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HomeMy WebLinkAbout2012 FMC,a -226 0 HOODS Permit No. ALARMS SPRINKLER SYSTEMS SPR, ° Y BOOTH Permit No. Permit No. File Number: / 7to 7 Z Address: Date Received: <3"--6 — ( 3 Business Name: Permit No. -4 S t sfield, CA 933 / w © ("D L. C SYSTEM: BUILDING SQUARE FEET: New Mod. ❑ ❑ Commercial Hood System Building Sq. Feet: ❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft: 1. ❑ ❑ Fire Sprinkler System 2. ❑ ❑ Spray Fin6sh System 3. ❑ ❑ Aboveground Storage Tank 4. ❑ ❑ Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank ❑ q/ Other. ,I--7W � AST UST Permit No. Permit No. 37 INSPECTION LAG Date Time Signature Comments: n : / v� %�l Bi�� FT , �>;L�� /- , pa_/�,��,/ r1 .2 -FST r1, : R,c,keel sew VR p B 3y 33f - 6rP V=Lw2ZiS VM-r- # Acw 2sn& /P 51"0115-- BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request Phone No. (661) 326 -3979 UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANK TESTI UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PRIOR TO OPERATION OF ANY SYSTEM, [ALL UST AND /OR AST SYSTEMS SHALL BE ',INSTALL, .COMPLETE AND ACCEPTED By MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT. DEPARTMENT (FINAL) '1 REMARKS: BUILDING ADDRESS: 5� JOB DESCRIPTION: �t= t�ti C� OCCUPANCY TYPE: OWNER: PERMIT NO. 37 CONTRACTOR: PHONE # FD 1743 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�gvstem control panel by the technician who performs the work A copy of this form must be provided to the tank system bwner /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: EZ STOP MOBIL Site Address: 101 19TH STREET Facility Contact Person: LEE Make/Model of Monitoring System: TLS -350 B. Inventory of Equipment Tested/Certified Check the a ro riate boxes to indicate sDecific eouioment ins ted/serviced: Bldg. No.: City: BAKERSFIELD Zip: _ Contact Phone No.: ( } Date of Testing/Servicing: 812812012 Tank ID: UNL87 Tank ID: PREM91 ® In -Tank Gauging Probe. Model: MAG ® In -Tank Gauging Probe. Model: MAG ® Annular Space or Vault Sensor, Model: 4201463 ® Annular Space or Vault Sensor. Model: 4201463 ® Piping Sump / Trench Sensor(s). Model: 2081304 ® Piping Sump / Trench Sensor(s). Model: 208/304 ® Fill Sump Sensor(s). Model: 208 /304 ® Fill Sump Sensor(s). Model: 2081304 ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector. Model: ® Electronic Line Leak Detector. Model: VEEDER -ROOT ® Electronic Line Leak Detector. Model: VEEDER -ROOT ® Tank Overfill / High -Level Sensor. Model; EOA ® Tank Overfill / High -Level Sensor. Model: EOA ❑ 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: DIESEL Tank ID: ® In -Tank Gauging Probe. Model: MAG ❑ In -Tank Gauging Probe. Model: ® Annular Space or Vault Sensor. Model: 420/463 ❑ Annular Space or Vault Sensor. Model: ® Piping Sump / Trench Sensor(s). Model: 208/304 ❑ Piping Sump / Trench Sensor(s). Model: ® Fill Sump Sensor(s). Model: 208/304 ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector. Model: ® Electronic Line Leak Detector. Model: VEEDER -ROOT ❑ Electronic Line Leak Detector. Model: ® Tank Overfill / High -Level Sensor. Model: EOA ❑ Tank Overfill / High -Level Sensor. Model: ❑ Other (specify equipment type and model in Section E on Page 2). ❑ Other (specify equipment type and model in Section E on Page 2). Dispenser ID: 112 Dispenser 1D: 314 ® Dispenser Containment Sensor(s). Model: 208/304 ® Dispenser Containment Sensor(s). Model: 208/304 ® Shear Valve(s). ® Shear Valve(s). ❑ Dispenser Containment Float(s) and Chain(s). ❑ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 516 Dispenser ID: 718 ® Dispenser Containment Sensor(s). Model: 208/304 ® Dispenser Containment Sensor(s). Model: 2081304 ® Shear Valve(s). ® Shear Valve(s). ❑ Dispenser Containment Float(s) and Chain(s). ❑ Dispenser Containment Float(s) and Chaln(s). Dispenser ID: 9110 Dispenser ID: 11/12 ® Dispenser Containment Sensor(s). Model: 208/304 ® Dispenser Containment Sensor(s). Model: 2081304 ® Shear Valve(s). ® Shear Valve(s). ❑ Dispenser Containment Float(s) and Chain(s). ❑ Dispenser Containment Float(s) and Chain(s). *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): RICHARD MASON Signature: Certification No.: 83688015297857 -UT License. No.: C60 