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Home My WebLink About2016 cold startA. Appendix VI (Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http: / /www.waterboards.ca.gov.) 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 test date. General Information Facility Name: V. G. Mini Mart Site Address: 6501 S. Union Ave. city: Bakersfield Bldg. No.:, Zip: 93307 Facility Contact Person: Roger Hakloogi Contact Phone No.: ( 61 ) 398 -6152 Make /Model of Monitoring System: Veeder Root TLS -350 Date of Testing /Servicing: 09 /29 /2016 Inventory of Equipment Tested /Certified Check the appropriate boxes to indicate specific equipment inspected /serviced: Tank ID: #1 Diesel (Split) Tank ID: #2 Supreme (Split) In -Tank Gauging Probe. Model: u In -Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: 794390-420 u Annular Space or Vault Sensor. Model: X Piping Sump / Trench Sensor(s). Model: 794380-208 LX Piping Sump / Trench Sensor(s). Model: - - Fill Sump Sensor(s). Model: n Fill Sump Sensor(s). Model: - Mechanical Line Leak Detector. Model: n Mechanical Line Leak Detector. Model: - Electronic Line Leak Detector. Model: n Electronic Line Leak Detector. Model: - Tank Overfill / High -Level Sensor. Model: n Tank Overfill I High -Level Sensor. Model: Other (s ci equipment a and model in Section E on Pa a 2). n Other (s eci a ui ment type and model in Section E on Pa a 2). Tank ID: #3 Unleaded Tank ID: _ In -Tank Gauging Probe. Model: u In -Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: 7A4 u Annular Space or Vault Sensor. Model: X Piping Sump / Trench Sensor(s). Model: 794390-208 u Piping Sump / Trench Sensor(s). Model: Fill Sump Sensor(s). Model: n Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: n Mechanical Line Leak Detector. Model: - Electronic Line Leak Detector. Model: n Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: n Tank Overfill / High -Level Sensor. Model: Other(specify equipment a and model in Section E on Pa e 2 . n Others ci equipment a and model in Section E on Page 2). Dispenser ID: 1/2 Dispenser ID: X Dispenser Containment Sensor(s). Model: 84799 -001 u Dispenser Containment Sensor(s). Model: .X Shear Valve(s). U Shear Valve(s). _ Dis enser Containment Floats and Chains . u Disp2nser Containment Float s) and Chain(s). Dispenser ID: 3/4 Dispenser ID: X Dispenser Containment Sensor(s). Model: 1 ❑ Dispenser Containment Sensor(s). Model: X Shear Valve(s). ❑ Shear Valve(s). - Dispenser Containment Float(s) and Chain(s). ❑ Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: X Dispenser Containment Sensor(s). Model: - 1 u Dispenser Containment Sensor(s). Model: X Shear Valve(s). u Shear Valve(s). - Dispenser Containment Float(s) and Chain(s n Dis enser 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 /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): X System set -up tXAlarm history report Technician Name (print). Ed Carpio Signature: Certification No.: Veeder Boot- A21731, ICC 5249952 License. No.: 589517 Testing Company Name: Sunset Mechanical Phone No.: 6( 61 ) 322 -0660 Testing Company Address: 4617 Kimber Ave. Bakersfield CA. 93307 Date of Testing/Servicing: 09 /29 / 2016 Monitoring System Certification Page 1 of 4 12/07 2/21/07 ----- SENSOR ALARM L 4: SUPREME STP STP SUMP FUEL ALARM. SEP 29 2016 4:.06 PM SENSOR ALARM - - - -- L 2:SUP - DIESEL ANNULAR ANNULAR SPACE FUEL ALARM SEP 29, 2016 4:46 PM SENSOR ALARM ----- L 5:UNLEADED STP STP SUMP FUEL ALARM SEP 29, 2016 4:08 PM ----- SENSOR ALARM L I:UNLEADED ANNULAR ANNULAR SPACE FUEL ALARM SEP 29, 2016 4:47 PM ----- SENSOR ALARM ----- L 3:DIESEL STP STP SUMP FUEL