HomeMy WebLinkAbout FMC RESULTS 2016MONITORING 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
Chevron
2525WhiteLaneBakersfield93304
BassemAzzi (805)217-0610
Veeder-RootTLS-350 06/01/2016
12.000gal.Regular
847390-107
794390-420 794390-420
794380-208 794380-208
PLLD
OPW61-SO
12,000gal.Super
847390-107
PLLD
OPW61-SO
12,000gal.Diesel
847390-107
794390-420
794380-208
OPW61-SO
PLLD
1-2 3-4
5-6 7-8
Bradley Seykora
B40738
2525WhiteLane Bakersfield,CA93304 06/01/2016
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
334.00
OPW
The annular sensor on the 87 tank only had enough wire to reach halfway to the bottom, a new veeder-root 420 sensor was installed to allow the
sensor to rest on the bottom.
Fuel was found and removed from the 87 STP sump, no leaks were found on the turbine head or product line and a precision line test was performed
on the 87 product line with passing results.
The 208 sensor in the 87 STP sump was originally found not programmed to shut down in the event of a fuel alarm and was corrected during testing
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:
ProactiveProp.,Inc.dbaWhiteLnChvn
15000OliveViewDr.,UnitG
Sylmar,CA91342
35165
06/01/2016
8339953-UT
Regular Electronic PLLD
Bradley Seykora
(805)217-0610BassemAzzi
Bakersfield,CA93304
2525WhiteLane
Chevron
22 PSI 65 ml Pass
PLLDElectronicPremium 18 PSI 50 ml Pass
PLLDElectronicDiesel 20 PSI 80 ml Pass
Bradley Seykora 8339953-UT
06/01/2016
White Lane Chevron TLS Setup
Responses Received:
200 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 JUN 1, 2016 8:08 AM TANK PRODUCT GALLONS INCHES WATER DEG F ULLAGE 1 DIESEL 2162 26.10 0.0 82.3 9860 2 SUPREME 91 4227 42.41 0.8 81.4 7795 3 REGULAR 87 9315 80.27 0.0 83.1 2707 I90500 JUN 1, 2016 8:08 AM SOFTWARE REVISION LEVEL VERSION 334.00 SOFTWARE# 346334-100-A CREATED - 15.05.29.10.36 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I50500 JUN 1, 2016 8:08 AM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM I50201 JUN 1, 2016 8:08 AM SHIFT TIME 1 : 5:00 AM I50202 JUN 1, 2016 8:08 AM SHIFT TIME 2 : DISABLED
I50203 JUN 1, 2016 8:08 AM SHIFT TIME 3 : DISABLED I50204 JUN 1, 2016 8:08 AM SHIFT TIME 4 : DISABLED I54600 JUN 1, 2016 8:08 AM TANK PER TST NEEDED WRN: DISABLED I54900 JUN 1, 2016 8:08 AM TANK ANN TST NEEDED WRN: DISABLED I55300 JUN 1, 2016 8:08 AM LINE RE-ENABLE METHOD PASS LINE TEST I55600 JUN 1, 2016 8:08 AM LINE PER TST NEEDED WRN: DISABLED I55900 JUN 1, 2016 8:08 AM
LINE ANN TST NEEDED WRN: DISABLED I50D00 JUN 1, 2016 8:08 AM PRINT TC VOLUMES ENABLED I50E00 JUN 1, 2016 8:08 AM TEMP COMPENSATION VALUE (DEG F ): 60.0
I60B00 JUN 1, 2016 8:08 AM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I51400 JUN 1, 2016 8:08 AM H-PROTOCOL DATA FORMAT HEIGHT I51A01 JUN 1, 2016 8:08 AM DAYLIGHT SAVING TIME ENABLED ON I51B00 JUN 1, 2016 8:08 AM DAYLIGHT SAVING TIME START DATE MAR WEEK 2 SUN 2:00 AM END DATE NOV WEEK 1 SUN 2:00 AM I51600 JUN 1, 2016 8:08 AM RE-DIRECT LOCAL PRINTOUT DISABLED
I50400 JUN 1, 2016 8:08 AM 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 JUN 1, 2016 8:08 AM TANK CHART SECURITY DISABLED I5BD00 JUN 1, 2016 8:08 AM CUSTOM ALARM LABELS DISABLED I56000 JUN 1, 2016 8:08 AM MASS/DENSITY DISABLED I88101 JUN 1, 2016 8:08 AM PORT SETTINGS: COMM BOARD : 1 (S-SAT ) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED DTR NORMAL STATE: HIGH I88102 JUN 1, 2016 8:08 AM
I88103 JUN 1, 2016 8:08 AM PORT SETTINGS: COMM BOARD : 3 (EDIM ) RS-232 SECURITY CODE : DISABLED I88104 JUN 1, 2016 8:08 AM I88105
JUN 1, 2016 8:08 AM PORT SETTINGS: COMM BOARD : 5 (RS-485) BAUD RATE : 2400 PARITY : NONE STOP BIT : 2 STOP DATA LENGTH: 7 DATA RS-232 SECURITY CODE : DISABLED I88106 JUN 1, 2016 8:08 AM PORT SETTINGS: COMM BOARD : 6 (RS-232) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED I52000 JUN 1, 2016 8:08 AM RECEIVER AUTO DIAL TYPE & START TIME RCVR LOCATION LABEL DIAL TYPE START TIME 1 ON DATE FEB 25, 2016 DISABLED 2 ON DATE FEB 25, 2016 DISABLED 3 ON DATE FEB 25, 2016 DISABLED 4 ON DATE FEB 25, 2016 DISABLED 5 ON DATE FEB 25, 2016 DISABLED 6 ON DATE FEB 25, 2016 DISABLED 7 ON DATE FEB 25, 2016 DISABLED 8 VEEDER-ROOT FMS ON DATE FEB 25, 2016 DISABLED I60100 JUN 1, 2016 8:08 AM
TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 DIESEL ON 2 SUPREME 91 ON 3 REGULAR 87 ON 4 OFF I60200 JUN 1, 2016 8:08 AM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 DIESEL
2 SUPREME 91 3 REGULAR 87 4 I60300 JUN 1, 2016 8:08 AM TANK PRODUCT CODE TANK PRODUCT LABEL 1 DIESEL 1 2 SUPREME 91 2 3 REGULAR 87 3 4 4 I60900 JUN 1, 2016 8:08 AM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 DIESEL 0.000450 2 SUPREME 91 0.000700 3 REGULAR 87 0.000700 4 0.000000 I60700 JUN 1, 2016 8:08 AM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 DIESEL 111.00 2 SUPREME 91 111.00 3 REGULAR 87 111.00 4 0.00 I60A00 JUN 1, 2016 8:08 AM TANK FULL VOLUME
TANK PRODUCT LABEL TANK PROFILE GALLONS 1 DIESEL 4 PTS 12022 2 SUPREME 91 4 PTS 12022 3 REGULAR 87 4 PTS 12022 4 1 PT 0 I60400 JUN 1, 2016 8:08 AM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 DIESEL 12022 2 SUPREME 91 12022 3 REGULAR 87 12022 4 0
I60500 JUN 1, 2016 8:08 AM TANK 4 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 DIESEL 12022 9677 6011 2357 2 SUPREME 91 12022 9677 6011 2357 3 REGULAR 87 12022 9677 6011 2357 4 0 0 0 0 I60600 JUN 1, 2016 8:08 AM TANK 20 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 DIESEL 12022 0 0 0 0 9677 0 0 0 0 6011 0 0 0 0 2357 0 0 0 0 2 SUPREME 91 12022 0 0 0 0 9677 0 0 0 0 6011 0 0 0 0 2357 0 0 0 0 3 REGULAR 87 12022 0 0 0 0 9677 0 0 0 0 6011 0 0 0 0 2357 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 JUN 1, 2016 8:08 AM
TANK PRODUCT LABEL METER DATA 1 DIESEL NO 2 SUPREME 91 NO 3 REGULAR 87 NO 4 NO I62F00 JUN 1, 2016 8:08 AM MAG PROBE FLOAT SIZE TANK PRODUCT LABEL FLOAT SIZE: 1 DIESEL 4.0 IN. 2 SUPREME 91 4.0 IN. 3 REGULAR 87 4.0 IN.
I62700 JUN 1, 2016 8:08 AM TANK HIGH WATER WARNING LIMIT TANK PRODUCT LABEL INCHES 1 DIESEL 2.0 2 SUPREME 91 2.0 3 REGULAR 87 2.0 I64200 JUN 1, 2016 8:08 AM WATER ALARM FILTER TANK PRODUCT LABEL 1 DIESEL LOW 2 SUPREME 91 LOW 3 REGULAR 87 LOW I62400 JUN 1, 2016 8:08 AM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 DIESEL 3.0 2 SUPREME 91 3.0 3 REGULAR 87 3.0 I62800 JUN 1, 2016 8:08 AM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 12022 2 SUPREME 91 12022 3 REGULAR 87 12022
4 0 I62300 JUN 1, 2016 8:08 AM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 10820 2 SUPREME 91 10820 3 REGULAR 87 10820 4 0 I62200 JUN 1, 2016 8:08 AM
TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 11421 2 SUPREME 91 11421 3 REGULAR 87 11421 4 0 I62900 JUN 1, 2016 8:08 AM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 1202 2 SUPREME 91 1202 3 REGULAR 87 1202 4 0 I62100 JUN 1, 2016 8:08 AM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 500 2 SUPREME 91 500 3 REGULAR 87 500 4 0 I62600 JUN 1, 2016 8:08 AM TANK LEAK ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 99 2 SUPREME 91 99 3 REGULAR 87 99 4 99
I62500 JUN 1, 2016 8:08 AM TANK SUDDEN LOSS LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 99 2 SUPREME 91 99 3 REGULAR 87 99 4 99 I60800 JUN 1, 2016 8:08 AM TANK TILT TANK PRODUCT LABEL INCHES
1 DIESEL 3.70 2 SUPREME 91 2.00 3 REGULAR 87 2.00 4 0.00 I60B00 JUN 1, 2016 8:08 AM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I60C00 JUN 1, 2016 8:08 AM TANK STICK HEIGHT OFFSET TANK PRODUCT LABEL INCHES 1 DIESEL 0.00 2 SUPREME 91 0.00 3 REGULAR 87 0.00 4 0.00 I61200 JUN 1, 2016 8:08 AM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 DIESEL NONE NONE 2 SUPREME 91 NONE NONE 3 REGULAR 87 NONE NONE 4 NONE NONE I63600 JUN 1, 2016 8:08 AM PERIODIC LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 DIESEL 0 2 SUPREME 91 0
3 REGULAR 87 0 4 0 I62A00 JUN 1, 2016 8:08 AM ANNUAL LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 DIESEL 0 2 SUPREME 91 0 3 REGULAR 87 0 4 0 I62C00 JUN 1, 2016 8:08 AM