D40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 392 -8687 Testing Company Address: 5643 BROOKS CT. BAKERSFIELD, CA 93308 Date of Testing/Servicing: 8/2812013 Page 1 of 5 UN-036 —1/4 www.unidoes.org Rev. 01/17M Jt t`Cl Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: Cmmnlete the fnllnwina eherkliat- ® Yes ❑ No* Is the audible alarm operational? • Yes ❑ No* Is the visual alarm operational? • Yes ❑ No* Were all sensors visually inspected, functionally tested, and confirmed operational? • Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? • Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) ® N/A operational? • Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment p N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) ® Sump/Trench Sensors; ® Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ® Yes; ❑ No. • Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no ❑ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 90% • Yes* ❑ No Was 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* IR No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑ Product; ❑ Water. If yes, describe causes in Section E, below. • Yes ❑ No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, if applicable • Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: 1) DIESEL SPILL BUCKET FAILED LAKE TEST. I CLEANED DRAIN AND RE- TESTED - PASSED r Page 2 of S UN -036 — 214 www.unidoes.org Rev. 01/17/08 Monitoring System Certification F. In -Tank Gauging / SIR Equipment: ✓ • • \j 'f ® 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 Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Complete the following checklist: ❑ Check this box if LLDs are not installed. ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ❑ N/A (Check all that apply) Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; [10.2 g.p.h. ® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ❑ No* Was the testing apparatus properly calibrated? ❑ Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ® N/A ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ❑ N/A or disconnected? ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions ❑ N/A or fails a test? ® Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ❑ N/A ® Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: UN -036 — 3/4 Page 3 of 5 wwwxnidoes.org Rev. 01 117/08 Jl 1%1I Monitoring System Certification Form: Addendum for Vacuum/Pressure Interstitial Sensors Y. Results of Vacuum/Pressure Monitoring Equipment Testing This page should be used to document testing and servicing of vacuum and pressure interstitial sensors. A copy of this form must be included with the Monitoring System Certification Form, which must be provided to the tank system owner /operator. The owner /operator must submit a copy of the Monitoring System Certification Form to the local agency regulating UST systems within 30 days of test date. Manufacturer: Model: 463 System Type: ❑ Pressure; ® Vacuum Sensor ID q:. 5 %axtu:R:6 Component(s) Monitored by this Sensor: VAPOR RETURN LINE S:1 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: 87 PRODUCT LINE S:2 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: 87 ANNULAR S:3 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: 87 -91 VENT LINE S:4 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: 91 PRODUCT LINE S:5 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: 91 /DIESEL ANNULAR S:6 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: DIESEL VENT S:7 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: DIESEL PRODUCT LINE S:8 Sensor Functionality Test Result: ® Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: ❑ Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass; ❑ Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: ❑ Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass; ❑ Fail How was interstitial communication verified? ❑ Leak Introduced at Far End of Interstitial Space;' ❑ Gauge; ® Visual Inspection; ❑ Other (Describe in Sec. J, below) Was vacuum /pressure restored to operating levels in all interstitial spaces? ® Yes ❑ No (If no, describe in Sec. J, below) J. Comments: Page 4 of 6 ' If the sensor successfully detects a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the sensor, vacuum/pressure has been demonstrated to be communicating throughout the interstice. UN -036A -1/1 www.unidoes.org Rev. 01/36/06 VbOotmg Cortiffaa oa UST Moufinring Sitc.Plm Site Addv=. 