The URL can be used to link to this page

Home My WebLink About FMC 2015MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of CaliforniaAuthority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A.General Information Facility Name:Bldg. No.: Site Address:City:Zip: Facility Contact Person: Contact Phone No.: Make/Model of Monitoring System:Date of Testing/Servicing: B.Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID:Tank ID: In-Tank Gauging Probe.Model:In-Tank Gauging Probe.Model: Annular Space or Vault Sensor.Model:Annular Space or Vault Sensor.Model: Piping Sump / Trench Sensor(s).Model:Piping Sump / Trench Sensor(s).Model: Fill Sump Sensor(s).Model:Fill Sump Sensor(s).Model: Mechanical Line Leak Detector.Model:Mechanical Line Leak Detector.Model: Electronic Line Leak Detector.Model:Electronic LineLeak Detector.Model: Tank Overfill / High-Level Sensor.Model:Tank Overfill / High-Level Sensor.Model: Other (specify equipment type and model in Section E on Page 2).Other (specify equipment type and model in Section E on Page 2). Tank ID:Tank ID: In-Tank Gauging Probe.Model:In-Tank Gauging Probe.Model: Annular Space or Vault Sensor.Model:Annular Space or Vault Sensor.Model: Piping Sump / TrenchSensor(s).Model:Piping Sump / Trench Sensor(s).Model: Fill Sump Sensor(s).Model:Fill Sump Sensor(s).Model: Mechanical Line Leak Detector.Model:Mechanical Line Leak Detector.Model: Electronic Line Leak Detector.Model:Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model:Tank Overfill / High-Level Sensor.Model: Other (specify equipment type and model in Section E on Page 2).Other (specify equipment type and model in Section E on Page 2). Dispenser ID:Dispenser ID: Dispenser Containment Sensor(s).Model:Dispenser Containment Sensor(s).Model: Shear Valve(s).Shear Valve(s). Dispenser Containment Float(s) and Chain(s).Dispenser Containment Float(s) and Chain(s). Dispenser ID:Dispenser ID: Dispenser Containment Sensor(s).Model:Dispenser Containment Sensor(s).Model: Shear Valve(s).Shear Valve(s). Dispenser Containment Float(s) and Chain(s).Dispenser Containment Float(s) and Chain(s). Dispenser ID:Dispenser ID: Dispenser Containment Sensor(s).Model:Dispenser Containment Sensor(s).Model: Shear Valve(s).Shear Valve(s). Dispenser Containment Float(s) and Chain(s).Dispenser Containment Float(s) and Chain(s). *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C.Certification -I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers’ guidelines. Attached to this Certification is information (e.g. manufacturers' checklists)necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report;(check all that apply):System set-up Alarm history report Technician Name (print):Signature: Certification No.:License. No.:804904 Testing Company Name:Confidence UST Services, Inc.Phone No.:(800)339-9930 Site Address:Date of Testing/Servicing: Page 1 of 3 Samco#5 1131OakStreetBakersfield,CA93304 SamJouda (661)399-3866 Veeder-Root TLS-350 09/22/2015 10,000 gal, Regular 847390-107 794390-409 794390-409 794380-208 794380-208 794380-208 794380-208 PLLD 847390-107 10,000 gal, Plus 847390-107 PLLD 847390-107 10,000 gal, Supreme 847390-107 794390-409 ■794390-409 794380-208 794380-208 794380-208 794380-208 847390-107 10,000 gal, Diesel 847390-107 PLLD 794380-208 PLLD 847390-107 1-2 794380-208 794380-208 794380-208 794380-208 3-4 5-6 7-8 9-10 AustinSterling B45438 1131OakStreet Bakersfield,CA9330409/22/2015 Monitoring System Certification D.Results of Testing/Servicing Software Version Installed: Complete the following checklist: Yes No*Isthe audible alarm operational? Yes No*Is the visual alarm operational? Yes No*Were all sensors visually inspected, functionally tested, and confirmed operational? Yes No*Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No* N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) operational? Yes No* N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; No. Yes No* N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent oftank capacity does the alarm trigger? % Yes*NoWas any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. Yes*NoWas liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Product; Water. If yes, describe causes in Section E, below. Yes No*Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable Yes No*Is all monitoring equipment operational per manufacturer’s specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E.Comments: Page 2 of 3 90 I pulled approximately 1 gallon of water between all 4 STP sumps and disposed of it in the HAZMAT drum Monitoring System Certification F.In-Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes No*Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes No*Were all tank gauging probes visually inspected for damage and residue buildup? Yes No*Was accuracy of system product level readings tested? Yes No*Was accuracy of system water level readings tested? Yes No*Were all probes reinstalled properly? Yes No*Were all items on the equipment manufacturer’s maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G.Line Leak Detectors (LLD):Check this box if LLDs are not installed. Complete the following checklist: Yes No* N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply)Simulated leak rate: 3 g.p.h.; 0.1 g.p.h ; 0.2 g.p.h. Yes No*Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No*Was the testing apparatus properly calibrated? Yes No* N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes No* N/A For electronic LLDs, have all accessible wiring connections been visually inspected? Yes No*Were all items on the equipment manufacturer’s maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H.Comments: Page 3 of 3 Leak Detector Test Results Sheet Customer Address: Work Order: Site Address: Test Date: Site Contact: Phone: Technician: Phone: 800-339-9930 ICC No.: Product Type LLD Type Model Serial No. Check Valve Holding Pressure Bleed Off ML. Leak Rate Tested: Pass/Fail 3 gph @ 10 psi 3 gph @ 10 psi 3 gph @ 10 psi 3 gph @ 10 psi 3 gph @ 10 psi 3 gph @ 10 psi 3 gph @ 10 psi 3 gph @ 10 psi Technician Name: Technician No.: Signature: Date: SamcoFoodStore,Inc 3817WilsonRoad,Ste.B Bakersfield,CA93309 35249 09/22/2015 8339953-UT Regular Electronic PLLD AustinSterling (661)399-3866SamJouda Bakersfield,CA93304 1131OakStreet Samco#5 12 psi 95 ml Pass PLLDElectronicPlus 11 psi110 ml Pass PLLDElectronicPremium 12 psi100 ml Pass PLLDElectronicDiesel 11 psi75 ml Pass AustinSterling 8339953-UT 09/22/2015 Samco food store system setup Responses Received: 200 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 SEP 22, 2015 6:23 PM TANK PRODUCT GALLONS INCHES WATER DEG F ULLAGE 1 SUPREME 3431 34.30 0.0 90.6 6253 2 PLUS 2039 23.54 0.0 88.4 7645 3 REGULAR 4452 45.42 0.0 91.4 5005 4 DIESEL 3730 36.48 0.0 92.8 5954 I90500 SEP 22, 2015 6:23 PM SOFTWARE REVISION LEVEL VERSION 332.00 SOFTWARE# 346332-100-A CREATED - 11.05.27.16.12 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS CSLD BIR FUEL MANAGER ISD/APM PLLD 0.10 AUTO 0.20 REPETITIV WPLLD 0.10 AUTO 0.20 REPETITIV I50500 SEP 22, 2015 6:23 PM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM I50201 SEP 22, 2015 6:23 PM SHIFT TIME 1 : 4:00 AM I50202 SEP 22, 2015 6:23 PM SHIFT TIME 2 : 12:00 AM I50203 SEP 22, 2015 6:23 PM SHIFT TIME 3 : DISABLED I50204 SEP 22, 2015 6:23 PM SHIFT TIME 4 : DISABLED I54600 SEP 22, 2015 6:23 PM TANK PER TST NEEDED WRN: DISABLED I54900 SEP 22, 2015 6:23 PM TANK ANN TST NEEDED WRN: DISABLED I55300 SEP 22, 2015 6:23 PM LINE RE-ENABLE METHOD PASS LINE TEST I55600 SEP 22, 2015 6:23 PM LINE PER TST NEEDED WRN: DISABLED I55900 SEP 22, 2015 6:23 PM LINE ANN TST NEEDED WRN: DISABLED I50D00 SEP 22, 2015 6:23 PM PRINT TC VOLUMES ENABLED I50E00 SEP 22, 2015 6:23 PM TEMP COMPENSATION VALUE (DEG F ): 60.0 I60B00 SEP 22, 2015 6:23 PM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I51400 SEP 22, 2015 6:23 PM H-PROTOCOL DATA FORMAT HEIGHT I51A01 SEP 22, 2015 6:23 PM DAYLIGHT SAVING TIME ENABLED ON I51B00 SEP 22, 2015 6:23 PM DAYLIGHT SAVING TIME START DATE MAR WEEK 2 SUN 2:00 AM END DATE NOV WEEK 1 SUN 2:00 AM I51600 SEP 22, 2015 6:23 PM RE-DIRECT LOCAL PRINTOUT DISABLED I50400 SEP 22, 2015 6:23 PM 232 SECURITY CODE PORT SECURITY CODE STATUS 1 000000 DISABLED 2 000000 DISABLED 3 000000 DISABLED 4 000000 DISABLED 5 000000 DISABLED 6 000000 DISABLED I21900 SEP 22, 2015 6:23 PM TANK CHART SECURITY DISABLED I5BD00 SEP 22, 2015 6:23 PM CUSTOM ALARM LABELS ENABLED I56000 SEP 22, 2015 6:23 PM MASS/DENSITY DISABLED I88101 SEP 22, 2015 6:23 PM PORT SETTINGS: COMM BOARD : 1 (EDIM ) RS-232 SECURITY CODE : DISABLED I88102 SEP 22, 2015 6:23 PM PORT SETTINGS: COMM BOARD : 2 (RS-232) BAUD RATE : 9600 PARITY : EVEN STOP BIT : 1 STOP DATA LENGTH: 7 DATA RS-232 SECURITY CODE : DISABLED I88103 SEP 22, 2015 6:23 PM PORT SETTINGS: COMM BOARD : 3 (S-SAT ) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED DTR NORMAL STATE: HIGH I88104 SEP 22, 2015 6:23 PM I88105 SEP 22, 2015 6:23 PM PORT SETTINGS: COMM BOARD : 5 (RS-485) BAUD RATE : 4800 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED I88106 SEP 22, 2015 6:23 PM 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 SEP 22, 2015 6:23 PM RECEIVER AUTO DIAL TYPE & START TIME RCVR LOCATION LABEL DIAL TYPE START TIME 1 ON DATE JAN 15, 2014 2:35 PM 2 ON DATE JAN 15, 2014 2:35 PM 3 ON DATE JAN 15, 2014 2:35 PM 4 ON DATE JAN 15, 2014 2:35 PM 5 ON DATE JAN 15, 2014 2:35 PM 6 Solvone Monthly Test ON DATE JAN 15, 2014 2:35 PM 7 ON DATE JAN 15, 2014 2:35 PM 8 VEEDER ROOT (FMS) DAILY DISABLED I60100 SEP 22, 2015 6:23 PM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 SUPREME ON 2 PLUS ON 3 REGULAR ON 4 DIESEL ON I60200 SEP 22, 2015 6:23 PM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 SUPREME 2 PLUS 3 REGULAR 4 DIESEL I60300 SEP 22, 2015 6:23 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 SUPREME 1 2 PLUS 2 3 REGULAR 3 4 DIESEL 4 I60900 SEP 22, 2015 6:23 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 SUPREME 0.000700 2 PLUS 0.000700 3 REGULAR 0.000700 4 DIESEL 0.000450 I60700 SEP 22, 2015 6:23 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 SUPREME 89.75 2 PLUS 89.75 3 REGULAR 89.75 4 DIESEL 89.75 I60A00 SEP 22, 2015 6:23 PM TANK FULL VOLUME TANK PRODUCT LABEL TANK PROFILE GALLONS 1 SUPREME 4 PTS 9684 2 PLUS 4 PTS 9684 3 REGULAR 4 PTS 9684 4 DIESEL 4 PTS 9684 I60400 SEP 22, 2015 6:23 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREME 9684 2 PLUS 9684 3 REGULAR 9684 4 DIESEL 9684 I60500 SEP 22, 2015 6:23 PM TANK 4 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 SUPREME 9684 7883 4904 1906 2 PLUS 9684 7883 4904 1906 3 REGULAR 9684 7883 4904 1906 4 DIESEL 9684 7883 4904 1906 I60600 SEP 22, 2015 6:23 PM TANK 20 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 SUPREME 9684 0 0 0 0 7883 0 0 0 0 4904 0 0 0 0 1906 0 0 0 0 2 PLUS 9684 0 0 0 0 7883 0 0 0 0 4904 0 0 0 0 1906 0 0 0 0 3 REGULAR 9684 0 0 0 0 7883 0 0 0 0 4904 0 0 0 0 1906 0 0 0 0 4 DIESEL 9684 0 0 0 0 7883 0 0 0 0 4904 0 0 0 0 1906 0 0 0 0 I61500 SEP 22, 2015 6:23 PM TANK PRODUCT LABEL METER DATA 1 SUPREME YES 2 PLUS YES 3 REGULAR YES 4 DIESEL YES I62F00 SEP 22, 2015 6:23 PM MAG PROBE FLOAT SIZE TANK PRODUCT LABEL FLOAT SIZE: 1 SUPREME 4.0 IN. 2 PLUS 2.0 IN. 3 REGULAR 4.0 IN. 4 DIESEL 2.0 IN. I62700 SEP 22, 2015 6:23 PM TANK HIGH WATER WARNING LIMIT TANK PRODUCT LABEL INCHES 1 SUPREME 1.0 2 PLUS 1.0 3 REGULAR 1.0 4 DIESEL 1.0 I64200 SEP 22, 2015 6:23 PM WATER ALARM FILTER TANK PRODUCT LABEL 1 SUPREME LOW 2 PLUS LOW 3 REGULAR LOW 4 DIESEL LOW I62400 SEP 22, 2015 6:23 PM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 SUPREME 2.0 2 PLUS 2.0 3 REGULAR 2.0 4 DIESEL 2.0 I62800 SEP 22, 2015 6:23 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 9842 2 PLUS 9842 3 REGULAR 9842 4 DIESEL 9842 I62300 SEP 22, 2015 6:23 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 8857 2 PLUS 8857 3 REGULAR 8857 4 DIESEL 8857 I62200 SEP 22, 2015 6:23 PM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 9349 2 PLUS 9349 3 REGULAR 9349 4 DIESEL 9349 I62900 SEP 22, 2015 6:23 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 1452 2 PLUS 1452 3 REGULAR 1476 4 DIESEL 1452 I62100 SEP 22, 2015 6:23 PM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 611 2 PLUS 611 3 REGULAR 611 4 DIESEL 611 I62600 SEP 22, 2015 6:23 PM TANK LEAK ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 99 2 PLUS 99 3 REGULAR 99 4 DIESEL 99 I62500 SEP 22, 2015 6:23 PM TANK SUDDEN LOSS LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 99 2 PLUS 99 3 REGULAR 99 4 DIESEL 99 I60800 SEP 22, 2015 6:23 PM TANK TILT TANK PRODUCT LABEL INCHES 1 SUPREME 0.00 2 PLUS 0.00 3 REGULAR 0.00 4 DIESEL 0.00 I60B00 SEP 22, 2015 6:23 PM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I60C00 SEP 22, 2015 6:23 PM TANK STICK HEIGHT OFFSET TANK PRODUCT LABEL INCHES 1 SUPREME 0.00 2 PLUS 0.00 3 REGULAR 0.00 4 DIESEL 0.00 I61200 SEP 22, 2015 6:23 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 SUPREME NONE NONE 2 PLUS NONE NONE 3 REGULAR NONE NONE 4 DIESEL NONE NONE I63600 SEP 22, 2015 6:23 PM PERIODIC LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREME 0 2 PLUS 0 3 REGULAR 0 4 DIESEL 0 I62A00 SEP 22, 2015 6:23 PM ANNUAL LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREME 0 2 PLUS 0 3 REGULAR 0 4 DIESEL 0 I62C00 SEP 22, 2015 6:23 PM TANK PERIODIC TEST TYPE TANK PRODUCT LABEL PERIODIC TEST TYPE 1 SUPREME STANDARD 2 PLUS STANDARD 3 REGULAR STANDARD 4 DIESEL STANDARD I62D00 SEP 22, 2015 6:23 PM TANK LEAK TEST FAIL ALARMS TANK PRODUCT LABEL 1 SUPREME GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 2 PLUS GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 3 REGULAR GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 4 DIESEL GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED I63100 SEP 22, 2015 6:23 PM TANK LEAK TEST AVERAGING TANK PRODUCT LABEL ANNUAL PERIODIC 1 SUPREME OFF OFF 2 PLUS OFF OFF 3 REGULAR OFF OFF 4 DIESEL OFF OFF I63000 SEP 22, 2015 6:23 PM IN-TANK LEAK TEST NOTIFY TANK PRODUCT LABEL TANK TEST NOTIFY: 1 SUPREME OFF 2 PLUS OFF 3 REGULAR OFF 4 DIESEL OFF I63200 SEP 22, 2015 6:23 PM TANK TEST SIPHON BREAK TANK PRODUCT LABEL SIPHON BREAK 1 SUPREME OFF 2 PLUS OFF 3 REGULAR OFF 4 DIESEL OFF I61000 SEP 22, 2015 6:23 PM TANK DELIVERY DELAY TANK PRODUCT LABEL 1 SUPREME 3 2 PLUS 3 3 REGULAR 3 4 DIESEL 3 I63A00 SEP 22, 2015 6:23 PM LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD TANK PRODUCT LABEL PUMP THRESHOLD 1 SUPREME 10.00% 2 PLUS 10.00% 3 REGULAR 10.00% 4 DIESEL 10.00% I61100 SEP 22, 2015 6:23 PM LEAK TEST METHOD - - - - - - - - - - - - TEST ON DATE : ALL TANK MAY 27, 2011 START TIME : DISABLED TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:DISABLED I61300 SEP 22, 2015 6:23 PM CSLD PROBABLITY OF DETECTION I61400 SEP 22, 2015 6:23 PM CSLD CLIMATE FACTOR I61600 SEP 22, 2015 6:23 PM TANK PRODUCT LABEL CAL UPDATE 1 SUPREME IMMEDIATE 2 PLUS IMMEDIATE 3 REGULAR IMMEDIATE 4 DIESEL IMMEDIATE I61A00 SEP 22, 2015 6:23 PM IN-TANK LEAK TEST EARLY STOP TANK PRODUCT LABEL TST EARLY STOP: 1 SUPREME DISABLED 2 PLUS DISABLED 3 REGULAR DISABLED 4 DIESEL DISABLED I61B00 SEP 22, 2015 6:23 PM IN-TANK LEAK GROSS TEST AUTO-CONFIRM I61C00 SEP 22, 2015 6:23 PM CSLD REPORT ONLY I62B00 SEP 22, 2015 6:23 PM TANK LAST ANNUAL TEST TANK PRODUCT LABEL DATE 1 SUPREME ??? 