TANK PERIODIC TEST TYPE TANK PRODUCT LABEL PERIODIC TEST TYPE 1 DIESEL STANDARD 2 SUPREME 91 STANDARD 3 REGULAR 87 STANDARD 4 STANDARD I62D00 JUN 1, 2016 8:08 AM TANK LEAK TEST FAIL ALARMS TANK PRODUCT LABEL 1 DIESEL GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 2 SUPREME 91 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 3 REGULAR 87 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 JUN 1, 2016 8:08 AM TANK LEAK TEST AVERAGING TANK PRODUCT LABEL ANNUAL PERIODIC 1 DIESEL OFF OFF 2 SUPREME 91 OFF OFF 3 REGULAR 87 OFF OFF
4 OFF OFF I63000 JUN 1, 2016 8:08 AM IN-TANK LEAK TEST NOTIFY TANK PRODUCT LABEL TANK TEST NOTIFY: 1 DIESEL OFF 2 SUPREME 91 OFF 3 REGULAR 87 OFF 4 OFF I63200
JUN 1, 2016 8:08 AM TANK TEST SIPHON BREAK TANK PRODUCT LABEL SIPHON BREAK 1 DIESEL OFF 2 SUPREME 91 OFF 3 REGULAR 87 OFF 4 OFF I61000 JUN 1, 2016 8:08 AM TANK DELIVERY DELAY TANK PRODUCT LABEL 1 DIESEL 1 2 SUPREME 91 1 3 REGULAR 87 1 4 1 I63A00 JUN 1, 2016 8:09 AM LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD TANK PRODUCT LABEL PUMP THRESHOLD 1 DIESEL 10.00% 2 SUPREME 91 10.00% 3 REGULAR 87 10.00% 4 10.00% I61100 JUN 1, 2016 8:09 AM LEAK TEST METHOD - - - - - - - - - - - - TEST ON DATE : ALL TANK MAY 29, 2015 START TIME : DISABLED
TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:DISABLED I61300 JUN 1, 2016 8:09 AM CSLD PROBABLITY OF DETECTION I61400 JUN 1, 2016 8:09 AM CSLD CLIMATE FACTOR
I61600 JUN 1, 2016 8:09 AM TANK PRODUCT LABEL CAL UPDATE 1 DIESEL IMMEDIATE 2 SUPREME 91 IMMEDIATE 3 REGULAR 87 IMMEDIATE 4 IMMEDIATE I61A00 JUN 1, 2016 8:09 AM IN-TANK LEAK TEST EARLY STOP TANK PRODUCT LABEL TST EARLY STOP: 1 DIESEL DISABLED 2 SUPREME 91 DISABLED 3 REGULAR 87 DISABLED 4 DISABLED I61B00 JUN 1, 2016 8:09 AM IN-TANK LEAK GROSS TEST AUTO-CONFIRM I61C00 JUN 1, 2016 8:09 AM CSLD REPORT ONLY I62B00 JUN 1, 2016 8:09 AM
TANK LAST ANNUAL TEST TANK PRODUCT LABEL DATE 1 DIESEL ??? 0, 0 2 SUPREME 91 ??? 0, 0 3 REGULAR 87 ??? 0, 0 4 ??? 0, 0 I63300 JUN 1, 2016 8:09 AM LEAK TEST REPORT FORMAT: NORMAL I63400
JUN 1, 2016 8:09 AM RECONCILIATION WARNING LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 0 2 SUPREME 91 0 3 REGULAR 87 0 4 0 I63500 JUN 1, 2016 8:09 AM RECONCILIATION ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 DIESEL 1 2 SUPREME 91 1 3 REGULAR 87 1 4 1 I63900 JUN 1, 2016 8:09 AM ACCU CHART END SHAPE FACTOR TANK PRODUCT LABEL 1 DIESEL END FACTOR: NONE 2 SUPREME 91 END FACTOR: NONE 3 REGULAR 87 END FACTOR: NONE 4 END FACTOR: NONE
I78000 JUN 1, 2016 8:09 AM PRESSURE LINE LEAK SETUP Q 1:DIESEL TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 250 FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 1:DIESEL
DISPENSE MODE: STANDARD SENSOR: HIGH PRESSURE PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO Q 2:SUPREME 91 TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 250 FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 2:SUPREME 91 DISPENSE MODE: STANDARD SENSOR: HIGH PRESSURE PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO Q 3:REGULAR 87 TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 250 FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 3:REGULAR 87 DISPENSE MODE: STANDARD SENSOR: HIGH PRESSURE PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO I77700 JUN 1, 2016 8:09 AM
I77800 JUN 1, 2016 8:09 AM I78C00 JUN 1, 2016 8:09 AM I78300 JUN 1, 2016 8:09 AM
I78F00 JUN 1, 2016 8:09 AM PRESSURE LINE LEAK DISPENSE THRESHOLD LINE LOW PRESSURE Q 1:DIESEL 0 PSI Q 2:SUPREME 91 0 PSI Q 3:REGULAR 87 0 PSI I78700 JUN 1, 2016 8:09 AM PRESSURE LLD SETUP REPORT Q 1:DIESEL IN-TANK ALARMS T 1:HIGH WATER ALARM T 1:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 2:FUEL ALARM L 1:SENSOR OUT ALARM L 2:SENSOR OUT ALARM L 1:SHORT ALARM L 2:SHORT ALARM Q 2:SUPREME 91 IN-TANK ALARMS T 2:HIGH WATER ALARM T 2:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 4:FUEL ALARM L 3:SENSOR OUT ALARM L 4:SENSOR OUT ALARM L 3:SHORT ALARM L 4: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 Q 3:REGULAR 87 IN-TANK ALARMS T 3:HIGH WATER ALARM LIQUID SENSOR ALMS
