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Home My WebLink AboutFMC 2013MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this fonn must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of this date. A. General Information Facility Name: Sully's Chevron Site Address: 11400 Ming Avenue City: Bakersfield Bldg. No.: ---- Zip: 93311 Facility Contact Person: Frank Sullivan Contact Phone No.: ----------------------- Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 10/15/2013 t!!~~P~!~.~bo?!.~.9,~.!f!n~~~;J!~;!:fS .. ~,~.~~ed Tank ID: 20,000 gal. Regular Tank 10: 12,000 gal. Su~er 0 In-Tank Gauging Probe. Model:847390-107 Iii In-Tank Gauging Probe. Model: 847390-107 Iii Annular Space or Vault Probe. Modei:Vacuum Iii Annular Space or Vault Sensor. Model: Vacuum [i] Piping Sump I Trench Sensor(s). Model:208/304 Iii Piping Sump I Trench Sensor(s). Model: 208/304 W Fill Sump Scnsor{s) Model: 208 /304 ~ Fill Sump Scnsor(s). Model: 208 I 304 W Mechanical Line Leak Detector. Model: FX-1V ~ Mechanical Line Leak Detector. Model: FX-1V 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: Iii Tank Overfill I High Level Sensor. Model: 847390-107 ~ Tank Overfill I High Leva! Sensor. Model: 847390-107 D Other (specify equip. type and model in Sec. Eon Pg. 2) 0 Other (specify equip. type and model in Sec. Eon Pg. 2) Tank 10: 10,000 gal. Diesel Tank ID: [x] In-Tank Gauging Probe. Model·847390-107 0 In-Tank Gauging Probe. Model: Iii Annular Space or Vault Sensor. ModeJ:Vacuum 0 Annular Space or Vault Sensor. Model: [!] Piping Sump I Trench Sensor(s). Model:208/ 304 0 Piping Sump I Trench Scnsor(s). Model: [!] Fill Sump Sensors(s). Model:208/ 304 0 Fill Sump Scnsor(s). Model: [X] Mechanical Line Leak Decector. Model:FX-1DV 0 Mechanical Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: ~ Tank Overfill I High Level Sensor. Model:847390-107 0 Tank Overfill I High Level Sensor. Model· 0 Other (specify equip. type and model in Sec. Eon Pg. 2) 0 Other (specify equip. typs and model in Sec. Eon Pg. 2) Dispenser I D: 1&2 Dispenser I D: _1_ & 4 [X] Dispenser Containment Sensor(s). Model: 208/304 ~ Dispenser Containment Sensor(s). Model: 208/304 [X] Shear Valve(s). !il Shear Valve(s). 0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s) Dispenser 10: 5&6 Dispenser 10: 7 & 8 W Dispenser Containment Sensor(s). Model: 208/304 !il Dispenser Containment Scnsor(s). Model: 208/304 ~ Shear Valve(s). ~ Shear Valve(s). 0 Dispenser Containment Float(s) and Chains(s). 0 Dispenser Containment Float(s) and Chain(s). Dispenser 10: 9 & 10 Dispenser I D: 11 & 12 ~ Dispenser Containment Sensor(s). Model: 208/304 ~ Dispenser Containment Sensor(s). Model: 208/304 Iii Shear Valve(s). W Shear Valve(s). 0 Dispenser Containment Float(s) and Chain(s) 0 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 -1 certify that the equipment identified in this document was inspected/services in accordance with the manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating such reports, I have attached a copy of the report; (clteck alit/tat apply) 0 System S t-up, x 1 Alarm history report Technician Name (print): Kristopher Karns Signature: ____ _.:z~~:S...:p...QS...~:::::~ Certification No: 834106 License No: 804904 ~~~----------------------------- Testing Company Name: Confidence UST Services, Inc. Phone No: 800-339-9930 Site Address: 11400 Ming Ave., Bakersfield, CA 93311 Date of Testing/Servicing: 10/15/2013 MONITORING SYSTEM CERTIFICATION For Use By All .Jurisdictions Within the State of California Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of this date. A. General Information Facility Name: Sully's Chevron Site Address: 11400 Ming Avenue City: Bakersfield Bldg. No.: ---- Zip: 93311 Facility Contact Person: Frank Sullivan Contact Phone No.: ------------------- Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 10/15/2013 ~!~.~~p~!~.~t? .. r.~.9.~.!f~~~!i!,.~~i!~~(.~~!!~ed Tank 10: Tank ID: 0 In-Tank Gauging Probe. Model: 0 In-Tank Gauging Probe. Model: 0 Annular Space or Vault Probe. Model: 0 Annular Space or Vault Sensor. Model: 0 Piping Sump I Trench Sensor(s). Model: 0 Piping Sump I Trench Sensor(s). Model: 0 Fill Sump Sensor(s) Model: 0 Fill Sump Sensor(s). Model: [J Mechanical Line Leak Detector. Model: 0 Mechanical Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: 0 Tank Overfill I High Level Sensor. Model: 0 Tank Overfill I High Leva! Sensor. Model: 0 Other (specify equip. type and model in Sec. Eon Pg. 2) 0 Other (specify equip. type and model in Sec. Eon Pg. 2) Tank 10: Tank ID: 0 In-Tank Gauging Probe. Model· 0 In-Tank Gauging Probe. Model: 0 Annular Space or Vault Sensor. Model: 0 Annular Space or Vault Sensor. Model: 0 Piping Sump I Trench Sensor(s). Model: 0 Piping Sump I Trench Sensor(s). Model: 0 Fill Sump Scnsors(s). Model: 0 Fill Sump Sensor(s). Model: 0 Mechanical Line Leak Decector. Model: 0 Mechanical Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: 0 Tank Overfill I High Level Sensor. Model: 0 Tank Overfill I High Level Sensor. Model: 0 Other (specify equip. type and model in Sec. Eon Pg. 2) 0 Other (specify equip. typs and model in Sec. Eon Pg. 2) Dispenser ID: 13 & 14 Dispenser 10: __!E.. & 16 [X] Dispenser Containment Sensor(s). Model: 208/304 ~ Dispenser Containment Sensor(s). Model: 208/304 [X] Shear Valvc(s). ~ Shear Valve(s). 