0, 0 2 PLUS ??? 0, 0 3 REGULAR ??? 0, 0 4 DIESEL ??? 0, 0 I63300 SEP 22, 2015 6:24 PM LEAK TEST REPORT FORMAT: NORMAL I63400 SEP 22, 2015 6:24 PM RECONCILIATION WARNING LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 0 2 PLUS 0 3 REGULAR 0 4 DIESEL 0 I63500 SEP 22, 2015 6:24 PM RECONCILIATION ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 1 2 PLUS 1 3 REGULAR 1 4 DIESEL 1 I63900 SEP 22, 2015 6:24 PM ACCU CHART END SHAPE FACTOR TANK PRODUCT LABEL 1 SUPREME END FACTOR: NONE 2 PLUS END FACTOR: NONE 3 REGULAR END FACTOR: NONE 4 DIESEL END FACTOR: NONE I78000 SEP 22, 2015 6:24 PM PRESSURE LINE LEAK SETUP Q 1:SUPREME TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 150 FEET 3.0IN DIA LEN: 175 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 1:SUPREME DISPENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO Q 2:PLUS TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 150 FEET 3.0IN DIA LEN: 175 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 2:PLUS DISPENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO Q 3:REGULAR TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 150 FEET 3.0IN DIA LEN: 175 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 3:REGULAR DISPENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO Q 4:DIESEL TYP:2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 110 FEET 3.0IN DIA LEN: 110 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T 4:DIESEL DISPENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO I77700 SEP 22, 2015 6:24 PM I77800 SEP 22, 2015 6:24 PM I78C00 SEP 22, 2015 6:24 PM PRESSURE LINE LEAK 0.20 TEST SCHEDULE LINE 0.20 GPH TEST Q 1:SUPREME DISABLED Q 2:PLUS DISABLED Q 3:REGULAR DISABLED Q 4:DIESEL DISABLED Q 5: DISABLED Q 6: DISABLED I78300 SEP 22, 2015 6:24 PM PRESSURE LINE LEAK 0.10 TEST SCHEDULE LINE 0.10 GPH TEST Q 1:SUPREME DISABLED Q 2:PLUS DISABLED Q 3:REGULAR DISABLED Q 4:DIESEL DISABLED Q 5: DISABLED Q 6: DISABLED I78F00 SEP 22, 2015 6:24 PM PRESSURE LINE LEAK DISPENSE THRESHOLD LINE LOW PRESSURE Q 1:SUPREME 0 PSI Q 2:PLUS 0 PSI Q 3:REGULAR 0 PSI Q 4:DIESEL 0 PSI Q 5: 0 PSI Q 6: 0 PSI I78700 SEP 22, 2015 6:24 PM PRESSURE LLD SETUP REPORT Q 1:SUPREME IN-TANK ALARMS T 1:HIGH WATER ALARM T 1:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 1:FUEL ALARM L 2:FUEL ALARM L 3:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L15:FUEL ALARM L16:FUEL ALARM L17:FUEL ALARM L 1:SENSOR OUT ALARM L 2:SENSOR OUT ALARM L 3:SENSOR OUT ALARM L14:SENSOR OUT ALARM L15:SENSOR OUT ALARM L16:SENSOR OUT ALARM L17:SENSOR OUT ALARM L 1:SHORT ALARM L 2:SHORT ALARM L 3:SHORT ALARM L16: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 Q 2:PLUS IN-TANK ALARMS T 2:HIGH WATER ALARM T 2:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 4:FUEL ALARM L 5:FUEL ALARM L 6:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L15:FUEL ALARM L16:FUEL ALARM L17:FUEL ALARM L 4:SENSOR OUT ALARM L 5:SENSOR OUT ALARM L 6:SENSOR OUT ALARM L13:SENSOR OUT ALARM L14:SENSOR OUT ALARM L15:SENSOR OUT ALARM L16:SENSOR OUT ALARM L17:SENSOR OUT ALARM L 4:SHORT ALARM L 5:SHORT ALARM L 6:SHORT ALARM L13:SHORT ALARM L14:SHORT ALARM L15:SHORT ALARM L16:SHORT ALARM L17: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 Q 3:REGULAR IN-TANK ALARMS T 3:HIGH WATER ALARM T 3:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 7:FUEL ALARM L 8:FUEL ALARM L 9:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L15:FUEL ALARM L16:FUEL ALARM L17:FUEL ALARM L 7:SENSOR OUT ALARM L 8:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L13:SENSOR OUT ALARM L14:SENSOR OUT ALARM L15:SENSOR OUT ALARM L16:SENSOR OUT ALARM L17:SENSOR OUT ALARM L 7:SHORT ALARM L 8:SHORT ALARM L 9:SHORT ALARM L13:SHORT ALARM L14:SHORT ALARM L15:SHORT ALARM L16:SHORT ALARM L17: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 Q 4:DIESEL IN-TANK ALARMS T 4:HIGH WATER ALARM T 4:LOW PRODUCT ALARM LIQUID SENSOR ALMS L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L13:FUEL ALARM L17:FUEL ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L13:SENSOR OUT ALARM L17:SENSOR OUT ALARM L10:SHORT ALARM L11:SHORT ALARM L12:SHORT ALARM L13:SHORT ALARM L17:SHORT ALARM Q 5: - NO ALARM ASSIGNMENTS - Q 6: - NO ALARM ASSIGNMENTS - I70200 SEP 22, 2015 6:25 PM LIQUID LABEL DEVICE LABEL 1 SUPREME ANNULAR 2 SUPREME FILL SUMP 3 SUPREME TURBINE SUMP 4 PLUS ANNULAR 5 PLUS FILL SUMP 6 PLUS TURBINE SUMP 7 REGULAR ANNULAR 8 REGULAR FILL SUMP 9 REGULAR TURBINE SUMP 10 DIESEL ANNULAR 11 DIESEL FILL SUMP 12 DIESEL TURBINE SUMP 13 DISPENSER 1-2 14 DISPENSER 3-4 15 DISPENSER 5-6 16 DISPENSER 7-8 17 DISPENSER 9-10 18 19 20 21 22 23 24 I70300 SEP 22, 2015 6:25 PM LIQUID TYPE SENSOR LOCATION TYPE 1 SUPREME ANNULAR TRI-STATE (SINGLE FLOAT) 2 SUPREME FILL SUMP TRI-STATE (SINGLE FLOAT) 3 SUPREME TURBINE SUMP TRI-STATE (SINGLE FLOAT) 4 PLUS ANNULAR TRI-STATE (SINGLE FLOAT) 5 PLUS FILL SUMP TRI-STATE (SINGLE FLOAT) 6 PLUS TURBINE SUMP TRI-STATE (SINGLE FLOAT) 7 REGULAR ANNULAR TRI-STATE (SINGLE FLOAT) 8 REGULAR FILL SUMP TRI-STATE (SINGLE FLOAT) 9 REGULAR TURBINE SUMP TRI-STATE (SINGLE FLOAT) 10 DIESEL ANNULAR TRI-STATE (SINGLE FLOAT) 11 DIESEL FILL SUMP TRI-STATE (SINGLE FLOAT) 12 DIESEL TURBINE SUMP TRI-STATE (SINGLE FLOAT) 13 DISPENSER 1-2 TRI-STATE (SINGLE FLOAT) 14 DISPENSER 3-4 TRI-STATE (SINGLE FLOAT) 15 DISPENSER 5-6 TRI-STATE (SINGLE FLOAT) 16 DISPENSER 7-8 TRI-STATE (SINGLE FLOAT) 17 DISPENSER 9-10 TRI-STATE (SINGLE FLOAT) 18 TRI-STATE (SINGLE FLOAT) 19 TRI-STATE (SINGLE FLOAT) 20 TRI-STATE (SINGLE FLOAT) 21 TRI-STATE (SINGLE FLOAT) 22 TRI-STATE (SINGLE FLOAT) 23 TRI-STATE (SINGLE FLOAT) 24 TRI-STATE (SINGLE FLOAT) I70400 SEP 22, 2015 6:25 PM LIQUID CATEGORY SENSOR LOCATION CATEGORY 1 SUPREME ANNULAR ANNULAR SPACE 2 SUPREME FILL SUMP PIPING SUMP 3 SUPREME TURBINE SUMP STP SUMP 4 PLUS ANNULAR ANNULAR SPACE 5 PLUS FILL SUMP PIPING SUMP 6 PLUS TURBINE SUMP STP SUMP 7 REGULAR ANNULAR ANNULAR SPACE 8 REGULAR FILL SUMP PIPING SUMP 9 REGULAR TURBINE SUMP STP SUMP 10 DIESEL ANNULAR ANNULAR SPACE 11 DIESEL FILL SUMP PIPING SUMP 12 DIESEL TURBINE SUMP STP SUMP 13 DISPENSER 1-2 DISPENSER PAN 14 DISPENSER 