19 T & KVTV ' +e Ie 6A ........ ::::.8 ::::: ::::::::::::::::: ...--- ...... ....... :: ::::::::::: :�:::: " : �::::::.::::: �:::::: ..... ..... ....................... ..::.:::::.:: :: : ::::: :::: :::::::::::::::: Date map was drawn. IL Z �� If you ab=dy have a diaVm thm shows aii reqund iniarmation, yqu Mq iwlude it rabert m this page, With your Monitoring by+atcrn Cendiadon. On your sine plan, show the genes! lmpnd of ranks and piping. Cl=iy Idem* locations of the following egLdprmnt, if insWtgd: mo7&oi ng sysEem ccnlrol panda; sensors monitoring tmk arnmlar spams, sumps, dispa as palls, spM cmadnaa, or sceaeda y corainerm areas; mechanical or Aleeffonic line l=ir defectors; sod in -tank Hquid levet probes (if used for leak detocd=)L N d* space pw Aded, ante the dot this Site Plan was prepared. Page , 4 of 4 tsr�aa —era -- ddoa.org tiay.e1n70 RICH ENVIRONMENTAL 5643 BROOKS CT. BAKERSFIELD, CA. 93308 OFFICE (661)392 -8687 FAX (661)392 -0621 PRODUCT LINE LEAK DETECTOR TEST WORK SHEET W /0#• FACILITY NAME: EZ STOP MOBIL FACILITY ADDRESS: 101 19TH STREET, BAKERSFIELD PRODUCT LINE TYPE: PRESSURE PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL DIESEL L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # ELLD UNL87 L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # ELLD PREM91 L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # ELLD L/D TYPE: YES PASS SERIAL # NO FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS DATE ACCORDING TO RED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATIONS. THE MECHANICAL LEAK DETECTOR TEST PASS / FAIL IS DETERMINED BY USING A LOW FLOW THRESHOLD TRIP RATE OF 3 GALLONS PER HOUR OR LESS AT 10 P.S.I. I ACKNOWLEDGE THAT ALL DATA COLLECTED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. TECHNICIAN RICHARD MASON SIGNATURE: �� ��� DATE: 8/28/13 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 for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: EZ STOP MOBIL Date of Testing: 8/28/13 Facility Address: 101 19TH STREET, BAKERSFIELD Facility Contact: LEE I Phone: Date Local Agency Was Notified of Testing: 8/2/13 Name of Local Agency Inspector (ifpresent during testing): ERNIE MADINA 2. TESTING CONTRACTOR INFORMATION Company Name:. RICH ENVIRONMENTAL Technician Conducting Test: RICHARD MASON Credentials': ❑ CSLB Contractor X ICC Service Tech. ❑ SWRCB Tank Tester ❑ Other (Specify) License Number(s): 5297857 -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic ❑ Vacuum ❑ Other Test Equipment Used: VISUAL I Equipment Resolution: 0 ......... ........ ...........s.__..........,.. _ , , Identify Spill Bucket (By Tank Number, Stored Product, etc. t DIESEL 2 UNL87 3 PREM91 4 DIESEL Bucket Installation Type: 0 Direct Bury X Contained in Sump ❑ Direct Bury X Contained in Sump ❑ Direct Bury X Contained in Sump D Direct Bury X Contained in Sum Bucket Diameter: 12" 12" 12" 12" Bucket Depth: 14" 14" 14" 14" Wait time between applying vacuum/water and start of test: 30MIN 30MIN 30MIN 30MIN Test Start Time (Ti): 1:00 1:00 1:00 3:00 Initial Reading (Ri): 5" 14" 14" 14" Test End Time (TF): 2:00 2:00 2:00 4:00 Final Reading (RF): 0" 14" 14" 14" Test Duration (TF — T,): 60MIN 60MIN 60MIN 60MIN Change in Reading (RF - R,): 5" 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 0 Test Result: ❑ Pass X Fail X Pass ❑ Fail X Pass ❑ Fail X Pass ❑ Fail Comments — (include information on repairs made prior to testing, and recommended follow -up forfailed tests) DIESEL BUCKET FAILED, I CLEANED DRAIN AND RETESTED - PASSED CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the Information contained in this report is true, accurate, and in jkM compliance with legal requirements. Technician's Signature: ? J' �— Date: 8/28113 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. SETUP T " ' 'IL-87 — S`'' I_13ETUP — — — — — — " Ply: i ° :: T CODE Al, 3 :I• 2013 1:09 PM :,I. COEF'F 1 '-000700 TF,'4:: :rl�pIETER Tr,'•1': :.F,. }FILE DO : 204.. -'ULL VOL Ts 15022 S`': r:: 1 .JN I TS NCH VOL 'NCH VOL 14765 U A: S`' :•` 1 :.ANGUAGE `NCH VOL t 3645 r' E;' p ::: ' "�_ NCH VOL S .:; : _ '1 DATE /TIME FORMAT '_'YYY • NCH VOL 12922 M {:, I ! HH:MM :SS xM NCH VOL 11282 -NCH VOL — }F' MOB I L 10381 - -NCH VOL 945Q 1 1 q:.. :rT' i ST NCH VOL 8516 VOL C(41, ! 