0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s) Dispenser ID: Dispenser 10: 0 Dispenser Containment Scnsor(s). Model: 0 Dispenser Containment Sensor(s). Model: 0 Shear Valve(s). 0 Shear Valve(s). 0 Dispenser Containment Float(s) and Chains(s). 0 Dispenser Containment Float(s) and Chain(s). Dispenser 10: Dispenser 10: 0 Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model: 0 Shear Yalvc(s). 0 Shear Yalve(s). 0 Dispenser Containment Float(s) and Chain(s) 0 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 -1 certify that the equipment identified in this document was inspected/services in accordance with the manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checkJist) necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating such reports, I have attached a copy of the report; (check all that apply) 0 System Set-up ~Alarm history report Technician Name (print): Kristopher Karns Signature: t;:;_:.' ¥ ~ Certification No: 834106 License No: 804904 ~~--------------------------Testing Company Name: Confidence UST Services, Inc. Site Address: 11400 Ming Ave., Bakersfield, CA 93311 Phone No: 800-339-9930 Date ofTesting/Servicing: 10/15t2013 D. Results ofTesting/Servicing Software Version Installed: 333.02 ---------------------------- Complete the following checklist: [i] Yes D No* Is the audible alarm operational? X Yes r l No* Is the Visual alam1 operational? ~'x Yes r l No* Were all sensors visually inspected, functionally tested, and conlirmed operational? ~Yes 0 No* Were all sensors installed at the lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? DYes @No* If alarms arc relayed to a remote monitoring station, is all communications equipment (e.g. modem) N/A operational? I[{] Yes 0No* For pressurized piping systems, docs the turbine automatically shut down if the piping secondary ON/A containment monitoring system detects a leak, fai Is to operate, or is electrically disconnected? If yes: which sensors initatc positive shut-down? ~ Sumpffrench Sensors[i] Dispenser Containment Sensors Did you confim1 positive shut-down due to leaks and sensor failure/disconnected? [i] Yes; 0 No; [i] Yes 0No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no [JN/A mechanical overfill prevention valve is installed). is the overfill warning alarm visual and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm trigger? I 90 I% ~Yes* 0No 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. D Yes• ~No Was liquid found inside any secondary containment systems designed as dry systems? 0 Product; 0 Water. If yes, describe causes in Section E, below. lr X YP.c;. f l No* Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. X Yes [ ] No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, discribe how and when these deficiencies were or will be corrected. E. Comments: We performed a Cold Start and upgraded software from it's original 332.00 to 333.02 because the old software had the Alarm Reduction setting but will not allow you to disable it for testing. L-4 # 7-8 420 Annular sensor was found with no Brine in the cup, and the Regular 420 Annular sensor was also found with no Brine and the float on the sensor was stuck in the up position. I also had to replace the 420 Annular secondary containment sensors for Dispenser# 1-2, # 5-6, # 13-14, and # 15-16. These four sensors were not operational. After the repairs they were re-tested and confirmed operational. F. In-Tank Guaging I SIR Equipment: [x] Check this box if tank guaging is used only for inventory control. D Check this box if tank guaging or SIR equipment is installed. This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring. Complete the following checklist· ~Yes D No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults? -No* Were all tank guaging probes visually inspected for damage and residue buildup? x Ye5 X Yes No* Was accuracy of system product level readings tested? X Yes No* Was accuracy of system water level readings tested? _ x Yes No* Were all probes reinstalled properly? ~Yes D No* Were all items on the equipment manufacn1rer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): D Check this box ifLLD's arc not installed. Lomptete the tollowm ClleCI<JISt: [i] Yes 0No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance? (Check a// that apply) Simulated leak rate: ~3 g.p.h.: Do. I g.p.h.; D0.2 g.p.h.; lfl Yes D No* Were all LLD's confirmed operational and accurate within regulatory requirments? "l.xJ Yes No* Was the testing apparatus properly calibrated? [i] Yes No* For machanical LLD's. does the LLD restrict product flow if it detects a leak? -N/A DYes '=-= No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? ~J N/A DYes b:J No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is [x] N/A disabled or disconnected? DYes W No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system ~ N/A malfunction or fails a test? DYes hJ No* For electronic LLD's, have all accessible wiring connections been visually inspected? ~~]Yes ~N/A 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: Monitoring Systen Certification Form: Addendum for Vacuum/Pressure Interstitial Sensors LG 163-1, Enc.Il I. 