3-4 DISPENSER PAN 15 DISPENSER 5-6 DISPENSER PAN 16 DISPENSER 7-8 DISPENSER PAN 17 DISPENSER 9-10 DISPENSER PAN 18 OTHER SENSORS 19 OTHER SENSORS 20 OTHER SENSORS 21 OTHER SENSORS 22 OTHER SENSORS 23 OTHER SENSORS 24 OTHER SENSORS I74200 SEP 22, 2015 6:25 PM I74300 SEP 22, 2015 6:25 PM I74400 SEP 22, 2015 6:25 PM I74700 SEP 22, 2015 6:25 PM I74800 SEP 22, 2015 6:25 PM I74900 SEP 22, 2015 6:25 PM I7BC00 SEP 22, 2015 6:25 PM I80200 SEP 22, 2015 6:25 PM I80300 SEP 22, 2015 6:25 PM I80400 SEP 22, 2015 6:25 PM I80700 SEP 22, 2015 6:25 PM RELAY LABEL DEVICE LABEL 1 OVERFILL ALARM 2 3 4 5 DISP.1-2 6 DISP.3-4 7 DISP.5-6 8 DISP.7-8 9 DISP.9-10 10 11 12 I80900 SEP 22, 2015 6:25 PM RELAY ORIENTATION RELAY DESIGNATION ORIENTATION 1 OVERFILL ALARM NORMALLY OPEN 2 NORMALLY OPEN 3 NORMALLY OPEN 4 NORMALLY OPEN 5 DISP.1-2 NORMALLY CLOSED 6 DISP.3-4 NORMALLY CLOSED 7 DISP.5-6 NORMALLY CLOSED 8 DISP.7-8 NORMALLY CLOSED 9 DISP.9-10 NORMALLY CLOSED 10 NORMALLY OPEN 11 NORMALLY OPEN 12 NORMALLY OPEN I80B00 SEP 22, 2015 6:25 PM RELAY TANK ASSIGNMENT RELAY DESIGNATION TANK 1 OVERFILL ALARM NONE 2 NONE 3 NONE 4 NONE 5 DISP.1-2 NONE 6 DISP.3-4 NONE 7 DISP.5-6 NONE 8 DISP.7-8 NONE 9 DISP.9-10 NONE 10 NONE 11 NONE 12 NONE I80A00 SEP 22, 2015 6:25 PM RELAY TYPE RELAY DESIGNATION TYPE 1 OVERFILL ALARM STANDARD 2 STANDARD 3 STANDARD 4 STANDARD 5 DISP.1-2 STANDARD 6 DISP.3-4 STANDARD 7 DISP.5-6 STANDARD 8 DISP.7-8 STANDARD 9 DISP.9-10 STANDARD 10 STANDARD 11 STANDARD 12 STANDARD I80C00 SEP 22, 2015 6:25 PM I80800 SEP 22, 2015 6:25 PM RELAY SETUP REPORT R 1:OVERFILL ALARM TYPE: STANDARD NORMALLY OPEN TANK #: NONE IN-TANK ALARMS ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM ALL:MAX PRODUCT ALARM R 2: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - R 3: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - R 4: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - R 5:DISP.1-2 TYPE: STANDARD NORMALLY CLOSED TANK #: NONE ISD HOSE ALARMS h 1:GROSS COLLECT FAIL h 2:GROSS COLLECT FAIL h 3:GROSS COLLECT FAIL h 4:GROSS COLLECT FAIL h 5:GROSS COLLECT FAIL h 6:GROSS COLLECT FAIL h 1:DEGRD COLLECT FAIL h 2:DEGRD COLLECT FAIL h 3:DEGRD COLLECT FAIL h 4:DEGRD COLLECT FAIL h 5:DEGRD COLLECT FAIL h 6:DEGRD COLLECT FAIL h 1:FLOW COLLECT FAIL h 2:FLOW COLLECT FAIL h 3:FLOW COLLECT FAIL h 4:FLOW COLLECT FAIL h 5:FLOW COLLECT FAIL h 6:FLOW COLLECT FAIL R 6:DISP.3-4 TYPE: STANDARD NORMALLY CLOSED TANK #: NONE ISD HOSE ALARMS h 7:GROSS COLLECT FAIL h 8:GROSS COLLECT FAIL h 9:GROSS COLLECT FAIL h10:GROSS COLLECT FAIL h11:GROSS COLLECT FAIL h12:GROSS COLLECT FAIL h 7:DEGRD COLLECT FAIL h 8:DEGRD COLLECT FAIL h 9:DEGRD COLLECT FAIL h10:DEGRD COLLECT FAIL h11:DEGRD COLLECT FAIL h12:DEGRD COLLECT FAIL h 7:FLOW COLLECT FAIL h 8:FLOW COLLECT FAIL h 9:FLOW COLLECT FAIL h10:FLOW COLLECT FAIL h11:FLOW COLLECT FAIL h12:FLOW COLLECT FAIL R 7:DISP.5-6 TYPE: STANDARD NORMALLY CLOSED TANK #: NONE ISD HOSE ALARMS h13:GROSS COLLECT FAIL h14:GROSS COLLECT FAIL h15:GROSS COLLECT FAIL h16:GROSS COLLECT FAIL h17:GROSS COLLECT FAIL h18:GROSS COLLECT FAIL h13:DEGRD COLLECT FAIL h14:DEGRD COLLECT FAIL h15:DEGRD COLLECT FAIL h16:DEGRD COLLECT FAIL h17:DEGRD COLLECT FAIL h18:DEGRD COLLECT FAIL h13:FLOW COLLECT FAIL h14:FLOW COLLECT FAIL h15:FLOW COLLECT FAIL h16:FLOW COLLECT FAIL h17:FLOW COLLECT FAIL h18:FLOW COLLECT FAIL R 8:DISP.7-8 TYPE: STANDARD NORMALLY CLOSED TANK #: NONE ISD HOSE ALARMS h19:GROSS COLLECT FAIL h20:GROSS COLLECT FAIL h21:GROSS COLLECT FAIL h22:GROSS COLLECT FAIL h23:GROSS COLLECT FAIL h24:GROSS COLLECT FAIL h19:DEGRD COLLECT FAIL h20:DEGRD COLLECT FAIL h21:DEGRD COLLECT FAIL h22:DEGRD COLLECT FAIL h23:DEGRD COLLECT FAIL h24:DEGRD COLLECT FAIL h19:FLOW COLLECT FAIL h20:FLOW COLLECT FAIL h21:FLOW COLLECT FAIL h22:FLOW COLLECT FAIL h23:FLOW COLLECT FAIL h24:FLOW COLLECT FAIL R 9:DISP.9-10 TYPE: STANDARD NORMALLY CLOSED TANK #: NONE ISD HOSE ALARMS h25:GROSS COLLECT FAIL h26:GROSS COLLECT FAIL h27:GROSS COLLECT FAIL h28:GROSS COLLECT FAIL h29:GROSS COLLECT FAIL h30:GROSS COLLECT FAIL h25:DEGRD COLLECT FAIL h26:DEGRD COLLECT FAIL h28:DEGRD COLLECT FAIL h29:DEGRD COLLECT FAIL h30:DEGRD COLLECT FAIL h25:FLOW COLLECT FAIL h26:FLOW COLLECT FAIL h27:FLOW COLLECT FAIL h28:FLOW COLLECT FAIL h29:FLOW COLLECT FAIL h30:FLOW COLLECT FAIL R10: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - R11: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - R12: TYPE: STANDARD NORMALLY OPEN TANK #: NONE - NO ALARM ASSIGNMENTS - I79000 SEP 22, 2015 6:26 PM EDIM:1 VR:349633-002-C TD:98.09.21.11.16 I79100 SEP 22, 2015 6:26 PM I72300 SEP 22, 2015 6:26 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 SMARTSENSOR ASSIGNMENT DEVICE LABEL CATEGORY 01 VFM 1-2 AIR FLOW METER 02 VFM 3-4 AIR FLOW METER 03 VFM 5-6 AIR FLOW METER 04 VFM 7-8 AIR FLOW METER 05 VFM 9-10 AIR FLOW METER 06 PRESSURE SENSOR 3-4 VAPOR PRESSURE 07 UNKNOWN 08 UNKNOWN 09 UNKNOWN 10 UNKNOWN 11 UNKNOWN 12 UNKNOWN 13 UNKNOWN 14 UNKNOWN 15 UNKNOWN 16 UNKNOWN 17 UNKNOWN 18 UNKNOWN 19 UNKNOWN 20 UNKNOWN 21 UNKNOWN 22 UNKNOWN 23 UNKNOWN 24 UNKNOWN 25 UNKNOWN 26 UNKNOWN 27 UNKNOWN 28 UNKNOWN 29 UNKNOWN 30 UNKNOWN 31 UNKNOWN 32 UNKNOWN 33 UNKNOWN 34 UNKNOWN 35 UNKNOWN 36 UNKNOWN 37 UNKNOWN 38 UNKNOWN 39 UNKNOWN 40 UNKNOWN I72A00 SEP 22, 2015 6:26 PM VACUUM SENSOR VOLUME DEVICE LABEL VOLUME IV4E00 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 EVR/ISD SETUP TYPE: VACUUM ASSIST VACUUM ASSIST TYPE: HEALY VAC IV4F00 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 NOZZLE A/L RANGE A/L RATIO: 0.95 - 1.15 IV4000 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 VAPOR PROCESSOR TYPE NONE IV4700 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 ASSESSMENT TIME START TIME: 10:00 AM TIME DELAY MINUTES: 1 IV5200 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 ACCEPT HIGH ORVR: NO IV4A00 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 ISD HOSE TABLE HOSE FP FP AFM HOSE ID ID LABEL ID LABEL 01 00 01 01 REGULAR 02 00 01 01 MID GRADE 03 00 01 01 PREMIUM 04 01 02 01 REGULAR 05 01 02 01 MID GRADE 06 01 02 01 PREMIUM 07 02 03 02 REGULAR 08 02 03 02 MID GRADE 09 02 03 02 PREMIUM 10 03 04 02 REGULAR 11 03 04 02 MID GRADE 12 03 04 02 PREMIUM 13 04 05 03 REGULAR 14 04 05 03 MID GRADE 15 04 05 03 PREMIUM 16 05 06 03 REGULAR 17 05 06 03 MID GRADE 18 05 06 03 PREMIUM 19 06 07 04 REGULAR 20 06 07 04 MID GRADE 21 06 07 04 PREMIUM 22 07 08 04 REGULAR 23 07 08 04 MID GRADE 24 07 08 04 PREMIUM 25 08 09 05 REGULAR 26 08 09 05 MID GRADE 27 08 09 05 PREMIUM 28 09 10 05 REGULAR 29 09 10 05 MID GRADE 30 09 10 05 PREMIUM IV4B00 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 PRODUCT/HOSE MAP TABLE FP AFID M1/H1 M2/H2 M3/H3 M4/H4 00 01 02/01 00/03 01/02 xx/xx 01 01 02/04 00/06 01/05 xx/xx 02 02 02/07 00/09 01/08 xx/xx 03 02 02/10 00/12 01/11 xx/xx 04 03 00/13 02/15 01/14 xx/xx 05 03 00/16 02/18 01/17 xx/xx 06 04 00/19 02/21 01/20 xx/xx 07 04 00/22 02/24 01/23 xx/xx 08 05 01/25 03/27 02/26 xx/xx 09 05 01/28 03/30 02/29 xx/xx IV4900 SEP 22, 2015 6:27 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 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 SEP 22, 2015 6:27 PM ISD VERSION: 01.04 