L 5:FUEL ALARM L 5:SENSOR OUT ALARM L 6:SENSOR OUT ALARM L 5:SHORT ALARM L 6: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 I70200 JUN 1, 2016 8:09 AM LIQUID LABEL DEVICE LABEL 1 DIESEL ANNULAR 2 DIESEL STP 3 SUPREME ANNULAR 4 SUPREME 91 5 REGULAR 87 ANNULAR 6 REGULAR 87 STP 7 8 I70300 JUN 1, 2016 8:09 AM LIQUID TYPE SENSOR LOCATION TYPE
1 DIESEL ANNULAR NORMALLY CLOSED 2 DIESEL STP TRI-STATE (SINGLE FLOAT) 3 SUPREME ANNULAR NORMALLY CLOSED 4 SUPREME 91 TRI-STATE (SINGLE FLOAT) 5 REGULAR 87 ANNULAR NORMALLY CLOSED 6 REGULAR 87 STP TRI-STATE (SINGLE FLOAT) 7 TRI-STATE (SINGLE FLOAT) 8 TRI-STATE (SINGLE FLOAT) I70400 JUN 1, 2016 8:09 AM LIQUID CATEGORY SENSOR LOCATION CATEGORY 1 DIESEL ANNULAR ANNULAR SPACE
2 DIESEL STP STP SUMP 3 SUPREME ANNULAR ANNULAR SPACE 4 SUPREME 91 STP SUMP 5 REGULAR 87 ANNULAR ANNULAR SPACE 6 REGULAR 87 STP STP SUMP 7 OTHER SENSORS 8 OTHER SENSORS I74200 JUN 1, 2016 8:09 AM I74300 JUN 1, 2016 8:09 AM I74400 JUN 1, 2016 8:09 AM I74700 JUN 1, 2016 8:09 AM I74800 JUN 1, 2016 8:09 AM I74900 JUN 1, 2016 8:09 AM I7BC00 JUN 1, 2016 8:09 AM
I80200 JUN 1, 2016 8:09 AM I80300 JUN 1, 2016 8:09 AM I80400 JUN 1, 2016 8:09 AM I80700 JUN 1, 2016 8:09 AM
I80900 JUN 1, 2016 8:09 AM I80B00 JUN 1, 2016 8:09 AM I80A00 JUN 1, 2016 8:09 AM I80C00 JUN 1, 2016 8:09 AM I80800 JUN 1, 2016 8:09 AM I79000 JUN 1, 2016 8:09 AM EDIM:1 VR:349633-002-C TD:98.09.21.11.16 I79100 JUN 1, 2016 8:09 AM I72300 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304
661-832-9781 SMARTSENSOR ASSIGNMENT DEVICE LABEL CATEGORY 01 VAPOR PRESSURE VAPOR PRESSURE 02 CANISTER VAPOR VALVE 03 UNKNOWN 04 DIS 1-2 FM AIR FLOW METER 05 DIS 3-4 FM AIR FLOW METER 06 DIS 5-6 FM AIR FLOW METER 07 DIS 7-8 FM AIR FLOW METER 08 ATMP PRESSURE ATM P SENSOR 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 IV4E00 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 EVR/ISD SETUP TYPE: BALANCE IV4F00
JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 NOZZLE A/L RANGE A/L RATIO: 0.95 - 1.15 IV4000 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304
661-832-9781 VAPOR PROCESSOR TYPE VEEDER-ROOT POLISHER IV4700 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 ASSESSMENT TIME START TIME: 10:00 AM TIME DELAY MINUTES: 1 IV5200 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 ACCEPT HIGH ORVR: NO IV4A00 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 ISD HOSE TABLE HOSE FP FP AFM REL HOSE ID ID LABEL ID ID LABEL 01 00 01 01 UU BLEND3
02 01 02 01 UU BLEND3 03 02 03 02 UU BLEND3 04 03 04 02 UU BLEND3 05 04 05 03 UU BLEND3 06 05 06 03 UU BLEND3 07 06 07 04 UU BLEND3 08 07 08 04 UU BLEND3 IV4B00 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781
PRODUCT/HOSE MAP TABLE FP AFID M1/H1 M2/H2 M3/H3 M4/H4 00 01 04/01 05/01 09/01 xx/xx 01 01 04/02 05/02 09/02 xx/xx 02 02 04/03 05/03 09/03 xx/xx 03 02 04/04 05/04 09/04 xx/xx 04 03 04/05 05/05 09/05 xx/xx 05 03 04/06 05/06 09/06 xx/xx 06 04 04/07 05/07 09/07 xx/xx 07 04 04/08 05/08 09/08 xx/xx IV4900 JUN 1, 2016 8:09 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 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 JUN 1, 2016 8:09 AM ISD VERSION: 01.05
White Lane Chevron Alarm History
Responses Received:
I10200 JUN 1, 2016 8:11 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 9344613 9510720 2 UNUSED 9313041 9478420 3 INTERSTITIAL BD 202117 202179 4 UNUSED 9309231 9477782 5 4 PROBE / G.T. 163208 163150 6 PLLD SENSOR BD 3950 3959 7 7SMARTSENSOR BD 506297 506469 8 UNUSED 9314508 9478310 9 UNUSED 9312092 9472225 10 PLLD POWER BD 99914 99885 11 UNUSED 9306772 9477682 12 UNUSED 9310800 9475173 13 UNUSED 9309071 9477374 14 UNUSED 9308808 9477132 15 UNUSED 9309268 9470223 16 UNUSED 9307560 9473193 COMM 1 SERIAL SAT BD 477345 477201 COMM 2 REMOTE DISPLAY 27470 27479 COMM 3 ELEC DISP INT. 100675 100515 COMM 4 UNUSED 9316581 9474557 COMM 5 RS485 SERIAL BD 68215 68219 COMM 6 RS232 SERIAL BD 14911 14926 I90200 JUN 1, 2016 8:11 AM SOFTWARE REVISION LEVEL VERSION 334.00 SOFTWARE# 346334-100-A CREATED - 15.05.29.10.36 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I11100 JUN 1, 2016 8:11 AM 826428 WHITE LNCHVRN 2525 WHITE LANE