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 the test date. Manufacturer: I Veeder-Root ~odel: ITLS-350 Sfstem type: 0 Pressure; G]vacuum; Sensor 10 Component(s) Monitored by this Sensor: Unleded Product S-t Sensor Funtionality Test Resultsfxl Pass I Fail Interstitial Communication Test Resuldx I Pasl; I Fail Component(s) Monitored by this Sensor: Vapor S-2 Sensor Funtionality Test Results:lxl Pass I Fail Interstitial Communication Test Result~:x I Pasf; j Fail Component(s) Monitored by this Sensor: Unleded Tank Annular S-3 Sensor Funtionality Test Results:!xl Pass I Fail Interstitial Communication Test ResuJI!j:x I Pas~; I Fail Component(s) Monitored by this Sensor: Unleded Vent S-4 Sensor Funtionality Test Results:Jxl Pass I Fail Interstitial Communication Test Result~:x I Pas$; I Fail Component(s) Monitored by this sensor: Super Product S-5 Sensor Funtionality Test Results{x l Pass I Fail Interstitial Communication Test Result!jx I Pas~; I Fail Component(s) Monitored by this Sensor: Super Vent S-6 Sensor Funtionality Test Results:lxl Pass I Fail Interstitial Communication Test Result~x I Pas~; I Fail Component(s) Monitored by this Sensor: Super I Diesel Tank Annular S-7 Sensor Funtionality Test Results:fxl Pass I Fail Interstitial Communication Test Result~x I Pas$; I Fail Component(s) Monitored by this Sensor: Diesel Vent S-9 Sensor Funtionality Test Results:Jxl Pass I Fail Interstitial Communication Test Result~x I Pas!;; I Fail Component(s) Monitored by this Sensor: Diesel Product S-10 Sensor Funtionality Test Resultsfxl Pass I Fail Interstitial Communication Test Resul~:x I Pas!; I Fail Component(s) Monitored by this Sensor: Sensor Funtionality Test Results:n Pass I Fail Interstitial Communication Test Result!j: I Pas$; I Fail Component(s) Monitored by this Sensor: Sensor Funtionality Test Results:n Pass I Fail Interstitial Communication Test Result!~: I Pas$; I Fail How was interstitial communication varifyed? fx =-lLeak Introduced at Far End oflnterstuial Space;• l x l Gauge; n Visual Inspection; n Othe(Discribe in Sec. J, below) Vacuum was r·estored to operating levels in all interstitial spaces: [!]Yes 0 No (If no, discribe in Sec. J Below) Comments=------------------------------------------------------------------------------ Introdued leak at ball valve. Page 4 of 4 I 1 If the sensor successfully detected 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. !3ULL 'IS CHEVRON 11400 1·11 NG r.VE BHI:EI<SF I ELD ('A 9::~:-J I I OCT 15, c'Ol ::J '01: 4Cj Ar'l S'.'ST£1"1 STr-;TUS REYOP.T L 4 : LOl.J L I ldU I (J 1-1U1P.I"l INVENTOR\' REPORT T 1 : UNLEAC•ED \/vLUilE a I O<i80 GHLS ULLAGE • 9020 GALS 90"'' ULLHGE= 7020 GHL~; TC VOLUt1E ~ 1 0% I GHLS HEIGHT 3 bJ.62 INCHSS WI-ITER VOL = I -l (;IlLS I.JATER = 0. 67 I NC:HES TEMP = 62.4 DEG F T 2: SUPREN VOLUt•lE UI.Li-\GE 90}~ ULLH(;Eu TC VOLUI•IE = HEIGHT WRTER VOL ~JATER TEla> T 3:DIESEL VOLUI•!E ULLAGE t-893 •::r~LS 5107 (;1-\LS 3907 Gr-\LS 6819 GALS 67.03 I NCHE;:: 10 GhLS 0.77 INCHES 7'5.3 DEG F 7380 2620 lt.20 7337 Gf.\LS GHLS GI-1LS GALS -88.01 90~-< ULLHt'iEa TC VOLLJI1E HEIGHT l.oJATER VOL I,Jf1TER I NC'HEf-i GALS INCHES DEG F TEI'-lP 7 0.68 72.9 * ); ~ ;.. ""' EIID " " " )o; " ---[J[ SPENSER HLARI•I ---- E I: C'OMI1UN I C11T I 01•1 1-\Lr)RI•I OCT 15, 201~ 4:~0 ~1 ,. S\'STEI"I SETUf• --------- OCT I 5, 20 l 3 Sl : SO Al"l S'.'STEI"' UNITS u.s. SYSTEI'l L1-1NGUAGE ENGLISH SYSTEM f•ATE 1' 111£ FORI'IAT l•lON DD YY'>:'V HH !I'IM :SS xf•l SULLYS CHEVRON I I 400 1·11 NG AVE SAKERSF I EL[I CA 93:J I I SHIFT TII"IE I SHIFT Tlr·l£ 2 SHIFT TINE 3 SHIFT TIME 4 t.: 15 Al"l 2:15 1-111 o~:oo 1-111 DISABl Er• TANK PER TST I'JEEL•Er• I.JRN f1ISHBLED TAI'II~ ANN TST NEElJED ~~RN DISABLED LINE RE · ENMBLF. I·IETHOD PASS L II IE TEST L I NE F•ER TST NEED ELl IARN DISABLED LINE ANN TST NEE[,E[J WRN DISABLE[J F'F~ I NT TC V<iLUI"lES ENHBLED TEI'IF' COI'lf-•Ef~SHT I ON 'VALUE <DEG F >: C:,O.O STICK HE I (;HT oFFSET [•ISI-IBLED ULLAGE: '30/" H -PROTOCOL D,;TA FOI<I'le~T HEIGHT [•IWLIGHT SHVII'I(; TII1E EN1-18LED START DHTC 11AR WEEf.: 2 SUN START TIME 2:00 Al'l END Df\TE NOV WEEK I SUN END Tlt1C 2:00 Al"l RE-Dif.:Et.:T LOCAL kf\lNWUl DISABLED EURO PROTOCOL F'REFIX s SYSTEI"l SECURITY CODE : 000000 f•·JA I NTEI'IHNCE HI STOR\' [JISHBLED TANK CHART SEC'liR IT'.' DISABLED CUSTOf•l r'o\Li-,RI-15 DISABLED SERVICE NoTICE DISI-IBLE[J I SO 31 6t. C'OUI•lTR\' CODE: VAF•OR 1'\0N I TOR 11'1':; T'iF'E .