4I .AT I OAS SETUP F : EL D . CA 93301 . NCH 553 — — . "NCH VOL ; 6611 =NCH VOL $l1::: SH::: T::ME 1 12:00 AA! T: ME 2 8:00 AM : 4735 NCH VOL P {•' •• :.E 7I hIGS : T: ME 3 DISABLED 3837 =NCH VOL : 2973 r =NCH VOL C(:d U° 1CvaRD 1 { RS -232 ) SH ": 'E:::)T METHOD T 1: l: I,.': DATE : ALL TANK LOW 2007 LOW T_' ME : DISABLED T :0.20 GAL/HR D C.'4 2 HOURS Tk:;'::' :,F,..,.y STOP :DISABLED T 12T REPORT FORMAT 114.00 NORMAL LINE LEAK SETUP 0 :. • •L, -87 :E11-91 T• .11.-3-OIN FIBERGLASS 2 ['.:A LEN: 200 FEET El:*A LEN: 0 FEET "W4 RATE: 3.0 GPH LOW rl'- A LEN: 200 FEET LOW E(A LEN: 0 FEET T 61'4 RATE: 3-0 GPH D SHUTOFF: NO LOW 413.suRE 0 Psi T NON-VENTED 114.00 MODE: :'ROF I LE irl"IRD 3173i: i!: NON-VENTED 7070 •k_ OFFSET: 0.0p31 :E11-91 T• .11.-3-OIN FIBERGLASS 2 ['.:A LEN: 200 FEET El:*A LEN: 0 FEET FL-_m:: cj:'ZE: 4.0 IN. "W4 RATE: 3.0 GPH LOW ?E ,'3SURE SHUTOFF: NO LOW ;'EllSURE 0 PSI T ".1' CODE D '0.':-' MODE :iL COEFF :.000450 SI:- '4::: NON-VENTED 114.00 OFFSET: rj,oPSI FL-_m:: cj:'ZE: 4.0 IN. WARNING 1.0 T E:33 3.0 PIN"X­" ".1' CODE 3 Tli::::*:: :iL COEFF :.000450 T(:,,.I:•: "I AMETER 114.00 TA'•1'.•: :'ROF I LE 20 PTS VOL, VOL 7070 J.. VOL : 6949 VOL : 6715 L('.4J ::NCH VOL 6420 9' ACH VOL 6082 SI.C17 C1'; __NCH VOL 5705 Th •I NCH VOL 5309 6040 :NCH VOL 4885 VOL _NCH VOL 4450 ::NCH ..NCH VOL 4008 VOL 3555 4559 .NCH VOL 3111 VOL NCH VOL 2662 :I "NCH VOL 2228 ::NCH VOL : 1806 3028 VOL : 1399 VOL :1 __NCH VOL : 1027 NCH VOL : 681 2.: VOL : •381 : 1592 ..NCH VOL : 143 FL-_m:: cj:'ZE: 4.0 IN. S WARNING 1.0 H", JA':'ER LIMIT: 3.0 Ti::: VOL: 7070 11'4 PERIODIC: 0% LIMIT 90% U,:;,: 114 ANNUAL 01/0 6363 Wl], :,F,.,:)DUCT 95% VOL, 7904 6716 Dl:*.,.'.:: 'W! LIMIT 15% :1 _NCH 1060 L('.4J ?ODUCT 500 LFi::i:-: :iLj.)RM L 1111 T: a SI.C17 C1'; •1 "..OSS LIMIT: 65 Th •I '-' T 3.00 6040 0:`7FSET 0.00 S l MANIFOLDED TAWS Tl::: hl L': '4::: 'lA'4IFOLDFX TANKS Ti::: 'I I i:VIETER 114.00 11'4 PERIODIC: 0% :99F I LE 0 U,:;,: 114 ANNUAL 01/0 VOL 0 PI', :: 111' TEST TYPE STANDARD AWC. .. '-EST FAIL ALARM DISABLED '111" TEST FAIL ALARM DISABLEV 1`1ST FA I L ALARM DISABLED AN *-1 AVERAG I NG: OFF PF.,:::, ::E;" AVERAG I NG: OFF Tt:, *,I..: :*E !:)T NOT I FY: OFF Tt-l'-:: :;T SIPHON BREAK :OFF Dl:'::..': 3"! DELAY : 1 M I N b% 1-in r T 2: ;'E:1'1-91 . : PF." _':., CODE 2 T11-7:; :1. COEFF ;.000700 TA A-: 'I I i:VIETER 114.00 Tf:,'f.•: :99F I LE 20 PTS LEi::i:•: FULL VOL 8042 NCH VOL, 7904 "NCH VOL 7638 :1 _NCH VOL 7304 NCH VOL 6918 NCH VOL 6489 ""NCH VOL 6040 NCH VOL 5557 ::NCH VOL 5064 NCH VOL 4559 :*NCH VOL 4043 :I "NCH VOL 3539 'NCH VOL 3028 :: NCH VOL : 2533 VOL : 2054 2.: 'NCH VOL : 1592 NCH VOL : 1168 ..NCH VOL 774 'NCH VOL 434 :'NCH VOL 162 Fll.,:.,:. E;::ZEI 3.0 IN. tAARNING 1.0 H:: 1: • JA'..ER LIMIT: 3.0 Mf:i:--: ;! :-ABEL VOL: 8042 OV-i'5 l.". LIMIT 90% 7237 H-,'.a-- :,R,')DUCT 95% 7639 DE :.R? L I M I T 1504 1206 LC4J ;'C-**)UCT 500 LEA,.•: :jLjlRM L I M I T: 8 SU•Y"- q -".OSS LIMIT: 65 Th 1-: "1 -..T 3.00 OFFSET 0.00 S:'17, ­ -1 11ANIFOLDED TANKS Tt:: N7E L' *•I';: 'fA*41FOLDED TANKS Tt:: W.:7 11'4 PERIODIC: ox 0 LEi::i:•: 1I '4 ANNUAL oyo 0 '110' TEST TYPE STANDARD AN1. .. '-EST FAIL ALARM DISABLED Pl::':il ­ :Q(,' TEST FAIL ALARM DISABLED 7:2ST FAIL ALARM DISABLED AW4 AVERAGING: OFF PER ::E.". AVERAGING: OFF TF:,'+.-• "Ei:ST NOTIFY: OFF T(•l'.*:.' :11' SIPHON BREAK'.OFF Dl::.:...' :R? DELAY I MIN Pljtj:;: in nnl L_-11! 4L,":37 FILL SUMP 'A :.'E (SINGLE FLOAT) ',Y:! : PIPING SUMP L'.:-: -IL;37 FILL WALL TI? ** :'A7E (S INGLE FLOAT) CA :Y! : PIPING SUMP L:.5: 113191 FILL SUMP TI ?::- "A'"E (SINGLE FLOAT) 'RV : PIPING SUMP L:.ta: :11191 FILL WALL TR ... "Pi-E (SINGLE FLOAT) PIPING SUMP L:.';': :E13EL FILL SUMP TI:::: Yi-E <S I NGLE FLOAT) :IR? PIPING SUMP L: :): *E13FL FILL WALL TF::* :'A'-E (S INGLE FLOAT) '-R? : PIPING SUMP L'.:�: 41.37 STP SUMP Tl;':'-- 'A':"E (SINGLE FLOAT) DY:­] "F? : STP SUMP L'2­1: 111.37 STP WALL TP.. 0;"..E (SINGLE FLOAT) CFi :-Y.! : STP SUMP ?E1,191 STP SUMP TR "A':7E (S INGLE FLOAT) !F`:! : STP SUMP • :0191 STP WALL n'. "A -E (SINGLE FLOAT) 'F'? : STP SUMP L'e.."t: '.ESEL STP SUMP Tf' - --- "A"'E (SINGLE FLOAT) Ch"'"ll" '.,Y2 , STP SUMP 'ESEL STP WALL TF. ..A_ ? ",- - ..E (SINGLE FLOAT) cf.i`:'-: '-F"! ' STP SUMP L',­;: SUMP TR., :pl,..E (SINGLE FLOAT) CA":". PIPING SUMP L',?