Samco food store alarm history before Responses Received: I10200 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 4477146 4140694 2 7SMARTSENSOR BD 507185 505230 3 4 PROBE / G.T. 163730 163020 4 INTERSTITIAL BD 202305 201730 5 INTERSTITIAL BD 202145 201495 6 INTERSTITIAL BD 202625 202061 7 PLLD SENSOR BD 3969 3954 8 UNUSED 4462798 4133600 9 UNUSED 4459449 4134494 10 PLLD POWER BD 101642 101399 11 PLLD POWER BD 101073 100881 12 RELAY BOARD 14949 14925 13 RELAY BOARD 14928 14968 14 RELAY BOARD 14949 14925 15 UNUSED 4458257 4139402 16 UNUSED 4458341 4133658 COMM 1 ELEC DISP INT. 101139 101106 COMM 2 RS232 SERIAL BD 14928 14925 COMM 3 SERIAL SAT BD 481691 480152 COMM 4 UNUSED 4461039 4137323 COMM 5 RS485 SERIAL BD 68582 68364 COMM 6 RS232 SERIAL BD 14907 14947 I90200 SEP 22, 2015 12:35 PM SOFTWARE REVISION LEVEL VERSION 332.00 SOFTWARE# 346332-100-A CREATED - 11.05.27.16.12 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS CSLD BIR FUEL MANAGER ISD/APM PLLD 0.10 AUTO 0.20 REPETITIV WPLLD 0.10 AUTO 0.20 REPETITIV I11100 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME h20 OTHER FP7: MID GRADE DEGRD COLLECT FAIL CLEAR 9-21-15 3:58PM h20 OTHER FP7: MID GRADE DEGRD COLLECT FAIL ALARM 9-19-15 10:05AM h 8 OTHER FP3: MID GRADE DEGRD COLLECT FAIL CLEAR 8-24-15 9:30AM h 8 OTHER FP3: MID GRADE DEGRD COLLECT FAIL ALARM 8-22-15 10:06AM h 8 OTHER FP3: MID GRADE DEGRD COLLECT FAIL CLEAR 8-22-15 10:06AM h 8 OTHER FP3: MID GRADE DEGRD COLLECT FAIL ALARM 8-21-15 10:05AM s 1 OTHER VFM 1-2 COMMUNICATION ALARM CLEAR 7-29-15 4:24PM s 1 OTHER VFM 1-2 COMMUNICATION ALARM ALARM 7-29-15 3:20PM h 4 OTHER FP2: REGULAR DEGRD COLLECT FAIL CLEAR 7-28-15 7:50PM h 4 OTHER FP2: REGULAR DEGRD COLLECT FAIL ALARM 7-28-15 10:04AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 7-19-15 10:35AM T 3 TANK REGULAR OVERFILL ALARM ALARM 7-19-15 10:30AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 7-12-15 7:07AM T 3 TANK REGULAR OVERFILL ALARM ALARM 7-12-15 6:59AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 7-04-15 1:15AM T 3 TANK REGULAR OVERFILL ALARM ALARM 7-04-15 1:08AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 6-27-15 11:05AM T 3 TANK REGULAR OVERFILL ALARM ALARM 6-27-15 11:00AM h20 OTHER FP7: MID GRADE GROSS COLLECT FAIL CLEAR 6-23-15 11:03AM h20 OTHER FP7: MID GRADE GROSS COLLECT FAIL ALARM 6-23-15 10:01AM h26 OTHER FP9: MID GRADE GROSS COLLECT FAIL CLEAR 6-17-15 10:57AM h26 OTHER FP9: MID GRADE GROSS COLLECT FAIL ALARM 6-17-15 10:04AM OTHER ISD GROSS PRES FAIL CLEAR 6-12-15 12:14PM h29 OTHER FP10: MID GRADE DEGRD COLLECT FAIL CLEAR 6-12-15 12:13PM Q 3 OTHER REGULAR PLLD SHUTDOWN ALARM CLEAR 6-12-15 12:11PM Q 2 OTHER PLUS PLLD SHUTDOWN ALARM CLEAR 6-12-15 12:11PM Q 1 OTHER SUPREME PLLD SHUTDOWN ALARM CLEAR 6-12-15 12:11PM OTHER ISD GROSS PRES FAIL ALARM 6-12-15 10:04AM Q 3 OTHER REGULAR PLLD SHUTDOWN ALARM ALARM 6-12-15 10:04AM Q 2 OTHER PLUS PLLD SHUTDOWN ALARM ALARM 6-12-15 10:04AM Q 1 OTHER SUPREME PLLD SHUTDOWN ALARM ALARM 6-12-15 10:04AM h29 OTHER FP10: MID GRADE DEGRD COLLECT FAIL ALARM 6-12-15 10:04AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 5-31-15 8:19AM T 3 TANK REGULAR OVERFILL ALARM ALARM 5-31-15 8:15AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 5-29-15 12:46AM T 3 TANK REGULAR OVERFILL ALARM ALARM 5-29-15 12:39AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 5-19-15 7:49AM T 3 TANK REGULAR OVERFILL ALARM ALARM 5-19-15 7:44AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 5-17-15 7:31AM T 3 TANK REGULAR OVERFILL ALARM ALARM 5-17-15 7:25AM h14 OTHER FP5: MID GRADE DEGRD COLLECT FAIL CLEAR 5-07-15 8:25AM h14 OTHER FP5: MID GRADE DEGRD COLLECT FAIL ALARM 5-06-15 10:03AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 4-24-15 8:33AM T 3 TANK REGULAR OVERFILL ALARM ALARM 4-24-15 8:27AM T 3 TANK REGULAR OVERFILL ALARM CLEAR 4-15-15 11:57PM T 3 TANK REGULAR OVERFILL ALARM ALARM 4-15-15 11:48PM T 3 TANK REGULAR OVERFILL ALARM CLEAR 4-13-15 11:25AM T 3 TANK REGULAR OVERFILL ALARM ALARM 4-13-15 11:18AM h14 OTHER FP5: MID GRADE DEGRD COLLECT FAIL CLEAR 4-10-15 3:46PM h14 OTHER FP5: MID GRADE DEGRD COLLECT FAIL ALARM 4-10-15 10:02AM I11200 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME h10 OTHER FP4: REGULAR DEGRD COLLECT WARN ALARM 9-22-15 10:06AM h21 OTHER FP7: PREMIUM DEGRD COLLECT WARN CLEAR 9-21-15 3:58PM h14 OTHER FP5: MID GRADE DEGRD COLLECT WARN CLEAR 9-21-15 3:58PM OTHER ISD GROSS PRES WARN CLEAR 9-21-15 3:51PM h 1 OTHER FP1: REGULAR DEGRD COLLECT WARN CLEAR 9-21-15 10:00AM OTHER ISD GROSS PRES WARN ALARM 9-20-15 10:05AM h 1 OTHER FP1: REGULAR DEGRD COLLECT WARN ALARM 9-20-15 10:05AM h21 OTHER FP7: PREMIUM DEGRD COLLECT WARN ALARM 9-19-15 10:05AM h14 OTHER FP5: MID GRADE DEGRD COLLECT WARN ALARM 9-19-15 10:05AM h20 OTHER FP7: MID GRADE DEGRD COLLECT WARN CLEAR 9-19-15 10:00AM h 4 OTHER FP2: REGULAR DEGRD COLLECT WARN CLEAR 9-19-15 10:00AM h 4 OTHER FP2: REGULAR DEGRD COLLECT WARN ALARM 9-18-15 10:05AM h25 OTHER FP9: REGULAR DEGRD COLLECT WARN CLEAR 9-18-15 10:00AM h25 OTHER FP9: REGULAR DEGRD COLLECT WARN ALARM 9-17-15 10:05AM h10 OTHER FP4: REGULAR DEGRD COLLECT WARN CLEAR 9-16-15 10:00AM h28 OTHER FP10: REGULAR DEGRD COLLECT WARN CLEAR 9-15-15 10:00AM SYSTEM PRINTER ERROR CLEAR 9-15-15 7:28AM SYSTEM PAPER OUT CLEAR 9-15-15 7:28AM SYSTEM PRINTER ERROR ALARM 9-15-15 7:27AM SYSTEM PAPER OUT ALARM 9-15-15 7:27AM h28 OTHER FP10: REGULAR DEGRD COLLECT WARN ALARM 9-14-15 10:05AM h 8 OTHER FP3: MID GRADE DEGRD COLLECT WARN CLEAR 9-14-15 10:00AM h13 OTHER FP5: REGULAR DEGRD COLLECT WARN CLEAR 9-13-15 10:00AM h20 OTHER FP7: MID GRADE DEGRD COLLECT WARN ALARM 9-12-15 10:05AM h13 OTHER FP5: REGULAR DEGRD COLLECT WARN ALARM 9-12-15 10:05AM h27 OTHER FP9: PREMIUM DEGRD COLLECT WARN CLEAR 9-12-15 10:00AM h27 OTHER FP9: PREMIUM DEGRD COLLECT WARN ALARM 9-11-15 10:05AM h10 OTHER FP4: REGULAR DEGRD COLLECT WARN ALARM 9-11-15 10:05AM h 8 OTHER FP3: MID GRADE DEGRD COLLECT WARN ALARM 9-11-15 10:05AM h28 OTHER FP10: REGULAR DEGRD COLLECT WARN CLEAR 9-06-15 10:00AM h15 OTHER FP5: PREMIUM DEGRD COLLECT WARN CLEAR 9-05-15 10:00AM h28 OTHER FP10: REGULAR DEGRD COLLECT WARN ALARM 9-04-15 10:05AM h20 OTHER FP7: MID GRADE DEGRD COLLECT WARN CLEAR 9-04-15 10:00AM h20 OTHER FP7: MID GRADE DEGRD COLLECT WARN ALARM 9-03-15 10:05AM h15 OTHER FP5: PREMIUM DEGRD COLLECT WARN ALARM 9-03-15 10:05AM h28 OTHER FP10: REGULAR DEGRD COLLECT WARN CLEAR 9-02-15 10:00AM h12 OTHER FP4: PREMIUM DEGRD COLLECT WARN CLEAR 9-02-15 10:00AM h12 OTHER FP4: PREMIUM DEGRD COLLECT WARN ALARM 9-01-15 10:04AM h28 OTHER FP10: REGULAR DEGRD COLLECT WARN ALARM 8-26-15 10:05AM SYSTEM PRINTER ERROR CLEAR 8-24-15 11:06AM SYSTEM PAPER OUT CLEAR 8-24-15 11:06AM SYSTEM PRINTER ERROR ALARM 8-24-15 10:42AM SYSTEM PAPER OUT ALARM 8-24-15 10:42AM h29 OTHER FP10: MID GRADE DEGRD COLLECT WARN CLEAR 8-24-15 9:31AM h30 OTHER FP10: PREMIUM DEGRD COLLECT WARN CLEAR 8-24-15 9:31AM h23 OTHER FP8: MID GRADE DEGRD COLLECT WARN CLEAR 8-24-15 9:31AM h23 OTHER FP8: MID GRADE DEGRD COLLECT WARN ALARM 8-23-15 10:05AM h30 OTHER FP10: PREMIUM DEGRD COLLECT WARN ALARM 8-22-15 10:06AM h23 OTHER FP8: MID GRADE DEGRD COLLECT WARN