BAKERSFIELD CA 93304 661-832-9781
PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME OTHER MISSING HOSE SETUP CLEAR 2-25-16 12:41PM OTHER MISS VAPOR PRES SEN CLEAR 2-25-16 10:42AM OTHER MISS VAPOR FLOW MTR CLEAR 2-25-16 10:42AM s 7 OTHER DIS 7-8 FM COMMUNICATION ALARM CLEAR 2-25-16 10:42AM s 6 OTHER DIS 5-6 FM COMMUNICATION ALARM CLEAR 2-25-16 10:41AM s 5 OTHER DIS 3-4 FM COMMUNICATION ALARM CLEAR 2-25-16 10:41AM s 4 OTHER DIS 1-2 FM COMMUNICATION ALARM CLEAR 2-25-16 10:41AM OTHER MISSING TANK SETUP CLEAR 2-25-16 10:39AM s 7 OTHER DIS 7-8 FM COMMUNICATION ALARM ALARM 2-25-16 10:38AM s 6 OTHER DIS 5-6 FM COMMUNICATION ALARM ALARM 2-25-16 10:38AM s 5 OTHER DIS 3-4 FM COMMUNICATION ALARM ALARM 2-25-16 10:38AM s 4 OTHER DIS 1-2 FM COMMUNICATION ALARM ALARM 2-25-16 10:38AM SYSTEM BATTERY IS OFF CLEAR 5-29-15 8:00AM OTHER MISS VAPOR PRES SEN ALARM 5-29-15 8:00AM OTHER MISS VAPOR FLOW MTR ALARM 5-29-15 8:00AM OTHER MISSING HOSE SETUP ALARM 5-29-15 8:00AM OTHER MISSING TANK SETUP ALARM 5-29-15 8:00AM SYSTEM BATTERY IS OFF ALARM 5-29-15 8:00AM I11200 JUN 1, 2016 8:12 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME SYSTEM PRINTER ERROR CLEAR 5-26-16 1:46PM SYSTEM PAPER OUT CLEAR 5-26-16 1:46PM SYSTEM PRINTER ERROR ALARM 5-26-16 1:45PM SYSTEM PAPER OUT ALARM 5-26-16 1:45PM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-22-16 4:45AM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-21-16 6:30AM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-16-16 2:10AM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-15-16 3:52PM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-12-16 8:38PM T 1 TANK DIESEL INVALID FUEL LEVEL CLEAR 5-12-16 8:37PM T 1 TANK DIESEL INVALID FUEL LEVEL ALARM 5-12-16 5:00PM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-10-16 1:50PM
T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-05-16 10:20PM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-04-16 9:22AM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 3-02-16 6:11AM T 1 TANK DIESEL DELIVERY NEEDED ALARM 2-29-16 10:00AM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 2-25-16 8:10PM T 1 TANK DIESEL DELIVERY NEEDED ALARM 2-25-16 10:39AM I20600 JUN 1, 2016 8:12 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781
TANK ALARM HISTORY TANK 1 DIESEL INVALID FUEL LEVEL MAY 12, 2016 5:00 PM DELIVERY NEEDED MAY 21, 2016 6:30 AM MAY 15, 2016 3:52 PM MAY 10, 2016 1:50 PM TANK 2 SUPREME 91 TANK 3 REGULAR 87 TANK 5 TANK 6 TANK 7 TANK 8 TANK 9 TANK 10 TANK 11 TANK 12 TANK 13 TANK 14 TANK 15 TANK 16 I38200 JUN 1, 2016 8:12 AM 826428 WHITE LNCHVRN
2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 PRESSURE LINE LEAK ALARM HISTORY REPORT Q 1:DIESEL Q 2:SUPREME 91 Q 3:REGULAR 87 I30200 JUN 1, 2016 8:12 AM
826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 DIESEL ANNULAR 2 DIESEL STP 3 SUPREME ANNULAR 4 SUPREME 91 5 REGULAR 87 ANNULAR 6 REGULAR 87 STP I31600 JUN 1, 2016 8:12 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 VAPOR PRESSURE 2 CANISTER 4 DIS 1-2 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 5 DIS 3-4 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 6 DIS 5-6 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 7 DIS 7-8 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 8 ATMP PRESSURE I40200 JUN 1, 2016 8:12 AM
I40300 JUN 1, 2016 8:12 AM I34200 JUN 1, 2016 8:12 AM I34700 JUN 1, 2016 8:12 AM IV0100