­'. : WATT TJ':! "f:i".E (81 NGLE FLOAT) CAI— "R? : PIPING SUMP L­.Q_ SETUP L ' ' •: :&?1-2 PAN TP:­ "A' -E (SINGLE FLOAT) Ch`..­-* '.IF? : DISPENSER PAN L 2': S::> 1 -2 WALL Tl;':.- "A"."E (SINGLE FLOAT) chl-".:: :,F? : DISPENSER PAN L '1:11: :S'*:>3-4 PAN TP­- :'l2;:"E (SINGLE FLOAT) ch,­: :-Y:!, : DISPENSER PAN L :c:*'>3-4 WALL TR ."A-E (SINGLE FLOAT) Cf :;-.... DISPENSER PAN L *--,: 'S?5-6 PAN TI :::: - :'A'-'"E (SINGLE FLOAT) CFt`.'.".:: : DISPENSER PAN L r.: *S?5-6 WALL Tli! - :'A"E (S I NGLE FLOAT) ce;.­ DISPENSER PAN L PAN TI: :'A"'E (SINGLE FLOAT) Crf­.'*.� :-R? : DISPENSER PAN L I! '.,cf?7-8 WALL TI? :: -- *'A" - 'E (SINGLE FLOAT) CA":`:.: :-F. DISPENSER PAN L ::': 'E;:?9-I0 PAN Tl:! :'Pi-E (SINGLE FLOAT) of:1, ,-: '-R? .. : DISPENSER PAN L:.: is *2;­)9-10 WALL TR ' : :'Fi '. "E (SINGLE FLOAT) : CAl. R? : DISPENSER PAN L'_ :. : 'S? 11 - 12 PAN TF!:'-. "A :'E (SINGLE FLOAT) CA .,R? : DISPENSER PAN WALL TY' -- Yi-E (S INGLE FLOAT) DISPENSER PA NI 0 '1: 'E'.:.3)EL .1I.-,3.0IN FIBERGLASS 2-J.. D_-A LEN: 150 FEET 3. Y.' fl.*:A LEN: 0 FEET Bill" * '-W*4 RATE: 3.0 OPH L(,. A-1 ;'ESSURE SHUTOFF :NO LOCI :!ESSURE 0 PSI T 3: 'EBEL D::*.-f--- -r&..::. MODE: S 13" .: T0RD ;': NON-VENTED IT,!*-;" OFFSET' O.OPSI L."''C: Z:w LOCKOUT SETUP L('-,l*-::'--; •T SCHEDULE Dh " *' , S'.'*k;: T*.ME: D I SABLED "I HE : D I SABLED .wt 1 -if t Q 3: '.U-3EL 4Y ALARMS Q ZEM-91 ll,'MH WATER ALARM 11.1 lk* ALARMS L SENSOR ALMS - 1. ilGH WATER ALARM 1'4E DISABLE SETUP L :'U'7L ALARM -11GH WATER ALARM li::i ALARM L. ALARM L.': 0., ) SENSOR ALMS Q IL. 87 :'U'.!L ALARM L lll..L ALARM "U :I ALARM :'Lf::L ALARM 11-1 W. ALARMS L I I -116',H WATER ALARM L X'4SOR OUT ALARM L -'L;': -L ALARM OUT ALARM 1. Lf:i ALARM L::0. :1 (SENSOR ALMS L :;E:'4SOR OUT ALARM L :*Ll::iL ALARM I. :'Ll-IL ALARM 'MR OUT ALARM :'LC'--'L ALARM I., :'U'L ALARM L I. :F-4SOR OUT ALARM L ;E '4SOR OUT ALARM 11'.1 ALARM '.-E'SOR OUT ALARM I.. :;E:'60R OUT ALARM L :;E'4SOR OUT ALARM L. .1,E:'4SOR OUT ALARM I.. %[::L ALARM 1, IE'GOR OUT ALARM L :;E: -4SOR OUT ALARM L LC L ALARM L 1. ll';:' ALARM 'IE'4SOR OUT ALARM L '4SOR OUT ALARM '0R OUT ALARM L OUT ALARM L :.E 1SOR OUT ALARM L -.Ze L ;:E;'4SOR OUT ALARM XiSOR OUT ALARM L X'rBOR OUT ALARM :;E I. :,E•4SOR OUT ALARM *4SOR OUT ALARM 1, :;E'4SOR OUT ALARM L �;E'4SOR OUT ALARM L -v':: :11EISOR OUT ALARM I,, :if;,4soR OUT ALARM L �;ElSOR OUT ALARM �'E*COR OUT ALARM I..:. -*,E'4SOR OUT ALARM 1. A: 1SOR OUT ALARM .;HORT ALARM L:. :.'E ISOR OUT ALARM L �ElSOR OUT ALARM '...+F)RT ALARM LLI., '.,E 4SOR OUT ALARM L :;EASOR OUT ALARM iFP:)RT ALARM .'.E'4SOR OUT ALARM L -XlSOR OUT ALARM :;K)RT ALARM L:-, i;E: -4SOR OUT ALARM L :;EASOR OUT ALARM L `; K)RT ALARM 1, ::H-)RT ALARM ; L X'4SOR OUT ALARM :;HORT ALARM L :;4)RT ALARM L:.: `-E:'6OR OUT ALARM 3EASOR OUT ALARM L ;HORT ALARM L :�FIORT ALARM 1.,;:! )FK)RT ALARM I.. :*+:)RT ALARM liESOR OUT ALARM ::F0RT ALARM 1, :;WRT ALARM l : L :*+)RT ALARM ::4.)RT ALARM L :;HORT ALARM L : .; K)RT ALARM ,4')RT ALARM 1. :*+)RT ALARM L ::4)RT ALARM L :;Fl;.)RT ALARM 1. ::f+)RT ALARM I. = 3'HORT ALARM :;i+)RT ALARM ALARM L. 'WRT ALARM ;,FN)RT ALARM L, :*+)RT ALARM L :4HORT ALARM L I.,:. 40')RT ALARM L "4)RT ALARM ::R:)RT ALARM :.:, ;i+)RT ALARM L '�+V)RT ALARM 1. :0)RT ALARM L, ��+)RT ALARM L 3F+)RT ALARM L ALARM LL -,W.)RT ALARM I,;':. :8ORT ALARM :;H,.)RT ALARM L' :IHORT ALARM +)RT ALARM I. :0)RT ALARM -:lI.:. `;FV)RT ALARM I.:.:i i.; F I -:) R T ALARM L ".,q:)RT ALARM :;H,',)RT ALARM V C) U'- 3:,-. &Z tf 25 z: • tj < 3> < — r- 3> cp Lu ;Z :c> < 3> CD op i�A t- -4 �o I t� C ON m C3 < 0 Cam'} 0 v < < 0 -4 z rr) oz 00 Z:r> rri co z 0 10, C, 0 F g m m Eo -i . . 111 4 -i rri m to F M z m 3> 0 U3 70 -3 z rrj 0 70 M 0 0 z 0 t-1 w r r- rr) z 65 7- C; rri x IV z uj w o x z w A14"L4 11-STORY REPORT A1,6:-, FI -.STORY REPORT Al..i:4.' H"STURY REPORT 9:7NSOR ALARM . ... ..... SENSOR ALARM ----- E;",?NSOR ALARM L :S*:)7-8 PAN L :S.?3-4 WALL L .'S? I - 2 PAN D 7 IE;.'.:"R PAN D'!'. ' PAN D::::--: -IS :7R PAN SEl: )UT ALARM FI'.*I,:,:. )LJ:)Rm SE'.I::; OUT ALARM AUGI 2013 2:30 PM ALIl-': 2013 2:56 PM AL43 ). 