-·t-~RB ISD r·lH:-JS [•Eiv;31 TV DISABLED FISCAL HEIGHT SEC:URIT'.' DISABLE[! I NIIENTOR'I ALI-IRI·IS LIN IT~ CONFIG: STMNIJI-\R!J I"IAX OR LABEL: VOLU1'1E HIGH PRODUCT: ~. I•IAX OVERF I LL : 1~ 11A:< [JEL IV NEEDE[J: % 11HX LOW ~·RODUcT : VOLUME tiLI-IRI'l REDUCT 1 ON DISABLED COI'II'\UN I CHT IONS SETUP PORT SETT I NL;S : COMI·I BOARD : I ~ £[' ll·l RS-232 SECURITY COI'E : D I tii"IBLH' t~OI•·If'l BOMRD : 2 <RS-232> B~UD RATE : 9b00 f'HR I TV : NONE STOP BIT : 1 STOP DATA LENGTH: 8 OfiTH RS-232 SECURITY CODE : DISI-IBLED AUTO TRAI,S111 T SETTINGS: HUTO LEHK HLHRI'l L 1 1·1 IT DISI-\BLED HUTO HIGH LJHT[R L I I'll T DISABLED AUTO OVl::RFILL LIMIT DISABLED AUTO LOW PRUDUGT DloABLED AIJTO THEFT L11"11T DISMBLED AUTO DELIVER·t START DISHBLED AUTO DEL I VER'/ END f•ISABLED 1-1UTO Ei<TERNAL INPUT ON DISABLCD AUTO EXTERNHL INPUL' OFF DISAI:JLED AUTO SENSOR PUCL Hl.t-IRI'1 [JISMBLED 1"\UTO SENSOR WHTER i-\LARI1 DISABLED AUTO SENSUR (>UT ALI-IRI'1 [JI8t'\BLED RS-232 END OF J•lESSI-IGE DIS1-1BLED IN-TnNK SETUF' T 1 : UNLEA[,ED f'RODUCT CODE THERMAL COEFP TRNI~ D I t-1!'\ETER TANI~ f'ROF l LE FULL VvL FLOAT SIZE: I.JATER Ml Nli1UI1 I . OUU'/00 l2U.00 1 F•T :?OUOO 4.0 IN. 0.000 J,IHTER WfiRN IN(; : 2. 0 HIGH WATER LIMIT: 3.0 r,Jr~TER ALHRI'1 FILTER: LOI•J l'lf~:: OR LABEL \IOLUI1E : 20000 HIGH PRODUCT % J·lf{>( : 95.1 <GI-ILLONS> : 190u0 <)\iERF ILL L 11'11 T ~ MAX : 90.1 <GALLONS> : !8000 DELI VERY L 11'11 T • .• 1'1R', : 10.1 <GALLONS> : 2000 LOI;J PRODUCT VOLUI"IE : 1000 LC1-1r 1-11.1-\Rf'l L!rll T: 99 SUDDEN LOSS LIMIT: 99 TANK TILT : 0.00 !=-ROBE OFFSET : 0.00 :-l!PHON I-IANIFOLDED TANKS Til: NONE 1.1 NE 1"1AN I FOLDEL• THNKS Til: NONE l.EAI-: t·ll N f'ER I OD I 1.: : LEM: ~·1 I N 1-lNI~UI-lL I'" '• .::uo P• 200 PERIO!JIC TEST T'IPE STAN[•AR[I ANNUAL TE:3T Ff-1 I L f\IJIRI·l D I SHBLE[• PERIODIC TEST ft-1IL Hl..HRI1 [J I SABLEEJ GROSS TEST FI-\IL HLHRI'I DISI-IBLED ANN TEST t-~\IERfiGI NG: OFF J>ER TEST AVERI-lGI NC;: OFF T14NI-: TEST NOTIFY: OFF TNI< TST 8 1 HION BREAI~ :OFF DEL I \IERV [•ELl-\'.' : I 1·11 N PUI1P THRESHOLD : 1 0. 00'• T 2: SUPREI'l PRODUCT CODE HIER~1HL COEFF T14NK D!At-lETER TANK PROFILE FULL VOL 2 : .000700 120.0(1 1 PT 12000 FLOI-IT SIZE: lJATER 1'1 IN 11•1Ut1 4.0 Ill. o.oon IJI-ITER WARN! N(; : 2. 0 HWH HATER LII"'IT: 3. 0 t..IATER ALI-\RI'1 F I L TER : LO~J 1'11-1>< OR LABEL VOLU~IE : 12000 HIGH PRODU•:'T >I) MAX : ':1':'·.1 \GALl .01-18 > : 11400 OVERFILL Llf'11T }• r'lflr: : 90.1 <GHLLONS> : 1080(: DELIVERY LIMIT % l'lA:..: : !IJ. I <Gr~J.Li>I~Si : 1200 LOL-J F'RODUGT \IOL.Ut1E : 1000 LEf-\1: 1-ILHRf'l L 111 J T : 99 f:t IDNo N LOSS L 11•11 T : 99 TANK TILT : 0.00 PROBE OFmET : 0.00 SIPHON 1'11-\NIFOLDED TANI\S Ttl: NONE LINE ~IAN I FOLDE(J ThNI\S Til: NONE LEAK r·liN PERIODIC: 1•-:; 120 LEAl~ 1'1 IN AJIINUI-\L : J•. 120 PERIODIC TE::;T TYPE STfif\II•f.iRD nNNUnL TEST Ff.IIL ALARI·I [,I SI-\BLECJ PERJO[JIC: TEST F141L i-ILfiRM DIS;;BLED GROSS TEST FAIL ALARI'l D I Sr~BLED ANN TEST ?1VERAGING: OFF PER TEST AVCRAG!NC: OFF TANK TCST NOTIFV: OFF TNK TST SIPHON BJ\EAI<:OFF DEL I VERY [1[L1-1Y PUf'lP THRESHOLD I 1'11 N 1 o.oo·. T 3:DJE8EL F'RODlJ('T COLlE THER1'1HL COEFF TAI>lf: D l At•IETER Tf.II~K PROF I LE FULL VOL FLUt\T SIZE: lJI-\TER 11 IN I I llJJ·1 3 .000450 120.00 I PT 10000 4.0 II~. 0. (IUIJ W~TER WARNING : 2. 0 HIGH WHTER LIMIT: 3.0 WATER t-ILARII F::..TER: LOW l"il·f· OR LABEL VOLUtiE : I Ou()U HIGH f·RODUI.~T "• ~ ... ~ I GALLONS I OVE~FILL LIIIIT ~. 11A;-: < G?ILLC·NS l [1EL I VER\' L I HIT ~. r1H:-c: \GALLONS) LOW f.'R()[IUCT \/OLUI'IE 9'i. I '::1500 90. I 9UULI I Q. I I 000 J 000 L~ r-~LARI·l L I t·1 IT : '39 SUDDEN LOSS L I 11 IT: 99 TANK TILT : 0.00 PROBE OFFSET : 0.00 s 1 PHON ~1,..,r·~ 1 FOLDED T MNI~S Til: N0r1E LINE tlt-~IH FOLDED Tf11H:S Til: NOliE LEAl~ 111N ~ ER I 0(11 C : :..&~1: t11 II HNNUi-iL 1 '; 100 1 •• '• 100 PER I OD 11:-TEST T'r'F'E 8TRN1JHR[• ANNUI-IL TEST F;;JL HLHR1''1 [I I :-:I~Bl.E[I F'ERIODIC TEST FI-IIL AL14RI·I DISABLED GROSS TEST FI-IIL ALARI'I DISHBLED 1-1NN TEST HVERt-~G I NG: OFF PER TEf.:T AVERI-\G I NG: OFF TI·H~K TEST NOT IF\': OFf' n;K TST 81 PH(;f I Bld::t-\K :oFF [IEL I VER'i DELA·t : J 1·11 N PUi1P THRESHOLD : I 0 . QO:; LEHf: TEST f IE1 HNJ TEST ON !JfiTC : HLL TAN!~ I·IIW 27. 2011 EiTAJ<T T I t-IC : lll SHBLED TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST E14RL'I STOP:Dl~I-IBLED l.Et-~1: TEST REH>RT FORI"IAT NORI'IAL L I GU I LJ SEr-r.-;<)f.: SETUF· L I :fJISP 1-'2. !:JtJ SUi·IP 2-1 ('1-\TEGOf<V : D I tii->EII.SER f'l-iN L ': fd Sk 3-4 m~ SUI·IP 2-1 ('1-\TCGORY : L1 I ::>PENSER PI-\N L .1 :fdSP 5 6 DI.J sunP d-1 l'I-ITF.~OR't : D l SPENSER PAl~ L <I:DISP 7-8 D~l SUI-!P 2-1 CI-ITEt";OR'/ : [i!Sf,ENSER Pnll L 5:t•ISP 9-10 r.w su·u:. 2-1 •:ATEGOP.'l : (•I SF'ENSEP. P/41~ L b : fJ I ::;p I I -I ::: r~~~ SUtiP 2-1 CATC•.>UJ<\' : Dl SPENSER f'l-\1'1 I. 'I: DIS~ I 8-1 4 DW SUMF' 2-1 •.'l-IT EGO!<'/ : [)I f.;;l ·CNSER f HI'~ L a:DISP 15 !6 W GUI·IJ·· 2-1 ('I-ITEGORY : niSPEiiSER PAl~ L 9:UNL STF- TRI :;THTE <SIJ¥;1.[ FLOI-iT> Cr~TEGORV : arr:· SUMP l.IO:UNL STP 14NN TRI-!:STI-\TE <SINGLE FL0ATl .;MTEGORV : HNI'JULAR SF-1-1\.:E Lll :UNL Fli.L TR I -STI-ITE < S I ~Jo..;LL FL014T) CATEGORY : OTHER f>f.l'lSORS LJ2:UNL FILl. 1\NI'l TRI-STATE {SINGLE FL01-1n CATEGORY' : ANNLII.nR til-'1¥ E L13 :SUP sn· Tl< I -STATE '::; l t~(;LE FLOAT l ('HTEGOI\Y : STr· f;u:IP L I ~ :SUP STr• iltl!