JUN 1, 2016 8:12 AM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 ISD ALARM STATUS REPORT EVR TYPE: BALANCE ISD TYPE: 01.05 VAPOR PROCESSOR TYPE: VEEDER-ROOT POLISHER OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME :100% EVR/ISD PASS TIME :100% VAPOR PROCESSOR :PASS WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 16-04-25 10:01:09 SENSOR OUT SELFTEST E 1 16-04-25 06:02:28 SENSOR OUT SELFTEST E 1 16-04-24 06:02:30 SENSOR OUT SELFTEST E 1 16-04-23 06:02:44 SENSOR OUT SELFTEST E 1 16-04-22 06:02:55 SENSOR OUT SELFTEST E 1 16-04-21 06:02:16 SENSOR OUT SELFTEST E 1 16-04-16 06:02:53 FLOW PERFORMANCE HOSE BLOCKAGE FP 6 BLEND3 0.59 16-03-09 06:01:09 FLOW PERFORMANCE HOSE BLOCKAGE FP 3 BLEND3 0.57 16-01-18 10:01:09 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.91 16-01-17 10:01:09 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.91 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-12-18 10:02:01 VAPOR PROCESSOR OVER PRESSURE DAILY 90% 2.30 15-12-10 10:01:09 SENSOR OUT SELFTEST PMC SENSOR FAULT 15-12-10 10:01:09 SENSOR OUT SELFTEST s 7 15-12-10 10:01:09 SENSOR OUT SELFTEST s 6 15-12-10 10:01:09 SENSOR OUT SELFTEST s 5 15-12-10 10:01:09 SENSOR OUT SELFTEST s 4 15-12-10 10:01:09 SENSOR OUT SELFTEST s 1 15-12-10 10:01:09 SENSOR OUT SELFTEST E 1 15-12-09 10:01:09 SENSOR OUT SELFTEST PMC SENSOR FAULT 15-12-09 10:01:09 SENSOR OUT SELFTEST s 7
SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 16-05-02 13:05:39 TIME CHANGE DETECTED AT: 16-03-03 13:05:38 16-04-25 10:01:09 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS 16-04-25 09:17:08 TIME CHANGE DETECTED AT: 15-05-29 09:17:07 16-04-25 09:02:31 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS 16-04-25 09:02:31 ISD STARTUP 16-04-25 09:01:58 ISD SHUTDOWN 16-04-25 08:58:41 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS 16-04-25 08:58:41 ISD STARTUP 16-04-25 08:51:24 ISD SHUTDOWN 16-04-25 08:32:12 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS
White Lane Chevron Testing Alarms
Responses Received:
I10200 JUN 1, 2016 1:01 PM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 9344613 9348182 2 UNUSED 9313041 9307019 3 INTERSTITIAL BD 202117 201667 4 UNUSED 9309231 9312429 5 4 PROBE / G.T. 163208 162908 6 PLLD SENSOR BD 3950 3989 7 7SMARTSENSOR BD 506297 505030 8 UNUSED 9314508 9312054 9 UNUSED 9312092 9308217 10 PLLD POWER BD 99914 99585 11 UNUSED 9306772 9311022 12 UNUSED 9310800 9311132 13 UNUSED 9309071 9306429 14 UNUSED 9308808 9302741 15 UNUSED 9309268 9310470 16 UNUSED 9307560 9312987 COMM 1 SERIAL SAT BD 477345 476143 COMM 2 REMOTE DISPLAY 27470 27437 COMM 3 ELEC DISP INT. 100675 100487 COMM 4 UNUSED 9316581 9308880 COMM 5 RS485 SERIAL BD 68215 68153 COMM 6 RS232 SERIAL BD 14911 14903 I90200 JUN 1, 2016 1:01 PM SOFTWARE REVISION LEVEL VERSION 334.00 SOFTWARE# 346334-100-A CREATED - 15.05.29.10.36 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I11100 JUN 1, 2016 1:01 PM 826428 WHITE LNCHVRN 2525 WHITE LANE
BAKERSFIELD CA 93304 661-832-9781
PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME Q 3 OTHER REGULAR 87 PLLD SHUTDOWN ALARM CLEAR 6-01-16 12:36PM Q 3 OTHER REGULAR 87 GROSS LINE FAIL CLEAR 6-01-16 12:36PM Q 3 OTHER REGULAR 87 PLLD SHUTDOWN ALARM ALARM 6-01-16 12:33PM Q 3 OTHER REGULAR 87 GROSS LINE FAIL ALARM 6-01-16 12:33PM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM CLEAR 6-01-16 11:51AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM CLEAR 6-01-16 11:51AM Q 3 OTHER REGULAR 87 PLLD SHUTDOWN ALARM CLEAR 6-01-16 11:50AM Q 3 OTHER REGULAR 87 GROSS LINE FAIL CLEAR 6-01-16 11:50AM Q 2 OTHER SUPREME 91 PLLD SHUTDOWN ALARM CLEAR 6-01-16 11:50AM Q 2 OTHER SUPREME 91 GROSS LINE FAIL CLEAR 6-01-16 11:50AM Q 1 OTHER DIESEL PLLD SHUTDOWN ALARM CLEAR 6-01-16 11:49AM Q 1 OTHER DIESEL GROSS LINE FAIL CLEAR 6-01-16 11:49AM L 5 ANNULAR REGULAR 87 ANNULAR FUEL ALARM CLEAR 6-01-16 11:29AM L 6 STP SUMP REGULAR 87 STP SENSOR OUT ALARM CLEAR 6-01-16 11:28AM L 3 ANNULAR SUPREME ANNULAR SENSOR OUT ALARM CLEAR 6-01-16 11:28AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM ALARM 6-01-16 11:28AM L 5 ANNULAR REGULAR 87 ANNULAR SENSOR OUT ALARM CLEAR 6-01-16 11:28AM L 5 ANNULAR REGULAR 87 ANNULAR FUEL ALARM ALARM 6-01-16 11:28AM L 1 ANNULAR DIESEL ANNULAR SENSOR OUT ALARM CLEAR 6-01-16 11:28AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM ALARM 6-01-16 11:28AM L 4 STP SUMP SUPREME 91 SENSOR OUT ALARM CLEAR 6-01-16 11:28AM L 2 STP SUMP DIESEL STP SENSOR OUT ALARM CLEAR 6-01-16 11:28AM L 3 ANNULAR SUPREME ANNULAR SENSOR OUT ALARM ALARM 6-01-16 11:27AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM CLEAR 6-01-16 11:27AM L 5 ANNULAR REGULAR 87 ANNULAR SENSOR OUT ALARM ALARM 6-01-16 11:27AM L 5 ANNULAR REGULAR 87 ANNULAR FUEL ALARM CLEAR 6-01-16 11:27AM L 2 STP SUMP DIESEL STP SENSOR OUT ALARM ALARM 6-01-16 11:27AM L 4 STP SUMP SUPREME 91 SENSOR OUT ALARM ALARM 6-01-16 11:27AM L 6 STP SUMP REGULAR 87 STP SENSOR OUT ALARM ALARM 6-01-16 11:27AM L 1 ANNULAR DIESEL ANNULAR SENSOR OUT ALARM ALARM 6-01-16 11:27AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM CLEAR 6-01-16 11:27AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM ALARM 6-01-16 11:27AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM ALARM 6-01-16 11:26AM L 5 ANNULAR REGULAR 87 ANNULAR FUEL ALARM ALARM 6-01-16 11:26AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM CLEAR 6-01-16 11:25AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM CLEAR 6-01-16 11:25AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM ALARM 6-01-16 11:24AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM CLEAR 6-01-16 11:24AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM ALARM 6-01-16 11:24AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM CLEAR 6-01-16 11:24AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM ALARM 6-01-16 11:24AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM CLEAR 6-01-16 11:23AM L 3 ANNULAR SUPREME ANNULAR FUEL ALARM ALARM 6-01-16 11:23AM
L 5 ANNULAR REGULAR 87 ANNULAR FUEL ALARM CLEAR 6-01-16 11:21AM L 5 ANNULAR REGULAR 87 ANNULAR FUEL ALARM ALARM 6-01-16 11:12AM L 1 ANNULAR DIESEL ANNULAR FUEL ALARM ALARM 6-01-16 11:07AM Q 3 OTHER REGULAR 87 PLLD SHUTDOWN ALARM ALARM 6-01-16 10:54AM Q 3 OTHER REGULAR 87 GROSS LINE FAIL ALARM 6-01-16 10:54AM Q 2 OTHER SUPREME 91 PLLD SHUTDOWN ALARM ALARM 6-01-16 10:51AM Q 2 OTHER SUPREME 91 GROSS LINE FAIL ALARM 6-01-16 10:51AM I11200 JUN 1, 2016 1:01 PM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781
NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME SYSTEM PRINTER ERROR CLEAR 5-26-16 1:46PM SYSTEM PAPER OUT CLEAR 5-26-16 1:46PM SYSTEM PRINTER ERROR ALARM 5-26-16 1:45PM SYSTEM PAPER OUT ALARM 5-26-16 1:45PM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-22-16 4:45AM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-21-16 6:30AM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-16-16 2:10AM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-15-16 3:52PM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-12-16 8:38PM T 1 TANK DIESEL INVALID FUEL LEVEL CLEAR 5-12-16 8:37PM T 1 TANK DIESEL INVALID FUEL LEVEL ALARM 5-12-16 5:00PM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-10-16 1:50PM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 5-05-16 10:20PM T 1 TANK DIESEL DELIVERY NEEDED ALARM 5-04-16 9:22AM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 3-02-16 6:11AM T 1 TANK DIESEL DELIVERY NEEDED ALARM 2-29-16 10:00AM T 1 TANK DIESEL DELIVERY NEEDED CLEAR 2-25-16 8:10PM T 1 TANK DIESEL DELIVERY NEEDED ALARM 2-25-16 10:39AM I20600 JUN 1, 2016 1:01 PM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 TANK ALARM HISTORY TANK 1 DIESEL INVALID FUEL LEVEL MAY 12, 2016 5:00 PM DELIVERY NEEDED MAY 21, 2016 6:30 AM MAY 15, 2016 3:52 PM MAY 10, 2016 1:50 PM TANK 2 SUPREME 91 TANK 3 REGULAR 87
TANK 5 TANK 6 TANK 7 TANK 8 TANK 9 TANK 10 TANK 11 TANK 12 TANK 13
TANK 14 TANK 15 TANK 16 I38200 JUN 1, 2016 1:01 PM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 PRESSURE LINE LEAK ALARM HISTORY REPORT Q 1:DIESEL JUN 1, 2016 10:46 AM PLLD SHUTDOWN ALARM JUN 1, 2016 10:46 AM GROSS LINE FAIL JUN 1, 2016 9:25 AM PLLD SHUTDOWN ALARM JUN 1, 2016 9:04 AM PLLD SHUTDOWN ALARM Q 2:SUPREME 91 JUN 1, 2016 10:51 AM PLLD SHUTDOWN ALARM JUN 1, 2016 10:51 AM GROSS LINE FAIL JUN 1, 2016 9:15 AM PLLD SHUTDOWN ALARM JUN 1, 2016 9:04 AM PLLD SHUTDOWN ALARM Q 3:REGULAR 87 JUN 1, 2016 12:33 PM PLLD SHUTDOWN ALARM JUN 1, 2016 12:33 PM GROSS LINE FAIL JUN 1, 2016 10:54 AM PLLD SHUTDOWN ALARM JUN 1, 2016 10:54 AM GROSS LINE FAIL JUN 1, 2016 9:14 AM PLLD SHUTDOWN ALARM JUN 1, 2016 9:04 AM PLLD SHUTDOWN ALARM I30200 JUN 1, 2016 1:01 PM