CLEAR 8-22-15 10:00AM h23 OTHER FP8: MID GRADE DEGRD COLLECT WARN ALARM 8-21-15 10:05AM I20600 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 TANK ALARM HISTORY TANK 1 SUPREME DELIVERY NEEDED APR 17, 2015 7:10 PM JAN 31, 2015 12:54 PM TANK 2 PLUS DELIVERY NEEDED AUG 5, 2015 8:57 AM AUG 3, 2015 7:07 AM TANK 3 REGULAR OVERFILL ALARM JUL 19, 2015 10:30 AM JUL 12, 2015 6:59 AM JUL 4, 2015 1:08 AM DELIVERY NEEDED FEB 9, 2015 11:51 PM TANK 4 DIESEL 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 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 PRESSURE LINE LEAK ALARM HISTORY REPORT Q 1:SUPREME JUN 12, 2015 10:04 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:38 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:22 AM PLLD SHUTDOWN ALARM FEB 15, 2015 10:03 AM PLLD SHUTDOWN ALARM FEB 1, 2015 10:04 AM PLLD SHUTDOWN ALARM JAN 31, 2015 10:03 AM PLLD SHUTDOWN ALARM Q 2:PLUS JUN 12, 2015 10:04 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:38 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:32 AM PLLD SHUTDOWN ALARM FEB 15, 2015 10:03 AM PLLD SHUTDOWN ALARM FEB 1, 2015 10:04 AM PLLD SHUTDOWN ALARM JAN 31, 2015 10:03 AM PLLD SHUTDOWN ALARM Q 3:REGULAR JUN 12, 2015 10:04 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:38 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:27 AM PLLD SHUTDOWN ALARM FEB 15, 2015 10:03 AM PLLD SHUTDOWN ALARM FEB 1, 2015 10:04 AM PLLD SHUTDOWN ALARM JAN 31, 2015 10:03 AM PLLD SHUTDOWN ALARM Q 4:DIESEL MAR 17, 2015 10:38 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:17 AM PLLD SHUTDOWN ALARM I30200 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 SUPREME ANNULAR 2 SUPREME FILL SUMP 3 SUPREME TURBINE SUMP MAR 17, 2015 10:22 AM FUEL ALARM 4 PLUS ANNULAR 5 PLUS FILL SUMP 6 PLUS TURBINE SUMP MAR 17, 2015 10:32 AM FUEL ALARM 7 REGULAR ANNULAR 8 REGULAR FILL SUMP 9 REGULAR TURBINE SUMP MAR 17, 2015 10:30 AM SETUP DATA WARNING MAR 17, 2015 10:27 AM FUEL ALARM 10 DIESEL ANNULAR 11 DIESEL FILL SUMP 12 DIESEL TURBINE SUMP MAR 17, 2015 10:17 AM FUEL ALARM 13 DISPENSER 1-2 MAR 17, 2015 10:38 AM FUEL ALARM 14 DISPENSER 3-4 15 DISPENSER 5-6 16 DISPENSER 7-8 17 DISPENSER 9-10 I31600 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 VFM 1-2 JUL 29, 2015 3:20 PM COMMUNICATION ALARM 2 VFM 3-4 3 VFM 5-6 4 VFM 7-8 5 VFM 9-10 6 PRESSURE SENSOR 3-4 I40200 SEP 22, 2015 12:35 PM I40300 SEP 22, 2015 12:35 PM I34200 SEP 22, 2015 12:35 PM I34700 SEP 22, 2015 12:35 PM IV0100 SEP 22, 2015 12:35 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.04 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :WARN EVR VAPOR COLLECTION :WARN EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME :100% EVR/ISD PASS TIME : 0% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 15-09-22 10:06:06 A/L RATIO DEGRADATION FP 4 REGULAR 0.80 15-09-21 10:04:59 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 1.36 15-09-21 10:04:59 A/L RATIO DEGRADATION FP 5 MID GRADE 0.73 15-09-20 10:05:00 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 1.36 15-09-20 10:05:00 A/L RATIO DEGRADATION FP 5 MID GRADE 0.78 15-09-20 10:05:00 A/L RATIO DEGRADATION FP 1 REGULAR 0.80 15-09-19 10:05:20 A/L RATIO DEGRADATION FP 7 PREMIUM 0.77 15-09-19 10:05:20 A/L RATIO DEGRADATION FP 5 MID GRADE 0.80 15-09-18 10:05:08 A/L RATIO DEGRADATION FP 7 MID GRADE 0.73 15-09-18 10:05:08 A/L RATIO DEGRADATION FP 2 REGULAR 0.79 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-09-19 10:05:20 A/L RATIO DEGRADATION FP 7 MID GRADE 0.75 15-08-22 10:06:18 A/L RATIO DEGRADATION FP 3 MID GRADE 0.78 15-08-21 10:05:50 A/L RATIO DEGRADATION FP 3 MID GRADE 0.78 15-07-28 10:04:21 A/L RATIO DEGRADATION FP 2 REGULAR 0.70 15-06-23 10:01:31 A/L RATIO GROSS BLOCKAGE FP 7 MID GRADE BLKD 15-06-17 10:04:21 A/L RATIO GROSS BLOCKAGE FP 9 MID GRADE BLKD 15-06-12 10:04:25 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.36 15-06-12 10:04:24 A/L RATIO DEGRADATION FP10 MID GRADE 0.67 15-05-06 10:03:34 A/L RATIO DEGRADATION FP 5 MID GRADE 0.76 15-04-10 10:02:18 A/L RATIO DEGRADATION FP 5 MID GRADE 0.80 SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 15-09-21 15:58:29 COLLECTION TEST HH20 GRADE TEST MANUALLY CLEARED 15-09-21 15:58:21 COLLECTION TEST HH21 GRADE TEST MANUALLY CLEARED 15-09-21 15:58:04 COLLECTION TEST HH14 GRADE TEST MANUALLY CLEARED 15-09-21 15:51:39 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-09-19 10:05:20 A/L RATIO GROSS DEGRADATION DISABLED FP 07 MID GRADE 15-08-24 09:31:29 COLLECTION TEST HH29 GRADE TEST MANUALLY CLEARED 15-08-24 09:31:25 COLLECTION TEST HH30 GRADE TEST MANUALLY CLEARED 15-08-24 09:31:15 COLLECTION TEST HH23 GRADE TEST MANUALLY CLEARED 15-08-24 09:30:39 COLLECTION TEST HH08 GRADE TEST MANUALLY CLEARED 15-08-24 09:20:17 PUMPS MANUALLY RE-ENABLED Samco food store alarm history after Responses Received: I10200 SEP 22, 2015 6:18 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 4477146 4140694 2 7SMARTSENSOR BD 507185 505230 3 4 PROBE / G.T. 163730 163020 4 INTERSTITIAL BD 202305 201730 5 INTERSTITIAL BD 202145 201495 6 INTERSTITIAL BD 202625 202061 7 PLLD SENSOR BD 3969 3954 8 UNUSED 4462798 4133600 9 UNUSED 4459449 4134494 10 PLLD POWER BD 101642 101399 11 PLLD POWER BD 101073 100881 12 RELAY BOARD 14949 14925 13 RELAY BOARD 14928 14968 14 RELAY BOARD 14949 14925 15 UNUSED 4458257 4139402 16 UNUSED 4458341 4133658 COMM 1 ELEC DISP INT. 101139 101106 COMM 2 RS232 SERIAL BD 14928 14925 COMM 3 SERIAL SAT BD 481691 480152 COMM 4 UNUSED 4461039 4137323 COMM 5 RS485 SERIAL BD 68582 68364 COMM 6 RS232 SERIAL BD 14907 14947 I90200 SEP 22, 2015 6:18 PM SOFTWARE REVISION LEVEL VERSION 332.00 SOFTWARE# 346332-100-A CREATED - 11.05.27.16.12 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS CSLD BIR FUEL MANAGER ISD/APM PLLD 0.10 AUTO 0.20 REPETITIV WPLLD 0.10 AUTO 0.20 REPETITIV I11100 SEP 22, 2015 6:18 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME Q 4 OTHER DIESEL PLLD SHUTDOWN ALARM CLEAR 9-22-15 5:49PM Q 4 OTHER DIESEL GROSS LINE FAIL CLEAR 9-22-15 5:49PM Q 1 OTHER SUPREME PLLD SHUTDOWN ALARM CLEAR 9-22-15 5:49PM Q 1 OTHER SUPREME GROSS LINE FAIL CLEAR 9-22-15 5:49PM Q 1 OTHER SUPREME PLLD SHUTDOWN ALARM ALARM 9-22-15 5:35PM Q 1 OTHER SUPREME GROSS LINE FAIL ALARM 9-22-15 5:35PM Q 3 OTHER REGULAR PLLD SHUTDOWN ALARM CLEAR 9-22-15 5:19PM Q 3 OTHER REGULAR GROSS LINE FAIL CLEAR 9-22-15 5:19PM Q 4 OTHER DIESEL PLLD SHUTDOWN ALARM ALARM 9-22-15 5:17PM Q 4 OTHER DIESEL GROSS LINE FAIL ALARM 9-22-15 5:17PM Q 1 OTHER SUPREME FUEL OUT CLEAR 9-22-15 5:16PM Q 3 OTHER REGULAR PLLD SHUTDOWN ALARM ALARM 9-22-15 4:52PM Q 3 OTHER REGULAR GROSS LINE FAIL ALARM 9-22-15 4:52PM T 1 TANK SUPREME PROBE OUT CLEAR 9-22-15 4:50PM Q 2 OTHER PLUS PLLD SHUTDOWN ALARM CLEAR 9-22-15 4:49PM Q 2 OTHER PLUS GROSS LINE FAIL CLEAR 9-22-15 4:49PM T 1 TANK SUPREME PROBE OUT ALARM 9-22-15 4:42PM T 1 TANK SUPREME PROBE OUT CLEAR 9-22-15 4:42PM T 1 TANK SUPREME PROBE OUT ALARM 9-22-15 4:35PM T 1 TANK SUPREME PROBE OUT CLEAR 9-22-15 4:33PM Q 2 OTHER PLUS PLLD SHUTDOWN ALARM ALARM 9-22-15 4:26PM Q 2 OTHER PLUS GROSS LINE FAIL ALARM 9-22-15 4:26PM Q 1 OTHER SUPREME FUEL OUT ALARM 9-22-15 4:14PM Q 2 OTHER PLUS PLLD SHUTDOWN ALARM CLEAR 9-22-15 3:39PM L 4 ANNULAR PLUS ANNULAR SENSOR OUT ALARM CLEAR 9-22-15 3:39PM Q 3 OTHER REGULAR PLLD SHUTDOWN ALARM CLEAR 9-22-15 3:39PM L 7 ANNULAR REGULAR ANNULAR SENSOR OUT ALARM CLEAR 9-22-15 3:39PM Q 1 OTHER SUPREME PLLD SHUTDOWN ALARM CLEAR 9-22-15 3:39PM L 3 STP SUMP SUPREME TURBINE SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L 1 ANNULAR SUPREME ANNULAR SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L 6 STP SUMP PLUS TURBINE SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L 2 PIPE SUPREME FILL SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L 5 PIPE PLUS FILL SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L16 DISP PAN DISPENSER 7-8 SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L15 DISP PAN DISPENSER 5-6 SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L14 DISP PAN DISPENSER 3-4 SENSOR OUT ALARM CLEAR 9-22-15 3:39PM Q 4 OTHER DIESEL PLLD SHUTDOWN ALARM CLEAR 9-22-15 3:39PM L13 DISP PAN DISPENSER 1-2 SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L12 STP SUMP DIESEL TURBINE SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L10 ANNULAR DIESEL ANNULAR SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L11 PIPE DIESEL FILL SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L 9 STP SUMP REGULAR TURBINE SUMP SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L17 DISP PAN DISPENSER 9-10 SENSOR OUT ALARM CLEAR 9-22-15 3:39PM L 6 STP SUMP PLUS TURBINE SUMP SENSOR OUT ALARM ALARM 9-22-15 3:35PM L 4 ANNULAR PLUS ANNULAR SENSOR OUT ALARM ALARM 9-22-15 3:35PM L 1 ANNULAR SUPREME ANNULAR SENSOR OUT ALARM ALARM 9-22-15 3:35PM L 7 ANNULAR REGULAR ANNULAR SENSOR OUT ALARM ALARM 9-22-15 3:35PM L 5 PIPE PLUS FILL SUMP SENSOR OUT ALARM ALARM 9-22-15 3:35PM L 3 STP SUMP SUPREME TURBINE SUMP SENSOR OUT ALARM ALARM 9-22-15 3:35PM L 2 PIPE SUPREME FILL SUMP SENSOR OUT ALARM ALARM 9-22-15 3:35PM I11200 SEP 22, 2015 6:18 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME h10 OTHER FP4: REGULAR DEGRD COLLECT WARN CLEAR 9-22-15 4:50PM T 2 TANK PLUS LOW TEMP WARNING CLEAR 9-22-15 2:50PM T 2 TANK PLUS LOW TEMP WARNING ALARM 9-22-15 2:47PM T 4 TANK DIESEL HIGH PRODUCT ALARM CLEAR 9-22-15 2:43PM T 4 TANK DIESEL HIGH PRODUCT ALARM ALARM 9-22-15 2:43PM T 1 TANK SUPREME HIGH PRODUCT ALARM CLEAR 9-22-15 2:37PM T 1 TANK SUPREME HIGH PRODUCT ALARM ALARM 9-22-15 2:37PM T 2 TANK PLUS HIGH PRODUCT ALARM CLEAR 9-22-15 2:29PM T 4 TANK DIESEL HIGH PRODUCT ALARM CLEAR 9-22-15 2:25PM T 1 TANK SUPREME HIGH PRODUCT ALARM CLEAR 9-22-15 2:25PM T 2 TANK PLUS HIGH PRODUCT ALARM ALARM 9-22-15 2:23PM SYSTEM PRINTER ERROR CLEAR 9-22-15 2:04PM SYSTEM PAPER OUT CLEAR 9-22-15 2:04PM SYSTEM PRINTER ERROR ALARM 9-22-15 2:02PM SYSTEM PAPER OUT ALARM 9-22-15 2:02PM SYSTEM PRINTER ERROR CLEAR 9-22-15 2:02PM SYSTEM PAPER OUT CLEAR 9-22-15 2:02PM SYSTEM PRINTER ERROR ALARM 9-22-15 2:02PM SYSTEM PAPER OUT ALARM 9-22-15 2:02PM SYSTEM PRINTER ERROR CLEAR 9-22-15 2:02PM SYSTEM PAPER OUT CLEAR 9-22-15 2:02PM SYSTEM PRINTER ERROR ALARM 9-22-15 2:02PM SYSTEM PAPER OUT ALARM 9-22-15 2:02PM SYSTEM PRINTER ERROR CLEAR 9-22-15 2:01PM SYSTEM PAPER OUT CLEAR 9-22-15 2:01PM SYSTEM PRINTER ERROR ALARM 9-22-15 1:47PM SYSTEM PAPER OUT ALARM 9-22-15 1:47PM T 4 TANK DIESEL HIGH PRODUCT ALARM ALARM 9-22-15 1:10PM T 1 TANK SUPREME HIGH PRODUCT ALARM ALARM 9-22-15 1:07PM T 1 TANK SUPREME INVALID FUEL LEVEL CLEAR 9-22-15 1:07PM T 1 TANK SUPREME DELIVERY NEEDED CLEAR 9-22-15 1:07PM T 3 TANK REGULAR INVALID FUEL LEVEL CLEAR 9-22-15 1:07PM T 3 TANK REGULAR DELIVERY NEEDED CLEAR 9-22-15 1:07PM T 1 TANK SUPREME INVALID FUEL LEVEL ALARM 9-22-15 1:06PM T 1 TANK SUPREME DELIVERY NEEDED ALARM 9-22-15 1:05PM T 3 TANK REGULAR DELIVERY NEEDED ALARM 9-22-15 1:05PM T 3 TANK REGULAR INVALID FUEL LEVEL ALARM 9-22-15 1:05PM T 2 TANK PLUS DELIVERY NEEDED CLEAR 9-22-15 1:03PM T 2 TANK PLUS DELIVERY NEEDED ALARM 9-22-15 1:02PM h10 OTHER FP4: REGULAR DEGRD COLLECT WARN ALARM 9-22-15 10:06AM h21 OTHER FP7: PREMIUM DEGRD COLLECT WARN CLEAR 9-21-15 3:58PM h14 OTHER FP5: MID GRADE DEGRD COLLECT WARN CLEAR 9-21-15 3:58PM OTHER ISD GROSS PRES WARN CLEAR 9-21-15 3:51PM h 1 OTHER FP1: REGULAR DEGRD COLLECT WARN CLEAR 9-21-15 10:00AM OTHER ISD GROSS PRES WARN ALARM 9-20-15 10:05AM h 1 OTHER FP1: REGULAR DEGRD COLLECT WARN ALARM 9-20-15 10:05AM h21 OTHER FP7: PREMIUM DEGRD COLLECT WARN ALARM 9-19-15 10:05AM h14 OTHER FP5: MID GRADE DEGRD COLLECT WARN ALARM 9-19-15 10:05AM h20 OTHER FP7: MID GRADE DEGRD COLLECT WARN CLEAR 9-19-15 10:00AM h 4 OTHER FP2: REGULAR DEGRD COLLECT WARN CLEAR 9-19-15 10:00AM I20600 SEP 22, 2015 6:18 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 TANK ALARM HISTORY TANK 1 SUPREME OVERFILL ALARM SEP 22, 2015 1:08 PM LOW PRODUCT ALARM SEP 22, 2015 1:06 PM SUDDEN LOSS ALARM SEP 22, 2015 1:05 PM HIGH PRODUCT ALARM SEP 22, 2015 2:37 PM SEP 22, 2015 1:07 PM INVALID FUEL LEVEL SEP 22, 2015 1:06 PM PROBE OUT SEP 22, 2015 4:42 PM SEP 22, 2015 4:35 PM SEP 22, 2015 2:40 PM DELIVERY NEEDED SEP 22, 2015 1:05 PM APR 17, 2015 7:10 PM JAN 31, 2015 12:54 PM TANK 2 PLUS OVERFILL ALARM SEP 22, 2015 2:29 PM SEP 22, 2015 2:24 PM SUDDEN LOSS ALARM SEP 22, 2015 1:02 PM HIGH PRODUCT ALARM SEP 22, 2015 2:23 PM DELIVERY NEEDED SEP 22, 2015 1:02 PM AUG 5, 2015 8:57 AM AUG 3, 2015 7:07 AM LOW TEMP WARNING SEP 22, 2015 2:47 PM TANK 3 REGULAR OVERFILL ALARM SEP 22, 2015 2:35 PM SEP 22, 2015 2:31 PM JUL 19, 2015 10:30 AM LOW PRODUCT ALARM SEP 22, 2015 1:05 PM SUDDEN LOSS ALARM SEP 22, 2015 2:25 PM INVALID FUEL LEVEL SEP 22, 2015 1:05 PM DELIVERY NEEDED SEP 22, 2015 1:05 PM FEB 9, 2015 11:51 PM TANK 4 DIESEL SUDDEN LOSS ALARM SEP 22, 2015 1:08 PM HIGH PRODUCT ALARM SEP 22, 2015 2:43 PM SEP 22, 2015 1:10 PM 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 SEP 22, 2015 6:18 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 PRESSURE LINE LEAK ALARM HISTORY REPORT Q 1:SUPREME SEP 22, 2015 5:35 PM PLLD SHUTDOWN ALARM SEP 22, 2015 5:35 PM GROSS LINE FAIL SEP 22, 2015 4:14 PM FUEL OUT SEP 22, 2015 3:35 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:26 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:20 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:15 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:08 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:01 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:57 PM PLLD SHUTDOWN ALARM Q 2:PLUS SEP 22, 2015 4:26 PM PLLD SHUTDOWN ALARM SEP 22, 2015 4:26 PM GROSS LINE FAIL SEP 22, 2015 3:35 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:26 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:20 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:15 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:08 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:58 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:51 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:14 PM PLLD SHUTDOWN ALARM Q 3:REGULAR SEP 22, 2015 4:52 PM PLLD SHUTDOWN ALARM SEP 22, 2015 4:52 PM GROSS LINE FAIL SEP 22, 2015 3:35 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:26 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:20 