~ TR I -STHTE \::>I I IGLE FLOI-IT > CATEGOR\' : HNIJULI~R SH1•~E L1 5: SUP FILL TRl-STt-~TE <Sl W;J.[ rl.OIIT CATEGORY : OTHER SENSORS LI6:SUP FILl. l-INN TR I -STi-1 TE < 8 li'JliLE FL011 T > CATEGOR·.' : ANNULAR f~l'll· 'E LJ7:DoL STP TRI-STATE <SINGLE FLOATI CATEGOJ.'N : Sn· :i:;UI'IP L I 8 : [•SL SH· ANN TR I -STAT f. <::;I 1-K;LE FLOnT> C'ATEGORV : ANIWLI-IJ.i ::iPHGE LI9:DSL FILL TRI-ST1-1TE <SINGLE FLOI-IT> C:1-1TEGORY : OTIIt:l< r:Et 180kS L20:0SL FILL HNN TRI-Sfi-ITE <Sih(;LE FLOhT> CATEGOR\ : ANNULI\R SF•t-~CE PUI'lP :::;ENSOR SET I JF· 8 I : Ut\LEHIJED TM~II: II: I D I SPEI\SE 110(1E : STHNDr-~R[I S 2: SUF'Rfrl TnNK ll: ~ DISPENSE ~K>DE: STf.INui-IRf' S 3 : D 11-:BEL THI~f.: II: ·• D I Sf-EN::!E I"KjD£';: STf1NDARD OUTPUT RELr1'. RETUP R I : UNLEHDE[l TYPE: PUMP cornRoL ourr·uT TAiir: II: I LIQUI[J SENSOR ~LI'lB L I :FUEL ~LI-iRI·l L 2: FUEL ALJ.iRI"I L 3: FUEL /1LARI·i L 4:FUEL f1LRRI'1 L 5: FUEL ALHRI1 L 6 :FUEL 1-\Lo-IRI"l L 7: FUEL HLARl'l L 8: FUEL. HLI-IRI'I L 9:FUEL ALHRH L 13: FUEL ALAR! I L I :SENSOR OUT 1-\LARI•I L 2 :SENSOR OUT ALARI·1 L 3: SENSOR OUT HLARI1 L 4 :SENSOR OUT ALARI4 L '5 :SENSOR OUT 1-\IARn L t,:SENSOR OUT ALARI'l L 7: SENSOR OUT 1-\LARI'I L 8: SENSOR OUT HLI-IRI•I L 9 :SENSOR OUT ALARI·I L I 3: SEI~SOR OUT ALARI1 L I :SHORT ~LI-\RI•I L 2: SHORT HLARt1 L 3 :SHORT ALARt1 L. <I :SHORT l-ll.HRtl L 5: SHORT f'ILARI"I L 6 :SHORT ALARI 1 L 7:SHORT ALARI'I L e:sHORT HLI-IRN L 9 :SHORT ~LARI'I o:. L 1 3 :SHORT ALARI'I I SD SITE I-ILARI•lS lSD GROSS PRES FAIL lSD DEGRD PRES FI-IIL lSD VAPOR LEAK FAIL I SD HOSE HLI-\RI1S ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW GOLLE('f rAIL K .!. • ;:,ur·Kt:.l'lc T'/PE: PUI·lP CONTROL OUH•UT TANK 11: 2 LIQUID SENSOR I-ILI'IS L. I :FUEL 1-\LARI I L 2: FUEL ALARI'l L 8: FUEL ALAR11 L 4: FUEL ~LHRM L 5:FUEL ALARM L 6 :FUEL ALHRI'I L 7: FUEL ALI-\RI•I L B: FUEL ALARI1 L 9 :FUEL nLI-\RI1 L I 8 : FUEL ALARI1 L 1 :SENSOR OUT AU,RI1 L 2:SENSOR OUT I-ILI-IRf'l L 3: SENSOR OUT 1-\LARI'l L 4 :SENSOR OUT 1-\LI-IRI"l L 5: SENSOR OUT ALARI'l L G :SENSOR OUT ALARI'I L 7 :SENSOR OUT 1-lLHRI•l L 8:SENSOR OUT 1-\LARI'I L 9:SENSOR OUT ALARI'I L I 3: SENSOR OUT ALARI'I L I :SHORT ALARI•l L 2: SHORT ALARI•I l. 3 :SHORT ALARl'l L 4 :SHORT ALARt1 L S:SHORT ALARM L 5:SHORT ALARM L 7: SHORT ALARtl L B :SHORT ALHRI·l L 9 :SHORT ALARI1 L13:SHORT ALARH lSD SITE ALARI'IS I SD GROSS !=•RES Ff-1 I L lSD DEGRD PRES FAIL lSD VAPOR LEAK FAIL lSD HOSE ALARMS ALL:GROSS COLLECT FAIL tiLL: DEGRD COLLECT FA II. R 3:111ESEL TYPE: PUI'IP CUNTROL OUTPUT Ti-~Nl< II: 3 LIQUID SENSOR t-~Lt1S L I :FUEL ALARI'I L 8: FUEL ALI-IR~1 Ll 7: FUEL ALHRI·I L I : f:iENSOR OUT ALARI'I L 8 :SENSOR OUT 1-\LHRf•l L I 7: SENSOR OUT ALARt1 L I :SHORT ALARI"l L 8: SHORT ALARI"l L17:SHORT ALARM R 4 : OVERF I LL ALI~RI'I T'IPC: 8THNDARD I\'ORMALL 'I OPEN TANK II: NONE IN-TANK 1-1L1-1RNS t-~LL : 0\/ERF I LL ALARI'I HLL: HIGH PRODUCT t-~LAP.I 1 ALL : I"IAX PRODUCT ALI-IRI1 sr·Jr,RTSEN::;0R SCTUf.· .:; l : UNL PRO[• C,.;TEGORY VAC SEti:::;OR PUMP 11: R 1 : UNLEI-\DEC• VOLUME: 100.0 GALLONS RELIEF VALVE: : NO s 2:VAPOR C1-1TEGvR\' Vi¥.: SENSOR PU11P 11: R I : UNLEADELI \IOLUI'IE: I 00. 0 (;HLLONS RELIEF VALVE: : NO s 3: UIIIL THI~K fii~N CATEGORY VAC SENSOR PUI'IF' II: R I : UNLEADED VOLU11E: I 00. 0 GALLONS RELJEF VALVE: : NO s 4 : UI~L VENT CI-\TEGOR\ VP.G SENSOR f'UMP 11: R l : UNLEADED VOLUI"IE: I 00.0 GALLO! IS REL I EF VnLVE : : 1~0 s 5:SUP PROD C1-1TEGORY VI-\C SENf.>OR PUI'1P li: R 2 : SUPREI'lE VOLU11E: I 00. 0 GALLONS RELIEF VALVE: : NO s 6:SUf-' VENT CATEGORY VH•~· SENSOR PUI'IP II: R 2: SUPRE!1E VOLU11E: l 00. 0 GALLONS RELIEF VnLVE: : NO 5 7 : SUF· TAN!\ HNN C'P.TEGORY VAC SENSOI< PUMP 11: R 2:SUPREME VOLUME: 100.0 GALLvi'IS RELIEF VALVE: : NO s S:ATM GI-\TEGOR\' 1-1TM r· SENSOR s 9:DSL VENT CATE1..~0RY VAC SENSOR Pl.Jf1P II: R 3:DIF.SEL VOLU1'1E: 1 00. 0 GALLONS RCLIEF Vi-ILVE: : NO stO:DSL PROD CATEGORY VI-IG SENSOR PUHP II: R 3:DIESEL IIOLUrlE: 1 00. 0 GALLONS RELIEF VALVE: : NO sl7:Fr"l 1-2 CI-\TEGORY AIR FLm~ t·IETER s 18: Fl•l 3-4 CATEGORY A I R FLOI~ tiETER s19:FI"l 5-E. CATEGORY A I R FLOI.-1 t1ETER s20: Fl1 7-8 CATEGOR'/ 1~ I R FLUW tiETER _::)..:: 1 .rn , ... ~ u CATCHOIN f\ I R FLOI.J 1·1ETCP. ~22:Fr1 11 -12 CI-ITEf:ORY 1-1 I R fLOitJ I·IETF.R s:1J:FM IJ-14 CI-IT!::GO~\' A I R FLO~J f•1E1'Ef< s24: HI I 5-1 b (1-\TI::GOR'.' VI-\POf< f-P.L:SSuRE s25:FI1 15-lt. ,:·ATE•:;OR'.' A I R fLOW r·IETER EVR 18[• SETUr· EVR TYPE: VI-\CUUI'I 1-\SS I ST VAC'UU'1 t1SS I ST T'ii>E HEHLY VA(: I<J<.>:.:::.:LE A/L RANGE I'IA" : I . I ".. I II N : 0 . 35 VAPO.Ii: 1-'ROC'ESSOR TY!=·E NONE nNAI.'I'S IS T Ir1ES T II·IE : I 0 : CJO 11M DELrW 1·11 NUTES: 1-\t::CEJ:.·T HIGH ORVJ<: r1 I f:iHBLF.L• I SO HOSE !I-~ FILE ID rP FL HL 1-\1-1 f<f< -----··· ----- 01 38 01 02 U1 02 02 34 U2 02 ll1 02 03 85 03 02 0:? 0:' 04 00 04 02 02 02 05 01 CJS 02 0] C2 05 02 Ob 02 OJ 02 07 OJ 07 02 0.:1 02 08 04 Jtl o~ .:. 04 82 0'3 05 09 0::! 05 02 10 06 10 02 05 0:? II 07 II 0:! 