2013 2.'30 PM FLC,'.'. :iLARM 9171z OUT ALARM FLIK'. 'iLARM AIK": 1. 2013 2:23 PM Al*b ­T 2013 2:30 PM AIX% 2013 2*.20 PM SE'-F OUT ALARM SE'-F i! OUT ALARM BE %E OUT ALARM At .X: ; 2012 11:45 PM ALIG 11:45 PM Al.K.; 2012 11:46 PM END END END if Ab:;`: H.-STORY REPORT Al-Ci':: FI-STORY REPORT Al.a;i F1'.STORY REPORT SJNSOR ALARM rl;'.:-7NSOR ALARM E:-,NSOR ALARM - - - -- L k;7-8 WALL L li: :S-':>5-6 PAN L :E01 -2 WALL D 7 -C ER PAN D': v�­:; - *:: I Ew`_:'z R PAN D 'I'. v.::::: 1S ER PAN SEA:: ')UT ALARM sl::'4*,': OUT ALARM SE'.I::; :iLAW AUGI 2013 2:57 PM At.11:':; 2013 2:30 PM ALV: :1, 2013 2:56 PM BE'•C OUT ALARM Fl.i::*'. :b:RM BE'-E: OUT ALARM A(A,:,., 2013 2.30 PM ' Atll::,; 2013 2:24 PM A1.43 2013 2:30 PM SE L ')UT ALARM SE-F.' OUT ALARM BY. ­.I::: OUT ALARM At .X: ; 2012 11:45 PM AD]: 2012 11:45 PM AL K.: 2012 11:45 PM is X END )i X X END END ALA:; Fl:: STORY REPORT Al..i"v; H.'. STORY REPORT AL,L;-, I,I_­ STORY REPORT SHNSOR A ARM ..... AL ER-14SOR ALARM S:21NSOR ALARM L CS?9 - 10 PAN L WALL L '.S?3-4 PAN D E;.'.::R PAN D 4c,; ::R PAN D -Lc:'.:.R PAN SEA:: ')UT ALARM F :iLARM SE'.I::; OUT ALARM AUGI 2013 2:30 PM AL13-1 :1, 2013 2:58 PM ALIl.:; 2013 2:30 PM FLI,:::. yL-ARM OUT ALARM FLI: ZARM ALIG 1, 2013 2:25 PM ' Atll::,; 2013 2:30 PM A0.3 1, 2013 2:21 PM F[Fl:'. UARM Ft.C'*. yU:IRM OUT ALARM onj,�o ii - ar, Pm 461 tr::' :,. 7ni2 11:47 PM ALKIT i', 2012 11'45 PM Al.i::;.­: VFSTORY REPORT X E ND X x X x x Al.j;*:, I'CSTORY REPORT &`NSOR ALARM L K-ENSOR ALARM L'.*-',: ?i-P191 FILL WALL F(I*:::. 3,ump FLI.--'*', Z,ARM ALIG 3. 2013 3:04 PM SEA OUT ALARM ALL; 2013 2:31 PM Ftf:::': :iLjiRM NC, 2012 6:15 PM X E ND X x X x x Al.j;*:, I'CSTORY REPORT &`NSOR ALARM L 'L:3 EL FILL SUMP P :,; Surip F(I*:::. HARM A I 11"4 'J, 2013 2:47 PM SY:1,` OUT ALARM ALIG 2013 2:30 PM SE *1::: OUT ALARM ALE:; 2012 11:46 PM X p: 01 X END Ah:'i FI:'STORY REPORT R]INSOR ALARM L.- !: -EISEL FILL WALL p . .. SUMP P::..,..• :iLARM AL113 2013 3:02 PM SF OUT ALARM ALP::; 2013 2:30 PM AIK,' t, 2013 . 2:14 PM FU":'-". 0:.94 PIM AL.f;j",; H*-'STORY REPORT X 1-i X x END X x x x x Al.j:•i7: H-STORY REPORT S-,:NSOR ALARM L*.::.: E;--:NSOR ALARM L:. -11J7 FILL WIP P::..,..• :iLARM SE'C ? -)UT ALARM ALA:; ii, 2013 2:30 PM ALP::; 2013 2:30 PM AIK,' t, 2013 . 2:14 PM FU":'-". :14-IRM ALI[-'. :1, 2013 2:14 PM X 1-i X x END X x x x x Al.j:•i7: H-STORY REPORT S-,:NSOR ALARM L*.::.: -IL 37 FILL WALL P SUMP FLf.:::­. :iLARM ALKI :1, 2013 2:54 PM Sl'.*.'V ' OUT ALARM ALP::; 2013 2:30 PM FIYE". Z,ARM 140'..' 2012 6;29 PM END X X X AI.,i::i:` F1'.STORY REPORT ALi::l'.:; I•I-STORY REPORT —NSOR ALARM S:':!NSOR ALARM ----- D: ;T1191 FILL SUMP P'-'.:,:: :,; 3 U M P FLK:,'. ;L,ARM ADI J. 2013 2:48 PM SE -:)UT ALARM At.113 2013 2:31 PM SL'•::: i' :)UT ALARM AL113 2013 2:30 PM ALi::l'.:; I•I-STORY REPORT —NSOR ALARM x;.; X * END X x x x x H'.*STORY REPORT S":NSOR ALARM - L:.:.: S'4 9-10 WALL D: 4S:::R PAN FLIE'l 4LARM At-11-: 2013 2:55 PM SE OUT ALARM AL0.3 1. 2013 2:31 PM FU'::.."' ' :,Lj:4RM ALP:;: ' ;-, 2012 11:45 PM x;.; X * END X x x x x H'.*STORY REPORT S":NSOR ALARM - L:.:.: :S."?11-12 PAN D: - FSH'R PAN SF:'-9:: ?OUT ALARM At-11-: 2013 2'31 PM FLI::"". :iLARM ALI,:% :i. 2013 2:27 PM FU.--::' 'LARM A1.11], :i. 2013 2*26 PM xil.: •:X END XXXXX Al.a:�i.`: I-I­.STORY REPORT c Olrr- ALARM S. � ALARM ----- l c'::NSOR E:','.> 11 -12 WALL D., 4.c;".R PAN Ft.l'::':. 'iLi'RM ALP—.; :1, 2013 2:56 PM SE3:: OUT ALARM ALP.':; 2013 2.31 PM c Olrr- ALARM :iLARM 2012 1:41 AM q( 1.:. ): * END A K x w x AL--t:': HFSTORY REPORT S'NSOR ALARM -- L: =. WALL P.-.:", ;, SUMP Ft.i::;::*. ;LARM Ai.11:::* ). 2013 2:49 PM OUT ALARM 2013 2:30 PM FIJ--::-.. :jLARM AUG :f, 2012 1:41 AM ;P.::" REVISION LEVEL Al.,ri. H". STORY REPORT Al.,i::i'-'; H-STORY REPORT Ft.l-.;:-. S. NSOR ALARM N Cl :71JARE MODULE L, ill, 91 STP WALL ALh*' S'37NSOR ALARM ----- - S""- lr- " AIJ,'*:; :.X, SUMP FLr-.::::. :1.01?M P " IBUMP Ai.11::; :j. 2013 2:53 PM Ft.l*-:;.'.. :iLj:!RM 1, 2013 2.'30 PM At.b-; !1. 2013 2:49 PM SE'•I::: ;' .,UT ALARM M 1013 SE'L A1.11]; i:, 2013 2:30 Pm 2 OUT ALARM A1.4 2013 2:30 PM Alp;: 2013 2:30 PM FUE". Z.0iRM SE,•F N(,'.' '42M12 11:33 PM :iLARM 2012 1:41 AM q( 1.:. ): * END A K x w x AL--t:': HFSTORY REPORT S'NSOR ALARM -- L: =. WALL P.