826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 DIESEL ANNULAR JUN 1, 2016 11:28 AM FUEL ALARM JUN 1, 2016 11:27 AM SENSOR OUT ALARM JUN 1, 2016 11:27 AM FUEL ALARM 2 DIESEL STP JUN 1, 2016 11:27 AM SENSOR OUT ALARM JUN 1, 2016 9:25 AM FUEL ALARM JUN 1, 2016 9:04 AM SENSOR OUT ALARM 3 SUPREME ANNULAR
JUN 1, 2016 11:28 AM FUEL ALARM JUN 1, 2016 11:27 AM SENSOR OUT ALARM JUN 1, 2016 11:26 AM FUEL ALARM 4 SUPREME 91 JUN 1, 2016 11:27 AM SENSOR OUT ALARM JUN 1, 2016 9:15 AM FUEL ALARM JUN 1, 2016 9:04 AM SENSOR OUT ALARM 5 REGULAR 87 ANNULAR JUN 1, 2016 11:28 AM FUEL ALARM JUN 1, 2016 11:27 AM SENSOR OUT ALARM JUN 1, 2016 11:26 AM FUEL ALARM 6 REGULAR 87 STP JUN 1, 2016 11:27 AM SENSOR OUT ALARM JUN 1, 2016 9:14 AM FUEL ALARM JUN 1, 2016 9:11 AM FUEL ALARM I31600 JUN 1, 2016 1:02 PM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 VAPOR PRESSURE 2 CANISTER 4 DIS 1-2 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 5 DIS 3-4 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 6 DIS 5-6 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 7 DIS 7-8 FM FEB 25, 2016 10:38 AM COMMUNICATION ALARM 8 ATMP PRESSURE I40200 JUN 1, 2016 1:02 PM
I40300 JUN 1, 2016 1:02 PM I34200 JUN 1, 2016 1:02 PM I34700 JUN 1, 2016 1:02 PM
IV0100 JUN 1, 2016 1:02 PM 826428 WHITE LNCHVRN 2525 WHITE LANE BAKERSFIELD CA 93304 661-832-9781 ISD ALARM STATUS REPORT EVR TYPE: BALANCE ISD TYPE: 01.05 VAPOR PROCESSOR TYPE: VEEDER-ROOT POLISHER OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME : 99% EVR/ISD PASS TIME :100% VAPOR PROCESSOR :PASS WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 16-04-25 10:01:09 SENSOR OUT SELFTEST E 1 16-04-25 06:02:28 SENSOR OUT SELFTEST E 1 16-04-24 06:02:30 SENSOR OUT SELFTEST E 1 16-04-23 06:02:44 SENSOR OUT SELFTEST E 1 16-04-22 06:02:55 SENSOR OUT SELFTEST E 1 16-04-21 06:02:16 SENSOR OUT SELFTEST E 1 16-04-16 06:02:53 FLOW PERFORMANCE HOSE BLOCKAGE FP 6 BLEND3 0.59 16-03-09 06:01:09 FLOW PERFORMANCE HOSE BLOCKAGE FP 3 BLEND3 0.57 16-01-18 10:01:09 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.91 16-01-17 10:01:09 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.91 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-12-18 10:02:01 VAPOR PROCESSOR OVER PRESSURE DAILY 90% 2.30 15-12-10 10:01:09 SENSOR OUT SELFTEST PMC SENSOR FAULT 15-12-10 10:01:09 SENSOR OUT SELFTEST s 7 15-12-10 10:01:09 SENSOR OUT SELFTEST s 6 15-12-10 10:01:09 SENSOR OUT SELFTEST s 5 15-12-10 10:01:09 SENSOR OUT SELFTEST s 4 15-12-10 10:01:09 SENSOR OUT SELFTEST s 1 15-12-10 10:01:09 SENSOR OUT SELFTEST E 1 15-12-09 10:01:09 SENSOR OUT SELFTEST PMC SENSOR FAULT
15-12-09 10:01:09 SENSOR OUT SELFTEST s 7 SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 16-06-01 10:03:04 READINESS ISD:PP EVR:PPP ISD & EVR READY 16-06-01 09:03:57 READINESS ISD:PP EVR:NNN EVR READINESS PENDING 16-06-01 09:03:57 ISD STARTUP 16-06-01 09:02:47 ISD SHUTDOWN 16-05-02 13:05:39 TIME CHANGE DETECTED AT: 16-03-03 13:05:38 16-04-25 10:01:09 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS 16-04-25 09:17:08 TIME CHANGE DETECTED AT: 15-05-29 09:17:07 16-04-25 09:02:31 READINESS ISD:PF EVR:NNN CHECK ISD SENSORS 16-04-25 09:02:31 ISD STARTUP 16-04-25 09:01:58 ISD SHUTDOWN
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.
Chevron 06/01/2016
2525WhiteLane Bakersfield,CA93304
BassemAzzi(805)217-0610
9/1/15
Kris Karns
Bradley Seykora
8339953-UT
Regular
12.00"
13.00"
5min.
8:45 am
7.00"
9:45 am
7.00"
1hour
0.00"
0.0625"
Super
12.00"
13.50"
5min.
10:00 am
5.50"
11:00 am
5.25"
1hour
0.25"
0.0625"0.0625"
Diesel
12.00"
10.50"
5min.
8:45 am
5.25"
9:45 am
5.25"
1hour
0.00"
06/01/2016