ALARM SEP 29, 2016 4:09 PM SYSTEM SETUP - - - - - - - - - - - - SY-13TEM SECURITY SEP 30, 2016 7:13 AM CODE : 000000 MAINTENANCE HISTORY DISABLED SYSTEM UNITS U.S. SYSTEM LANGUAGE TANK CHART SECURITY ENGLISH DISABLED SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM CUSTOM ALARMS V-G-MINI MART DISABLED 6501 S-UNION BAKERRFIELD,CA 93307 SERVICE NOTICE DISABLED SHIFT TIME I : DISABLED SHIFT TIME 2 : DISABLED SHIFT TIME 3 : DISABLED ISO 3166 COUNTRY SHIFT TIME 4 : DISABLED CODE: TANK PER TST NEEDED WRN DISABLED VAPOR MONITORING TYPE TANK ANN TST NEEDED WRN GARB ISD DISABLED f MASS/DENSITY LINE RE-ENABLE METHOD DISABLED PASS LINE TEST LINE PER TST NEEDED WRN FISCAL HEIGHT SECURITY DISABLED DISABLED LINE ANN TST NEEDED WRN DISABLED INVENTORY ALARMS UNITS PRINT TC VOLUMES CONFIG: STANDARD ENABLED MAX OR LABEL: VOLUME HIGH PRODUCT: % MAX TEMP COMPENSATION OVERFILL : % MAX VALUE (DEG F ): 60.0 DELIV NEEDED: % MAX STICK HEIGHT OFFSET LOW PRODUCT : VOLUME DISABLED ULLAGE: 904 ALARM REDUCTION H-PROTOCOL DATA FORMAT DISABLED HEIGHT DAYLIGHT SAVING TIME ENABLED START DATE MAR WEEK 2 SUN START TIME 2:00 AM END DATE NOV WEEK I SUN END TIME 2:00 AM RE-DIRECT LOCAL PRINTOUT DISABLED EURO PROTOCOL PREFIX S COMMUNICATIONS SETUP IN-TA*" SETUP - - - - - - - - - - - - PORT SETTINGS: T I:DIESEL PRODUCT CODE I COMM BOARD : I (RS-232) THERMAL COEFF :,000450 TANK DIAMETER 96-00 BAUD RATE : 1200 TANK PROFILE : 20 PTS PARITY : NONE FULL VOL : 5013 STOP BIT : 1 STOP 91.2 INCH VOL : 4928 DATA LENGTH: 8 DATA 66.4 INCH VOL : 4763 RS-232 SECURITY 81.6 INCH VOL : 4552 SIPHON�MAN I FOLDED TANKS CODE : DISABLED 76.8 INCH VOL : 4315 T#: NONE 72.0 INCH VOL : 4047 LINE MAN IFOLDED TANKS COMM BOARD : 2 (EDIM y 67.2 INCH VOL : 3767 T#: NONE RS-232 SECURITY 62.4 INCH VOL : 3464 CODE DISABLED 57.6 INCH VOL : 3093 52.8 INCH VOL : 2847 LEAK MIN PERIODIC: AUTO TRANSMIT SETTINGS: 48.0 INCH VOL : 43.2 INCH VOL : 262-3 2208 451 38.4 INCH VOL : 1887 LEAK MIN ANNUAL 9�lll AUTO LEAK ALARM LIMIT 33.6 INCH VOL : 1581 451 DISABLED 28.8 INCH VOL : 1285 AUTO HIGH WATER LIMIT 24.0 INCH VOL : 994 DISABLED 19.2 INCH VOL : 730 PERIODIC TEST TYPE AUTO OVERFILL LIMIT 14.4 INCH VOL : 482 STANDARD DISABLED AUTO LOW PRODUCE' INCH VOL : 272 4.8 INCH VOL : 103 ANNUAL TEST FAIL DISABLED ALARM DISABLED AUTO THEFT LIMIT DISABLED FLOAT SIZE: 4.0 IN. PERIODIC TEST FAIL AUTO DELIVERY START WATER MINIMUM 0.500 ALARM DISABLED DISABLED AUTO DELIVERY END WATER WARNING 2.0 GROSS TEST FAIL DISABLED HIGH WATER LIMIT: 3.0 ALARM DISABLED AUTO EXTERNAL INPUT ON WATER ALARM FILTER: 'LOW DISABLED ANN TEST AVERAGING: OFF AUTO EXTERNAL INPUT OFF PER TEST AVERAGING: OFF DISABLED MAX OR LABEL AUTO SENSOR FUEL ALARM VOLUME : 5010 TANK TEST NOTIFY: OFF DISABLED AUTO SENSOR WATER ALARM HIGH PRODUCT TNK TST SIPHON BREAK :OFF DISABLED % MAX : 95.0 AUTO SENSOR OUT ALARM (GALLONS) : 4760 DELIVERY DELAY : 3 MIN DISABLED PUMP THRESHOLD : 10.00% OVERFILL LIMIT % MAX : .0 90 (GALLONS) 4509 DELIVERY LIMIT % MAX 14.0 (GALLONS) 701 RS-232 END OF MESSAGE LOW PRODUCT DISABLED VOLUME 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 0.00 PROBE OFFSET 0.00 T 2: SUPREME PRODUCT CODE 2 THERMAL COEFF :.000700 TANK DIAMETER 96.00 96.00 TANK PROFILE : 20 PTS 6313 FULL VOL : 7018 91.2 INCH VOL : 6899 86.4 INCH VOL : 6666 81.6 INCH VOL : 6376 76.8 INCH VOL : 6043 72.0 INCH VOL : 5666 67.2 INCH VOL : 5273 62.4 INCH VOL : 4849 57.6 INCH VOL : 4422 52.8 INCH VOL : 39136 48.0 INCH VOL : 3532 43.2 INCH VOL : 3091 38.4 INCH VOL : 2642 33.6 INCH VOL : 2214 28.8 INCH VOL : 1799 24.0 INCH VOL : 1392 19.2 INCH VOL : 1022 14.4 INCH VOL : 675 9.6 INCH VOL : 381 4.8 INCH VOL : 145 