06 t12 12 08 12 o·-· .:. Ob 02 13 09 13 02 07 02 I~ I 0 14 U2 Ul 02 15 II 15 02 oa 02 16 32 lb 02 08 0:? I SD 1-1 I RFLOL.I 11ETER 111-1P I D BER I ML I~UI"I 1.1-\HEL --------·---------I 413:39 Fr·l 1-2 2 41325 FM 3 ·I 3 41332 FM 5-6 " 41338 Fl-1 7-8 5 54619 Fl1 ~-I 0 b 5~6010 Fl1 11-12 7 54GI7 Fr1 13-14 8 ~1338 FM 1'5-16 lSD FUEL GJ;;H(JE HOSr ~F I 2 3 4 FP 1"1HH t1HH MHH 1•1HH 1-\1-1 -------------------· ----· 00 104 004 204 u u 01 105 005 205 u lJ 02 lOt. 006 206 U U 83 107 007 207 u u 04 lOB 008 208 il U 05 109 00~ 20S u U 06 IIC 010 210 U U 07 Ill 011 211 U U 0~ 112 012 212 u u 09 I 13 013 213 U U 10 114 014 214 u u II I I 5 015 215 5 U 32 I 16 016 216 5 U 83 101 001 201 5 u 84 20? 10? 002 5 u 35 103 OOJ 203 U U Lf.IBEL T1-18LE I : UN1-1SS I GNED BLEND3 REGULI-I~ 11ID GRADE PREt11 UM GOLD BRONZE SILVER BLEND2 RIEND4 2: 3: 4: !): 6: 7: 8: .-,. :0• I U: ·---SEI~SOR ALARII L 9 :UNL sn· STP BUI1f.' 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STf' MNN IINNUL~R Sf·HC£ FUEL ~L~lR11 OCT I 5 . ?fJ I 3 I 0 : I '! 1-\1•1 -----Sl:.r:SOR f.ILnRr1 1.1::.:: 1mL r1 u. r~r·JN HtiNULI-\R SPI-\C'E FUEL HLriRM OCT I 5 . 2C I J I 0 : I 8 1-'41 -----SENSOR I·)L~I\r1 Lll :Ur~L FILL OTHE~ SENGORS FUEL HI.ARri OCT I ':I • ~0 I 3 ! U : 1 9 Arl SULL \'8 CHI::VP.ON I 1 400 t11 NG 1-1\IE BAKER::>F I ELD CA 9331 I OCT 15. ?OJ') IQ: 19 H1"1 .::;'.'STEr-1 f.:iTRTI J:; F:F.F'OJ.;T L 4 :LOW l.l .::.,u I [1 Fll.l-llm L ! 0 :FUEL Ml.Hid·l L I I :FUEL 1-\L/IF.Il E I : CC.t1HUN I c,:,T I 01~ MLARM I SD SENSOR OUT l-'1-1~!11 --· ---:~ENi;OR ALhr~"1 LI5:SUP FILL OTHER SEI~SORi-: FUCL 1-.Lr-~P.Il OGT l5. 2U 11 I (I: I 9 Al'l -----SEi,S0R MUIR~! L1 9: IJSL FILl. (lTHEI< SEN!:iORS FUEL ALI-IRI'l t1GT I 5. 20 I 3 1 n: 24 11~1 -SE1~:.ioR r11.1~f..tl L 2:r•1::w ::t-·1 DlGPJ::NSI:R ~·HN LOL.J L l ldU I U I-ILARII OCT I !:1. 2013 I 0:26 Rl·1 ----SENSOR 1-\Lr-IRI'I L 5 : D I ::it' ':J-I .J [•I SJ:I£1-ISER FAt/ LOW L I ldU I (c ALARr·1 O•~T I 5, ::!0 I 3 I (I: 27 Al1 :.:iENSOR ALAP.Il L b : l)[ Sl=' I I -I 2 [i I SFCNSEP. f'i-\N h ·I· I L. IOU I D HLHR~1 OCT I 5. .:'\JI 3 I U :: '1 HN -----SEI•iSOF: fiLHRI ·1 L 1 :ursF· 1-2 DISfEHSER PAN SENSOr;! OUT ALI1RII .:cT t?. 2013 10:40 A:>l -:3ENSOR ?\LI-\RI·l L I :nJSP I 2 [II SF ENSER PAN LOL I L I1:1U I [J ALI-IRI·t OGT l'"i. :ttJI3 IU:41 1-1!'1 -----SENbOf.: i-\LAI<Il L 1 :ntm· 1-2 lll SPENoi::R PAN !.OW L I uU I [1 14L?\RI'l 0CT J". 2013 JO:o.l?. A~l -----SENSOR nL;IRI·J I. I : D J.~:r· I -2 [1) SF•EJIISER PAN L()I,J L I QUI [1 HLhP.I"I OCT 1". 2UI~ 10:~3 ~M --·-8£1/S\.:k nl.HI\'1'1 L I: !JI:.~· 1-2 DISPENSE~< YHN LOW LIGtU)[J 11Lt>Rt1 ocT 15. :·111:.1 10:<14 1-11"1 ~t SENSOR t-~d\RI1 L 1 : D I SP I -2 ) [II oi>ENSER PHN LOI,I L I GJU I [• Hlt1f\'f'·l OCT 15. 2018 JO:o.~t. Atl SULL 'IS C'HI:VP.ON II <IUO 1·11 NG hVE B1-1I:ERSF I ELrl ,~A r!O:J I I OCT 15. 2013 JO:o.lt:) ;.;:·1 S':STEr-1 STHTUS REH>RT ------------ L I : L0L-J L1 GIJ I [i fiLAP.tl L 2 : LOLJ Ll GUIll Al.ARt I L 5 :LOW L I~<~U I [J ~ILI-IRI'I L t.:LOW LI01JJro 1\LHF!I'I L1 U: FUEL ALARt·l E I :u·,I·I"IUNICATION HLAF.I1 IS[; SEN;:)()R OUT !,'AJ'<tJ -----SEI·JS(,R AlltRI1 • L14 :SUJ:• STP ANI1 HIINUI.AR 81-'Rt.'l.: FUEL r-~LHRI"' OCT 15. 2013 10:~8 ~1 -• ---:3Et1SOP. ALAF:t1 -L I :[oJSP 1-2 D I :~f ENSER fAN SEI iSOR OIJJ" ~Li-11\11 jCT !5. 201J 10:50 H11 ' ~ -----SCN:-:,">R HLARtl l. I :DISP I -2 D I SPEN:=WP. h~N LOI.J L I (IU I D 1-1L11R11 O('T IS . ~·IJ I 0 10: ':1.:! At·l -----SEt ,;:;of< HLHP.i I I. 3:L•!Sf· !:,-6 D I SN:II::lER I 'HI~ :':iE::IISOR OUT ALHRI'I OCT I 'j. 20 I 3 I I : 00 H~l tiEl~: ;(IJ-: AL1-1F:i·l L 3:[JISJ"' 5-6 D I SPEtkiEI< 1-'1-11'1 LQL.J L I 0U I Lt F.L~\Rt·1 OCT I"). 20 I J I l : 02 Al"l -----SFtvSC•P nl flf<l•1 L 8 :!liSP 5 C. [•! :=;] ENSEP. ~·MI LOW L I llll I [J f1LHP.I•I OCT I 5, "~IJI 3 I I :02 Hl·l SULL'iS r:'HE\!P.{)t.J I l •10(1 rJ I r :G 1-1VE B•1l:CI<:3FIELD C?l ~3Jl I OCT l 5, 20 I 8 I I : 06 llf"l .. I ~ ~ )> :3\'STEt1 ::m ;TUS 1\EfPP.T ~ L ; : LVW t.10u, r; ~~.~n~ -. / L t>: W I,IIJlJID r:.L4flH L111:FUEL nLt-\Ril E I : ('0111'1111~ II·,., Tl ON Al.HI\'1·1 I SD SEN:jt/R OUT I•IMRN V' ';.,-' II ----SENSOR ALi,~RI•l L J:DJ~~r· 5-6 d ,. DISPENSER f·AN ::iLNSOR OUT AL OCT I 5. 20 l 3 I . (I ':I f11' I ----·-8ENS1.lP. nLnh'tl L J:DJSF '5-6 IJISPE~~F.R ;:.HII LOW LIQUID ALA~1 OCT I 5. 20 I 3 I I : J 3 l-It I 9' ·L SENSOr< hLHR'·l I. 8:DISP 15-16 DISPENSER F·1-1N :.;;[NL.:OR OUT AL1-1Rt1. OGT 15. 2013 Ill r; Al'l !' (/~;' -----SEIISOR ALAR!'! L 8 :[II SP ! 5-I t. [II S~'LN:3ER Pf'IN LO~I L I 1:;,u I [) Al ':"Rr·J OCT I 5. 20 i :{ ll : I 9 1-111 SEI·ISOR I-ILARI'I L 8:DISP 15-lo rll SPeNSER PHN SENSOR OUT ALI-IF.i'l OCT I ft. 2013 I I :20 1-111 '<ttt ~nt{JJ. ~i.. ---~-~E'I3~//fLHRH -----L El. L I ;,y I ,c. [• I SF'ENSER J1 LOl<l Lluiii[J ~ hRII OCT I 5. 201 j II :22 AI·! ..( ., :c::CI~~OR II).,.;Rt'J !. A:DISP 15-16 [• I SPI:::N~:ER f·,.;N LOIIJ L IOU I D ALHI<14 OCT I 5. :'0! :3 II :26 F.l·l -----SEr•SOP. 1-\LARil l. 7: I'll SP I .J-I •I DJSr·ENSt::R fHtl SEI·ISOR OlJf HI.AI¢'1 0•:1· I ':i • :20 I 3 I I : 30 i-\t1 SUL!.Vf.J 1.:1t£Vf\vN 1 1 4 on r'll r~.-: I-III[ DHKI:J-!:31' I EL[I CA ~13311 Ot';T 11.i . ~l) I 8 I I : 88 141"1 S'o'STD1 f:Tn fUS REPORT ---.. ----- L 'I :sEriS<.>f: OUT ALhRM 1: I : COMHUN I ('f-iTJ <)H r-~Lf.oRI•l I SD SEI,SOJ.: OUT 1-IARN -!";Cr r:::oR 1~L~Rr1 l. 7 : D I Sf• I 3-I 4 (• I :.:;r•F.NSER f-Htl LOW L I (IU I[, ~1LHRI'1 OCT 15, 2013 II ;J.J AM ----...:LNSOP. 1-1L1iRI'I L 7 :[II Sf• I 3 -I -1 D I SI-UISER Phi~ L~~ LIQUID hLA~' OCT I 5 . 20 I 3 I I : 35 ,:,~1 BULL >'S ~"'HE\/ RON I I <IUU I'll N(; AVE BAI:ERSF! EU1 1_'1-\ -:1381 I OCT 15. ~813 II :3~ HM S';::iTE~i Sf,..ITf.IG REPC>RT L 7: J.(JI.J Ll GU I [1 !-IL/~Ri·l E I : COt•J·IUJ·J I (·,.;T I 01 I ALHP.~I I S[l f;;Et1:30R ~)liT L<'I-IP.II SULLVS C'HEVF:<lll 11400 111N(, AVE (1;-;l:CP.bf I ELD CH 9331 I OCT I 5, 20 I 3 I I : 8'::l ,.;1·1 S·o'STEI'I STHTIIS P.E~'(iRT E I :r\)t1i1UIHCHTION AUIRI·J IS[> SEN:=-:(;R OUT L•lt~RI~ 111\IEtiTC>R·t I<E!>ORT T I : UliLEA[IE[l VOLUME ~ I bb I b •:';f\1.:'·: ULLAGE -3:3e4 ·~ALS '1.-r-.. ULLHGE • I ~II :4 GHI.~ TC" VOLUt IE -16-l G l GI'ILS HE IL:HT • 92. ~1 I N<;HES IJ!-ITCR VOL • 0 G,.;LS t...IHTER "' (1. (JO I NC:HF.S TEMP • '13.8 [lEG F T 2: SIIPRCJ1 VOLU11E = 6320 GALS ULLHGC • 5GOO <;~-;LS 90% ULLAGE~ 4480 Gl-ll.S TC II<JLUI'IE = 6255 ,·;fiLS HEIGHT • t•?, -.::· I N•~Hc:-; H,.;TER VOL • 0 GALS tJATER • 0. 00 I 1~1 'HES TEMP • 7·1. t=. l>EG r T 3:DIESF.I. '101 .U< 1E .. 4344 GALS ULLH0E -565~ GHLS 9(r-; ULI.HGE• <1656 GALS TC VOLUi·IE " <1309 G•1Lf> HEIGHT -53. tfU INCII£:3 WnTER VvL • 0 t;~LS WtlTER • 0. uO I NCHEB 'I Er-1P • 77. '5 nEG F A ~ A A A ENU -~ • A * ---Sf lnRTf;J:rt~OP. hLARI1 ~ 4 :IH~L V.CNT NO Vl-•···uLJ"l ~~u~RI1 OCT I 5 , :?0 I J I I : 4 3 1-\1"1 'it.. ~- '\ ---;-J li-IRT:::r:r lt>Of: I oLHkl I :5 2:11nfOR 1~0 \IN': ULf1 1-\LHRI: OCT I 5. ~0 I 3 I l : 43 ;-~J·I -··-SJ1,.,RT:.::.I:.:IISvR 11LnRt1 5 I :UHL PkOIJ 1~0 VI-\I'''JUtl HL~F:il OCT J5. 2013 I I :43 ~tl ---sr-111RTSENSt'R I-\I.I-\Rf1 !!-I : UIIL PkOL• HI (;II Ll •)U I [1 ALARti vCT 15. 2013 ll :·~4 AJ·1 ---SI~I-IRT:TI-iS\lR AI.HRt1 .s 2:W\['0R HI•3H Lli~UID AL-1RM OCT I 5 . ,~U I 3 I 1 : 4 4 Ht1 ·-i:ii lnRT:~EriSOR MLAR; 1 s 4:UNL V.CNT Ill GH Ll>dlll [! 11l.I-\Rt1 OCT 15. 2013 II :44 it:·! --:A'lnF:T.3J::II.':lVR f-ILHRI-1 .:: J: LINL TANK 1\NJ J NO VACUU11 I-ILHP.J1 OCT 15. tU13 II :55 ~1 ::ULL'lti CHC\/~:ON 1140C t1111G fiVE E.inKCI\SFIEU Cn •J:;JII O•::T 1 5. zrn 3 1 1 :'57 r-'111 S'.'STU1 :":;;TI-ITUS REPORT -------L: I : ('01-V•HJI~ l •.:HT I (JI'I AU..RI1 I SD SENSOR OUT l,lf-11<1'1 -::1-11-11\TSEI ;SOl\' ALAF.II ~ ~:SUP PJ..:O[l rK) V1~f'UU11 I-1LAR1•1 ~~T 15. 2013 !I :58 ~1 ·-~"'HR n-a N:':'VR ALhR1'1 s 6 ::-;up VEHT NO \lt~I'UUM 1-\LAFJI O('T I 5 . 20 I 8 I I : !)ij Atl ---Sl1nRTSEtt.3 11..: nLHRtl s 7: f:IJP TAI~K nNI~ NU VhCUUtl 11LHRH C:t.'T 15, 2013 ll :59 Atl --: 'lhRTSENMr~ ,:;Lt1Rtl s 5 :SUP != ROT1 HIGH L10UID hLARM O~T 1~. 2013 II :5J Ht1 :.::1-1.-\RT~'·EHSvR 1-1L1--1RM ;;; 6:SUP IJF.NT It I GH 1.1 OU 1 D ALf-,RI1 OCT 1 !.J. :::013 11 :59 Hl"l ---SI~I-IRTSJ::IIS')R Hl.h~~l ~ 9 : f.;';L VI :1-rr 1~0 VAC'IIUJ•l ~\Lr.l\r1 OCT 1 ''.. 2'J 13 I~: fi'J j:IH .. --;:>f"IAI<:TSF.IiSOk ;-;LNF.I1 ;; ':l: [•SL \/EIH HIGH LIGUIIJ f-ILHRN OCT I '5. 201 3 I '· : u 3 HI ---Sllt-~RTf;Ert.:;vJ.: r1LHRI·1 51 U: DSL T·P.C•D NO \/H('UUI1 ;.,L,,RI1 VCT 15, 2UI ~~ 12:03 f'f"1 -811;-;RTSENSUk HLARt·1 - siO:DSL 1-'f<OD H1t:;H L l~tll!r' HLI-\Rf•l oCT 15, :2013 12:03 HI --· :':iJ·1ART:;LN!:>GP. AI HR~l s I 0 : [,SL I'P.O[• HIGH L!t;IUID HL,.;P.M OCT 15. ~ul'J 12:0'5 HI __ .. Sl·lhRT:.iEJ•,SOP. ALr1RI1 - s Q: IJSL VEl IT H 1 (;H 1.1 GIIII.J HLI \F.!' I ocT 15 . .::c1rJ 1;;o:os rr·t SULL··.-s •:HEI/ROf\1 11400 1•11 NO:; H\/E BFiKER:;;r I ELD CA 9331 I OCT l 5 • 20 I 3 I 2: 0'/ HI SVSTEi"l f'Tr-~TUS i<EkORT E I :(:(JI'li'IUf'll('f-l'fiON ~U>~RII I SD ::>Er~SOR OUT l~HRII I Mll:NTOR'; REr·O.RT T I : UI~LEH[ E[ \/0Lli1F ~ I E.t. I f, G,.;L:,:; ULL~:;E • 3884 GHLS 90l~ ULLAGE~ I 38<1 (;ALS TC VOLUi"'E 2 1 E.4o I Gf~LS HEIGHT c 92.91 III:'HES ~JATER VOL = 0 (;HLS ~·JnTER • 0. DO I Nt'HES TE11P .. 73. 3 DEC F T 2: SIIJ.REI'l VOLUf'IE .. 6320 GALS ULLAGE • 5t.80 Gl\1.8 '.40~; ULLI-IGE• 4480 GI-\LS Tt": \/OLUHE • G255 GALS HEIGHT • 62. 5 I I W:Hr::·; !.·.lATER VOL -0 GALS ~Jf1TER ~ 0. 00 I Nf:HES TEr1P • 7<1. 6 [lEt:; F T 3:LIESEL \lvLUI-IE ULL1-1•:;E 90·+ UL!J1GF" TC VOLU:"IE HEIGHT .JATtR VOL WATER TEI'l? 484<1 G~LS 565t: Gl-llf' 4t.56 GHLS 4309 GALS "i8 • tt':) III,:;HE!'S CJ GI-lLS 0. Q(J I NC'Ifl::_; 77.5 DEG F • • ~ X ~ END ~ ~ ~ ~ ~ SULI :iS (:IIE\IROI~ 11400 I'll NG AVE 8AKEP.SF' I El.fl Cl-\ •)331 I OCT 15. 701~ 12:09 ~1 S'o':OiTE11 STi-ITLIS REPORT nLL fLINCT I Cii'<.S N(1P.I ~L I INENTOIN RH·ORT T I : UNLEhl•ED VULUt1E "' I G1.1 7 i;I-\LS UI.LI-\o:;E = 338 3 (;HL:";; 90· ULLI-\GE= 1383 (;t".LS TC VOLU·tE "' 11:.46 I .;,.;u:: HE I •>HT .. 92 . 91 llolt'HD:: WI-ITER VOL = 0 GnLS WATER = u. 00 II'I.~'HI::::i:> TEI1P ~ 78. 3 [JEG r T 2: SUrREI1 VOLU11E UI.Lho;E 90~~ ULLHGE~ TC VOLUME • HEIGHT = ~VATER VOL a WI-ITER TEMr' T 3:DIESEL VOLUME ULLN;E 90~; ULLHGE~ T( · VOLIJ"'E HEIGHT vJATER VOL - !HTER TEI'n: 632ll •~HL!':i 5680 GALS 4480 GALS 6255 GAL:.: 62.51 INCHES 0 G,..;LS 0.00 INCHES 74.t. DEC F <1344 Gf.ILS 5t.% GALS 4656 GHLC:; 430'3 GHLS 53. 80 I tl ~HI ~. 