 12.00"
Bucket Depth: 15.75"
Wait time between applying 5 min. vacuum/water and start of test:
Test Start Time (T1): 9:30AM
Initial Reading (R1): 8.50"
Test End Time (TF): 10:30 AM
Final Reading (RF): 8.50"
Test Duration (T F -T,): 1 hour
Change in Reading (RF-R1): 0.00"
Pass/Fail Threshold or 0.0625 Criteria:
Test Result: X Pass O Fail 0 Pass O Fail 0 Pass O Fail 0 Pass 0 Fail
Comments-(include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFJCA TION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true, accurate, and in f ull compliance with legal requirements.
Technidan 'sSignaWre>~ Date> 2112/2013
1 State laws and regulatio~tly require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
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Job Order I Invoice #: '3 v 3 2 8;
Date Called
J-IL{-\~
Time To Whom SU 0 WITH ONI OEN,;e· "COMPliANCE WITH CONFIDENCE'
Loc. 970703 Lie. 804904
Toll Free#: 1-800-339-9930
Name: C onfidt:m:t: LST Site Name C.::::/,~t-w~ C.LoP.vtb~
Street 16250 \kacham Road Street
'-( '"~ f:.ct ~ rN ,e. ,4. v-e A.Ju e.
City: i3J!~I!rslicld, Cl\ 93312 City: ~a kers-f.{'d..J State: (!_ * Ztp: 9~3c<f
Terms Store No.
Descnotton of work performed:
\:) c..t t ft\)11;'-~,e... ).J o!V,·~c-t'N~ c~rt'~cc -1-,~t-.J ~~-'fpo,.J~e-~cC-~-+-~. b V ~ /
•r~ Oo>~~('~J' d../-L ~ cr~ ~. ~:~e~~~· '-(~ ~~t:: ~:.t:J,S'Dr" .. w~c.; ~l~-L loll·.J.L
A.Nu-Jt:i" II ~·c..s q_/ ~sk ~!>:~~
---
TRAVEL and LABOR (0 5 Hour Monomum Labor Charge) OVERTIME (5:00 PM -7:00AM)
Date Technician(s) Name Start End Total OT Start OTEnd OTTotal
2 • ll·\ ~ ~~;I ~Yk'oC71: Travel
Labor 1 lrs
Travel
Date Technocian(s) Name Start End Total OT Start OTEnd OTTotal
Travel
Labor
Travel
Date Technocian(s) Name Start End Total OT Start OTEnd OTTotal
Travel
Labor
Travel
SUPPLIES-MATERIALS -RENTALS Check One
Qty. UST Parts Sote Parts
1.. VeecY.er "'~c. t--~" l V ~U~r-L )Q
.:L Veeel~r-, ~c=.o-\-'12u $eJ.Jgc:.c-)<1
COMMENTS
Store Employoo Sognaturo
t; y " ·--;.:,
N\/C.. C