FLOAT SIZE: F 4.0 IN. WATER MINIMUM 0.500 WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 WATER ALARM FILTER: LOW MAX OR LABEL VOLUME 7014 HIGH PRODUCT % MAX : 95.0 (GALLONS) : 6663 OVERFILL LIMIT 96.00 % MAX : 90.0 (GALLONS) : 6313 DELIVERY LIMIT : 12139 % MAX : 14.0 (GALLONS) : 982 LOW PRODUCT INCH VOLUME : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS .T#: NONE LEAK MIN PERIODIC: 9:k4 631 LEAK MIN ANNUAL 91 631 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM D I SABLED' GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 3 MIN PUMP THRESHOLD : 10.00% T 3:UNLEADED PRODUCT CODE 3 THERMAL COEFF :.000700 TANK DIAMETER 96.00 TANK PROFILE : 20 PTS OVERFILL LIMIT FULL VOL : 12139 91.2 INCH VOL : 11933 86.4 INCH VOL : 11518 81.6 INCH VOL : 11030 76.8 INCH VOL : 10452 72.0 INCH VOL : 9803 67.2 INCH VOL : 9100 62.4 INCH VOL : 8393 57.6 INCH VOL : 7637 52.8 INCH VOL : 6883 48.0 INCH VOL : 6111 43.2 INCH VOL : 5339 38.4 INCH VOL : 4575 33.6 INCH VOL : 3825 28.8 INCH VOL : 3100 24.0 INCH VOL : 2409 19.2 INCH VOL ; 1761 14.4 INCH VOL : 1171 9.6 INCH VOL : 655 4.8 INCH VOL : 244 FLOAT SIZE: 4.0 IN. WATER MINIMUM 0.500 WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 WATER ALARM FILTER: LOW MAX OR LABEL VOLUME : 12139 HIGH PRODUCT % MAX : 95.0 (GALLONS) : 11532 OVERFILL LIMIT % MAX : 90.0 (GALLONS) : 10925 DELIVERY LIMIT % MAX : 9.0 (GALLONS) : 1093 LOW PRODUCT VOLUME : 1000 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS T#: NONE LEAK MIN PERIODIC: Tl� 1092 LEAK MfN ANNUAL 9?/o 1092 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TESTY"FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: 'OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 3 MIN PUMP THRESHOLD : 10.00% LEAK TEST METHOD TEST ON DATE : ALL TANK JAN 2, 2017 START TIME : 2:00 AM TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:ENABLED LEAK TEST REPORT FORMAT NORMAL LIQUID SENSOR SETUP — — — — — — — — — — — — L I:UNLEADED ANNULAR TRI—STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 2:SUP—DIESEL ANNULAR TRI—STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 3:DIESEL STP TRI—STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 4:SUPREI,,IE STP TRI—STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 5:UNLEADED STP TRI—STATE (SINGLE FLOAT) CATEGORY : STP SUMP EXTERNAL INPUT SETUP — — — — — — — — — — — — I I :HIRT VP PROCESSOR NORMALLY OPEN OUTPUT RELAY SETUP — — — — — — — — — — — — R I:UNLEADED TYPE: STANDARD NORMALLY CLOSED TANK #: 3 LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL R 2:SUPREME TYPE: STANDARD NORMALLY CLOSED TANK #: 2 LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL :SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL R 3:DIESEL TYPE: STANDARD NORMALLY CLOSED TANK #: I LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM SMARTSENSOR SETUP s I:DISP 1-2 FM CATEGORY AIR FLOW METER 5 2:DISP 3-4 FM CATEGORY AIR FLOW METER - s 3:DISP 5-6 FM CATEGORY AIR FLOW METER s 4:DISP 3-4 PS CATEGORY VAPOR PRESSURE EVR/ISD SETUP E'ER TYPE: BALANCE BALANCE NOZZLE TYPE HUSKY I SD HOS ID FP 01 01 02 02 03 03 04 04 05 05 06 06 E Ti FL 01 02 03 04 05 06 )BLE HL 02 02 02 02 02 02 AA RR 01 02 01 02 02 02 02 02 03 00 03 02 ISD AIRFLOW METER MAP ID SERIAL NUM LABEL r1 69104 DISP 1-2 F 2 68963 DISP 3-4 F 3 68595 DISP 5-6 F ISD FUEL GRADE HOSE MAP 1 2 3 4 FP MHH MHH MHH MHH AA ------------------------ 01 201 901 101 U U 1 02 202 902 102 U U 1 03 203 903 103 U U 2 04 204 904 104 U U 2 05 205 905 105 U U 3 06 206 906 106 U U 3 LABEL TABLE 1: UNASSIGNED 2: BLEND3 3: REGULAR 4: MID GRADE 5: PREMIUM 6: GOLD 7: BRONZE 8: SILVER 9: BLEND2 10:,BLEND4