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:15 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:08 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:58 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:51 PM PLLD SHUTDOWN ALARM SEP 22, 2015 1:45 PM PLLD SHUTDOWN ALARM Q 4:DIESEL SEP 22, 2015 5:17 PM PLLD SHUTDOWN ALARM SEP 22, 2015 5:17 PM GROSS LINE FAIL SEP 22, 2015 3:35 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:26 PM PLLD SHUTDOWN ALARM SEP 22, 2015 3:01 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:56 PM PLLD SHUTDOWN ALARM SEP 22, 2015 2:52 PM PLLD SHUTDOWN ALARM SEP 22, 2015 1:26 PM PLLD SHUTDOWN ALARM MAR 17, 2015 10:38 AM PLLD SHUTDOWN ALARM MAR 17, 2015 10:17 AM PLLD SHUTDOWN ALARM I30200 SEP 22, 2015 6:19 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 SUPREME ANNULAR SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 1:41 PM FUEL ALARM 2 SUPREME FILL SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:52 PM FUEL ALARM 3 SUPREME TURBINE SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:57 PM FUEL ALARM MAR 17, 2015 10:22 AM FUEL ALARM 4 PLUS ANNULAR SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:14 PM FUEL ALARM 5 PLUS FILL SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:51 PM FUEL ALARM 6 PLUS TURBINE SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:58 PM FUEL ALARM MAR 17, 2015 10:32 AM FUEL ALARM 7 REGULAR ANNULAR SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 1:45 PM FUEL ALARM 8 REGULAR FILL SUMP SEP 22, 2015 2:51 PM FUEL ALARM 9 REGULAR TURBINE SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:58 PM FUEL ALARM MAR 17, 2015 10:30 AM SETUP DATA WARNING 10 DIESEL ANNULAR SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 1:26 PM FUEL ALARM 11 DIESEL FILL SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:52 PM FUEL ALARM 12 DIESEL TURBINE SUMP SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 2:56 PM FUEL ALARM MAR 17, 2015 10:17 AM FUEL ALARM 13 DISPENSER 1-2 SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 3:01 PM FUEL ALARM MAR 17, 2015 10:38 AM FUEL ALARM 14 DISPENSER 3-4 SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 3:08 PM FUEL ALARM 15 DISPENSER 5-6 SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 3:15 PM FUEL ALARM 16 DISPENSER 7-8 SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 3:20 PM FUEL ALARM 17 DISPENSER 9-10 SEP 22, 2015 3:35 PM SENSOR OUT ALARM SEP 22, 2015 3:26 PM FUEL ALARM I31600 SEP 22, 2015 6:19 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 VFM 1-2 JUL 29, 2015 3:20 PM COMMUNICATION ALARM 2 VFM 3-4 3 VFM 5-6 4 VFM 7-8 5 VFM 9-10 6 PRESSURE SENSOR 3-4 I40200 SEP 22, 2015 6:19 PM I40300 SEP 22, 2015 6:19 PM I34200 SEP 22, 2015 6:19 PM I34700 SEP 22, 2015 6:19 PM IV0100 SEP 22, 2015 6:19 PM 827979 CHEVRON C.S.I 1131 OAK ST. BAKERSFIELD,CA. 9-8109PH661-324-7621 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.04 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :WARN EVR VAPOR COLLECTION :WARN EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME :100% EVR/ISD PASS TIME : 0% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 15-09-22 10:06:06 A/L RATIO DEGRADATION FP 4 REGULAR 0.80 15-09-21 10:04:59 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 1.36 15-09-21 10:04:59 A/L RATIO DEGRADATION FP 5 MID GRADE 0.73 15-09-20 10:05:00 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 1.36 15-09-20 10:05:00 A/L RATIO DEGRADATION FP 5 MID GRADE 0.78 15-09-20 10:05:00 A/L RATIO DEGRADATION FP 1 REGULAR 0.80 15-09-19 10:05:20 A/L RATIO DEGRADATION FP 7 PREMIUM 0.77 15-09-19 10:05:20 A/L RATIO DEGRADATION FP 5 MID GRADE 0.80 15-09-18 10:05:08 A/L RATIO DEGRADATION FP 7 MID GRADE 0.73 15-09-18 10:05:08 A/L RATIO DEGRADATION FP 2 REGULAR 0.79 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-09-19 10:05:20 A/L RATIO DEGRADATION FP 7 MID GRADE 0.75 15-08-22 10:06:18 A/L RATIO DEGRADATION FP 3 MID GRADE 0.78 15-08-21 10:05:50 A/L RATIO DEGRADATION FP 3 MID GRADE 0.78 15-07-28 10:04:21 A/L RATIO DEGRADATION FP 2 REGULAR 0.70 15-06-23 10:01:31 A/L RATIO GROSS BLOCKAGE FP 7 MID GRADE BLKD 15-06-17 10:04:21 A/L RATIO GROSS BLOCKAGE FP 9 MID GRADE BLKD 15-06-12 10:04:25 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.36 15-06-12 10:04:24 A/L RATIO DEGRADATION FP10 MID GRADE 0.67 15-05-06 10:03:34 A/L RATIO DEGRADATION FP 5 MID GRADE 0.76 15-04-10 10:02:18 A/L RATIO DEGRADATION FP 5 MID GRADE 0.80 SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 15-09-22 16:50:53 COLLECTION TEST HH11 GRADE TEST MANUALLY CLEARED 15-09-22 16:50:53 COLLECTION TEST HH12 GRADE TEST MANUALLY CLEARED 15-09-22 16:50:53 COLLECTION TEST HH10 GRADE TEST MANUALLY CLEARED 15-09-21 15:58:29 COLLECTION TEST HH20 GRADE TEST MANUALLY CLEARED 15-09-21 15:58:21 COLLECTION TEST HH21 GRADE TEST MANUALLY CLEARED 15-09-21 15:58:04 COLLECTION TEST HH14 GRADE TEST MANUALLY CLEARED 15-09-21 15:51:39 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-09-19 10:05:20 A/L RATIO GROSS DEGRADATION DISABLED FP 07 MID GRADE 15-08-24 09:31:29 COLLECTION TEST HH29 GRADE TEST MANUALLY CLEARED 15-08-24 09:31:25 COLLECTION TEST HH30 GRADE TEST MANUALLY CLEARED SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (if applicable), should be provided to the facility owner/operator forsubmittal to the local regulatory agency. 1.FACILITY INFORMATION Facility Name:Date of Testing: Facility Address: Facility Contact:Phone: Date Local Agency Was Notified of Testing : Name of Local Agency Inspector (if present during testing): 2.TESTING CONTRACTOR INFORMATION Company Name:Confidence UST Services, Inc. Technician Conducting Test: Credentials1:CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s):CSLB#804904 ICC# 3.SPILL BUCKET TESTING INFORMATION Test Method Used:Hydrostatic Vacuum Other Test Equipment Used:Lake TestEquipment Resolution:0.0625” Identify Spill Bucket (By Tank Number, Stored Product, etc.) 1234 Bucket Installation Type: Direct Bury Contained in Sump Direct Bury Contained in Sump Direct Bury Contained in Sump Direct Bury Contained in Sump Bucket Diameter: Bucket Depth: Wait time between applying vacuum/water and start of test: Test Start Time (TI): Initial Reading (RI): Test End Time (TF): Final Reading (RF): Test Duration (TF – TI): Change in Reading (RF -RI): Pass/Fail Threshold or Criteria: Test Result: Pass Fail Pass Fail Pass Fail Pass Fail Comments –(include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. Technician’s Signature:________________________________________________ Date:_________ 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. Samco#5 09/22/2015 1131OakStreet Bakersfield,CA93304 SamJouda(661)399-3866 09/18/2015 KrisKarns AustinSterling 8339953-UT Regular 12.00" 12.50" 5 min 1:30 pm 9.00" 2:30 pm 0.00" 1 hour 9.00" .0625 Plus 12.00" 12.50" 5 min 1:30 pm 8.50" 2:30 pm 0.00" 1 hour 8.50" 0.625 0.625 Supreme 12.00" 12.50" 5 min 1:30 pm 9.00" 2:30 pm 7.50" 1 hour 1.50" Diesel 12.00" 12.50" 5 min 1:30 pm 8.25" 2:30 pm 0.00" 1 hour 8.25" 0.625 All 4 ﬁll spill buckets failed hydrostatic test and need to be replaced 09/22/2015