0 GALS 0.00 INC'HEl:i 77.'5 DEG F ~ * ~ • ~ END ~ • -~ ~ 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: Sully's Chevron T Date ofTesting: 10/15/2013 Facility Address: 11400 Ming Avenue, Bakersfield, CA 93311 Facility Contact: Frank Sullivan I Phone: Date Local Agency Was Notified of Testing: 9/18/2013 Nafl1e_()!_~ocal A~e_n_~y Inspector (if present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Kristopher Karns Credentials1: X CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester Other (Specify) License Number(s): CSLB #804904 ICC #5264406-UT SWRCB# 09-1743 3. SPILL BUCKET TESTING INFORMATION Test Method Used: x llydrostatic 0 Vacuum 0 Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625" ·- Identify Spill Bucket (By Tank I Regular 2 Super 3 Diesel 4 Number, Stored Product, etc.) Bucket Installation Type: Direct Bury Direct Bury .-Direct Bury 0 Direct Bury x Contained in Sump x Contained in Sump x Contained in Sump ::; Contained in Sump Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 12.00" 12.00" 12.00" Wait time between applying 5 min. 5 min. 5 min. vacuum/water and start of test: Test Start Time (T1): 9:30AM 9:30AM 9:30AM Initial Reading (R1): 10.50" 10.50" 11.00" Test End Time (TF): 10:30 AM 10:30 AM 10:30 AM Final Reading (RF): 10.50" 10.50" 11.00" Test Duration (T F-T1): I hour I hour I hour Change in Reading (RF-R1): 0.00" 0.00" 0.00" Pass/Fail Threshold or 0.0625" Criteria: 0.0625" 0.0625" Test Result: X Pass 0 Fail X Pass OFail X Pass OFail 0 Pass 0 Fail Comments-(include informati!>11_0n repairs made prior to testing, and recommendedfollow-up[orfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained iu this report is true, accurate, and iu full compliance with legal requirements. Technician's Signature: {:: ... ,. ~~ Date: I 0/ I 5/20 13 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. Ilowever, local requirements may be more stringent. I Di e s e l 11" 1 1'\1 " 1 1 " 1 no l Su l l y ' s Ch e v r o n 11 4 0 0 Ml n g Av e . Ba k e r s f i e l d , CA 93 3 1 1 Re g u l a r 20 ,00 0 ga l . D TL S - 3 5 0 Su p e r 1 ? nn n ma l es o o Ov e r f i l l D Al a r m L 1 - UO C 1- 2 , 20 8 & 30 4 se n s o r L2 - UD C 3- 4 , 20 8 & 30 4 se n s o r L3 - UD C 5- 6 , 20 8 & 30 4 se n s o r L4 - UD C 7·8, 20 8 & 30 4 se n s o r L5 - UD C 9- 1 0 , 20 8 & 30 4 se n s o r L6 - UD C 11 - 1 2 . 20 8 & 30 4 se n s o r L7 - UD C 13 · 1 4 , 20 8 & 30 4 se n s o r L8 - UD C 15 -16 , 20 8 & 30 4 se n s o r L9 - 87 ST P , 20 8 se n s o r L 10 - 87 ST P A n n ., 30 4 se n s o r L 11 - 87 Fi l l , 20 8 se n s o r L 12 - 87 Fi l l An n .• 30 4 se n s o r L 13 - 91 ST P , 20 8 se n s o r L 14 - 91 ST P An r L , 30 4 se n s o r L 15 - 91 Fi l l , 20 8 se n s o r L 16 - 91 Fi l l An n ., 30 4 se n s o r L 17 - D5 L ST P , 20 8 se n s o r L 18 - D5 L ST P An n ., 30 4 se n s o r L 19 - OS L Fi l l , 20 8 se n s o r L2 0 - DS L Fi l l An n ., 30 4 se n s o r 51 - 87 Pr o d u c t , Va c se n s o r 52 - Va p o r , Va c se n s o r S3 - 87 Ta n k An n . , Va c se n s o r 54 - 87 Ve n t , Va c se n s o r 55 - 91 Pr o d u c t , Va c se n s o r 56 - 91 Ve n t , Va c se n s o r 57 - 91 & D S L Ta n k An n ., Va c se n s o r 59 - DS L Ve n t , Va c se n s o r S 1 0 - DS L Pr o d u c t , Va c se n s o r 1 - Ma g Pr o b e 2 - FX ~ 1 V LL D 3 • FX - 1 D V LL D ~flOE"+, iilsfi ., +' ~'liuc'f\0 "BUILD WITH CONFIDENCE" Lic.970703 ~flDf"+. CJO C\ '((\ ~USTCJ. -,,CES•~ "COMPLIANCE WITH CONFIDENCE" Lie. 804904 Job Order /Invoice #: 3t<.ft1 Date Cptted /O/t!5( t3 nme fd;SO Toll Free #: 1-800-339-9930 I <; D 5<-NS~ DL:I c..>->A-S ~1.) Si:.h Dvce.c IV V ut~IJ Name: Confidence UST Site Name: 5"uU_t/ 1_( Street: 16250 Meacham Road Street: tlq.oo f.npt ,L_ AJC City: Bakersfield CA 93314 City: -&J<:-g~~'"' }> State: t::-:;:1 , Zip: q f S ( ( Terms: Alil11#.d'~ "· ~ Jlt{,l1<:;. ·~r::I!A. Store No: Descriotion of work oerformed: L -t( I t011.:J 1-flJ o el'\ .Ll,:]J . '"~" ~i2..tu.4l j) IJ(L(Jv6-MONt LoP-l.i'J lr-C££2.( !AlL 1-J .<> /~1?, >-.-s~ ~ 3:J t"){'.. (;:',..;:77, oA~"'"" TD ~?? a;) ~'FTZ_. '>APe: _..,..,. ~ /'r.t ,U\ br<A.I:?t ~ ;T.A.i4nAA 0.:'1\ 1-rll'tk ~ nC' r-._ B. v ""'Ll IA/.JrP / • lo 'bo ~r') iA.J£ 1-14 /) M /' bl t) ..5/A,?_/ .N>,.,A ll 7lJ e. ( L -lt . .;( :r~ AAH..J t.tVA~ FoLJNC) N.f"l l 1 noJJ ' //_£./.... 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F= fOwt ... t~ v...> ,;n.,.l.. t-.>1"\ l~ Ch:>t !"-. ~ WE:t2.d/ I ~~.-R=~,<t _gqf.-fs3'/ lt=rL-UD II,) "'->tTH-&ut....Jtc-SoLv'IT~ ~ TRAVEL and LABOR (0.5 Hour Minimum Labor Charge) OVERTIME (5:00 PM -7:00AM) Dale Technician(s) Name Start End Total OT Start OTEnd OTTotal Travel Labor ll'v Travel Date Technician(s) Name Start End Total OT Start OTEnd OTTotal Travel Labor Travel Date Technician(s) Name Start End Total OTStart OTEnd OTTotal Travel Labor Travel I SUPPLIES -MATERIALS -RENTALS Check One Qty. / 1\.r 0 c.. "f71C. _.,STP~ Site Parts t -sg~ D~ SoF/w~ FOR. u~_r_l\L(L &of"C-~So,:;-r I,.-/ 4--::f'} 'f]q 0 -lf-;) () fJ/VAnl (A/2 ~ A/<t<-.f2S MP .:Ji (-:J -S-{.., R.-lf !f~U. COMMENTS Store Employee Print Narnf: Store Employee Signature: Date ro lt.5 {1 ~ INVOICE-WHITF SITE CANA'