-.:", ;, SUMP Ft.i::;::*. ;LARM Ai.11:::* ). 2013 2:49 PM OUT ALARM 2013 2:30 PM FIJ--::-.. :jLARM AUG :f, 2012 1:41 AM K END W X A X x Al.j:4'� H'.9TORY REPORT ;P.::" REVISION LEVEL L::? : ',N X27.04 S_,_ I :IF':30 346327-100-E Ft.l-.;:-. :1, - 07.02.06.10.28 N Cl :71JARE MODULE OUT ALARM ALh*' 'C,­)IC IN -TANK TESTS FU_-;;:'­ IA:_ IN-TANK TESTS K END W X A X x Al.j:4'� H'.9TORY REPORT x 1; N: x END x k x x x AL,::,:' E;.-�NSOR ALARM - -- L::? : -137 STP SUMP S_,_ I lm? Ft.l-.;:-. Z.,vM 2013 4:39 PM OUT ALARM ALh*' 2013 2:30 PM FU_-;;:'­ :il.i:)RM AIJ,'*:; S, 2013 2:13 PM x 1; N: x END x k x x x AL,::,:' H' ::§TORY REPORT ALj­i::;. H'..'STORY REPORT E:'..:?N30R ALARM E,.--.:.NSOR ALARM :E',")E STP SUMP L2::l: -IL:37 STP WALL S ...... All? SF.: OUIT ALARM Ft.l*:*:.-, 4ARM AU1-4 1, 2013 2.'30 PM At.[":; 2013 2:54 PM iLA M 1013 SE'L :)UT ALARM A t. 2 2:17 PM A1.4 2013 2:30 PM FtJ::'- A.j-IR� FUE". Z.0iRM SE,•F O IT ALARM fl.l:::'_ a-ARM 2012 11:46 PM oc: ' ., 2012 12:38 PM x END Yc X X )t x AI.,,::,"i H- S ORY REPORT ALj­i::;. Fl.'.'STORY REPORT E:'..:?N30R ALARM c.:.7.NSOR ALARM ----- :E',")E STP WALL L 0191 STP SUMP :jLARM SE t., . OUT ALARM AU1, ;1, 2 13 2:54 PM AD]; :-, 2013 2:30 PM ul OU ALARM Ft.l*::"'. :iL:IRM AIL., 2 13 2:30 Pm A1.11'.,, it, 2013 2:17 PM FtJ::'- A.j-IR� FUE". Z.0iRM 2612 8:16 PM A I 3 . 2012 12:18 AM AI i:'i.; HSTORY REPORT f — ... ... 'IAG•:TSENSOR ALARM -- s : ESEL VENT LINE H:: .I6IUID ALARM A[.Irl 3, 2013 4:10 PM N(:- '„ '•LI.JM ALARM Al.li I, 2013 4: 20 PM NO '„ : :U.JM ALARM ALb: :; :I, 2012 1:27 AM x I: 3-: X END n ALi'i:; FI :: STORY REPORT —• °••• lk:11TSENSOR ALARM -- s I: :'M PRES 4: �: * END 1•I -.STORY REPORT — 'IkiTSENSOR ALARM -- s : E3EL PRODUCT LINE H. IQUID ALARM Alba :I. 2013 4:20 PM NO ;LI.JM ALARM A1.11 ; :r, 2013 4:20 PM N(., '.. :' Ll JM ALARM AIK':; :I, 2012 1:27 AM AIA:; N(; Al.ba NO ,. ALb: NO NOV Fl-'STORY REPORT 'IAi: ?TSENSOR ALARM VENT LINE LI JM ALARM :r. 201:3 4:22 PM U.JM ALARM 2012 1:29 AM LI.JM ALARM • 2011 12:09 PM r: END AI..i::6 H "STORY REPORT _ •IA: :ZTSENSOR ALARM -- s 17191 PRODUCT LINE NO '„ ::U311 ALARM A1.11-,* 2013 4:23 PM H_i:l - AQUID ALARM Alb; :. 2013 4:22 PM NO '„ Al JM ALARM AU13 :I, 2012 1:30 AM * X X END Al.j':L; H'. STORY REPORT — •••••• 1AiRTSENSOR ALARM -- s : :.: :E:I191 —DSL ANNULAR N( . : U.JM ALARM Alb:;, :r, 2013 4:23 PM N( '.• ::LI.1M ALARM A1.b:3 .1, 2012 1:29 AM NO LI .JM ALARM Al.b; :I. 2012 12:08 AM AI..e i` FI :: STORY REPORT —° 'IFi:�TSENSOR ALARM -- s :. ; :iF'-)R RETURN LINE H::,:::- .,16)UID ALARM 2013 4:17 PM NO :'LI.JM ALARM ALb.; il, 2013 4:15 PM �:)AT I ON ALARM C( +H" I I JA A :1. 2013 5:41 AM X >� X END X x* x x Alj:' :: HSTORY REPORT — ... ••• 1Ai ;'TSE NSOR ALARM -- s •IL 37 PRODUCT LINE NO '•. .. I Q U I D ALARM Al.b„ ;I, 2013 4:17 PM NC, '•• ':LI.1M ALARM A1.11]; 2013 4:16 PM H::1; .,IQUID ALARM Al.b:"' :I. 2012 1:24 AM X .: % END * w x m AI..r is H " $TORY REPORT _ lA iTSENSOR ALARM - — s 1: IL-37 mNNULAR NO '•. Ll .Al ALARM Al.b„ :I. 2013 4:15 PM NO '- XI JM ALARM A1.11]; :, 2012 1:24 AM N(, '., 'LI.1M ALARM rvl'r_' :', 201 1 1 ? : 03 PM J 1 1`11 /�/ AL.F ": H :. STORY REPORT — E::NSOR ALARM - - - -- 0 3: : E ,3EL PI.- 7, '41 JTDOWN ALARM Alb., J, 2013 3:48 PM GIN',' L. 'NE FAIL ALb -.; 3, 2013 3:48 PM Pl..::...: FI.JTDOWN ALARM 2013 2:30 PM PI....:: >H.JTDOWN ALARM 2013 227 PM JTDOWN ALARM AUG 2013 2:26 PM PL,_., ;H.JTDOWN ALARM A1.4-:; 2013 2:25 PM PL ;FI JTDOWN ALARM ALI," ;1. 2013 2:23 PM : ;H.ITDOWN ALARM Al.k; 2013 2:20 PM PI..;...:; : :H.JTDOWN ALARM At-b": 2013 2 :17 PM PI :..:: ;HJTDOWN ALARM At.b_, :1, 2012 12:42 AM ZD I tai A, i AL.i- c: FI :: STORY REPORT _ — :;::NSOR ALARM - - - -- Q •IL. -87 PI., "* ;H.JTDOWN ALARM Al,h::; :1. 2013 3:37 PM L.:: NE FA I L ALb., ;, 2013 3:37 PM GIN'. :: : ;HJTDOWN ALARM ALk:: 2013 2:30 PM PI.,:., : JFI.JTDOWN ALARM Al.b ; :1. 2013 2:25 PM '>UTDOWN ALARM ALIG ;, 2013 2:24 PM PI,: * "" ;FIJTDOWN ALARM AIXI: :1. 2013 2:23 PM PI::::: :;H.JTDOWN ALARM ALb_, .: , 2013 2: 21 PM PI., "., "' ;H.JTDOWN ALARM At.p': 1. 2013 2:20 PM PI.. ::.. ": .H.JTDOWN ALARM A1.10 ;. 2013 2:17 PM PI..::...:: : ;H.JTDOWN ALARM Alb: :; 1, 2012 12 :40 AM ZD I tai A, i AL.i- c: FI :: STORY REPORT _ S NSOR ALARM - - -- Q :.: •IL. -87 PI.. =..:.: ;HJTDOWN ALARM A1.11:; ;, 21D13 4:39 PM ;H.ITDOWN ALARM Alb*: :I, 2013 3:47 PM GIN'. :: L.-NE FAIL ALk:: ;, 2013 3:47 PM PI „ "., :;H JTDOWN ALARM Alb.; J, 2013 2:30 PM : ;H.JTDOWN ALARM Al.11::: J, 2013 2:25 PM PI... ": ;H.JTDOWN ALARM AI.b--; :1, 2013 224 PM PI.::..::: ;FI.ITDOWN ALARM Al.u:;; :1, 2013 2:23 PM ' ;H JTD%JN ALARM A1JG: . 2013 2 :21 PM PI.. ::.. ": ;FIJTDOWN AL.ARhI Alb: :1, 2013 2:20 PM PI.::..::: ;H-JTDOWN ALARM At.b; ;, 2013 2:13 PM �D v 11-k k f/ MONITOR CERT. FAILURE REPORT SITE NAME : EZ STOP MOBIL DATE : 8/28/13 ADDRESS: 101 19TH STREET TECHNICIAN: RICHARD MASON THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: 1) DIESEL SPILL BUCKET FAILED. I CLEANED DRAIN AND RE- TESTED - PASSED LABOR: PARTS INSTALLED : NAME : TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR CONVIENENCE. UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION (Please note that these are separate Individual tests and will be charged per separate type test accordingly.) *�Wi A ar a 11 1 /►1RI /R1r f BAKERSFIELD FIRE DEPARTMENT Prevention Services Q 10 l k-E S -mv-ET Bakerstield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 1 PERMIT # • ENHANCED LEAK DETECTION El ❑ SB -989 SECONDARY CONTAINMENT • TANK TIGHTNESS 8 FUEL MONITORING CERTIFICATION FD2095 (Rev 03/08) FACILITY NAME & PHONE # OF CONTACT PERSON ADDRESS 6 OWNER NAME OPERATOR NAME PERMTTTO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS TANK TESTING.COMPANY. TESTING COMPANY NAME & PHONE # OF CONTACT PERSON MAILING ADDRESS �jlQ� -13 �C�OOk.S GT. — ��KEiRSF lE.� -� NAME & PHONE TESTER OR SPECI INSP R CERTIFICATION # S09 eso DATE & TIME TEST To BE CqVDVCTED r ICC # TEST METHOD APPLICANT SIG ^ DATE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08) BILLING & PERMIT STATEMENT PERMIT NO.: B 8 R S F I D *F'Rff Ali<rY r BAKERSFIELD FIRE DEPT. Prevention Services 1600 Truxtun Ave Ste 401 Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax (661) 852 -2171 Ap permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT m 10 ❑ PERIVI IT TYPE Alarms - New & Modifications - (Minimum Charge) SITE INFORMATION LOCATION OF PROJECT 6 PROPERTY OWNER STARTING DATE PLET N DA T NAME VIA, 6b PROJECT NAME 84 98. ADDRESS [, r $280.00 PHONE NO. PROJECT ADDRESS CITY STATE ZIP CODE CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE. EXPIRATION DATE J 14Y1'1 �c S �C tt O 5O f v NA o 201 PHONE NO. CONTRACTOR COMPANY NAME ►C �V FAX Nn.. p - OO ADDRESS CITY ZIP wut 9 Ap permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT m 10 ❑ PERIVI IT TYPE Alarms - New & Modifications - (Minimum Charge) FEE CALCULATION $280.00 TOTAI TREASURY DUE ACCT ■ 84 • ■ 98 ❑ Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee ■ ■ 84 98. ❑ Sprinklers - New & Mod fications - (Minimum Charge) $280.00 ■ ■ 84 98 ❑ Over 10,000 Sq. Ft Sq. Ft x.028 = Permit fee ' ■ 84 98 ❑ Minor Sprinkler Modifications (< 10 heads) $ 96.00 [Inspection Only] ' 84 98 ❑ Commercial Hoods — New & Modifications $ 470.00 ■ 84 98 ❑ Additional Hoods $ 58.00 ■ ■ 84 98 ❑ Spray Booths - New & Modifications $470.00 ' ' 84 98 ❑ Aboveground Storage Tanks (Insfa11adordlnsp. -18' Time) $180.00 ' 82 ❑ Additional Tanks $ 96.00 ; 82 ❑ 1 Aboveground Storage Tanks (RemovaUinspection) $109.00 : 82 ❑ Underground Storage Tanks (Installadon.11nspection) $878.00 (per tank) ■ 82 ❑ Underground Storage Tanks (Modification) $878.00 (per site) ■ 82 ❑ Underground Storage Tanks (Minor Modification) $167.00 ■ 82 ❑ Underground Storage Tanks (RemovA $573.00 (per tank) ■ 84 ❑ Oilwell (Installation) $96.00 96.00 ; 84 Mandated Leak Detection (Testing) Lei Monit. NSB989. Note: $96.00 for each type of test /per ' e (even if s eduled at the same time) / ,� n : ■ 82 • Tents $ 96.00 (per tent) ' 84 • Pyrotechnic - (Per event, Plus Insp. Fee 0 $96 per hour) $ 96.00 + (5 hrs. min. standby tee /inspection)=$576.00 84 ❑ After hours inspection fee $121.00 ; 84 • RE-INSPECTION(S) /FOLL OW-UP INSPECTION(S) $ 96.00 (per hour) ■ 84 • Portable LPG (Propane): NO. OF CAGES? $ 96.00 ' 84 • Explosive Storage $266.00 ' 84 • Copying & File Research (File Research Fee $50.00 per hr) 250 per page 84 ❑ Miscellaneous 1 84 FD 2021 (Rev. 06107) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer)