HomeMy WebLinkAboutFMC RESULTS RETEST 2016Testing and Inspection Certificate
Tanknology Inc.
11000 North MoPac Expressway, Suite 500, Austin, TX 78759
800-800-4633 www.tanknology.com Page 1 of 1
Test Date 12/12/2016 Tanknology WO#SC1-3433940
Test Purpose COMPLIANCE Customer PO#
Customer Location
PENSKE TRUCK LEASING
P.O. BOX 7635
READING, PA 19603
PENSKE CA-094 (CA-094/0198-10)
2929 E. BRUNDAGE
BAKERSFIELD, CA 93307
Attn: BRIAN YAZEMBOSKI Attn: Jorge Or David
(610) 603-8450
(661) 322-3146
Test / Inspection Description Item Tested Date
Tested Result
Leak Detection Monitoring System Inspection See test report for details 12/12/2016 Pass
Tanknology Representative: JEFFREY KERTIS Technician: Edwin Pineda
Telephone: (800) 964-0010 Technician Certification: (See forms)
Appendix VI
(Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http://www.swrcb.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.
A. General Information
Facility Name:PENSKE CA-094 Bldg. No.:
Site Address:2929 E. BRUNDAGE City:BAKERSFIELD Zip:93307
Facility Contact Person:Jorge Or David Contact Phone No.:661-322-3146
Make/Model of Monitoring System:Veeder Root TLS-350 Date of Testing/Servicing:12/12/2016
B. Inventory of Equipment Tested/Certified
Check the appropriate boxes to indicate specific equipment inspected/serviced:
Tank ID:T1 - Diesel
In-Tank Gauging Probe.Model:
Annular Space or Vault Sensor.Model:VR-301/303
Piping Sump / Trench Sensor(s).Model:
Fill Sump Sensor(s).Model:
Mechanical Line Leak Detector.Model:Red Jacket FX1DV
Electronic Line Leak Detector.Model:
Tank Overfill / High-Level Sensor.Model:
Other (specify equipment type and model in Section E on Page 2).
Tank ID:T2 - Diesel
In-Tank Gauging Probe.Model:
Annular Space or Vault Sensor.Model:VR-301/303
Piping Sump / Trench Sensor(s).Model:794380-352
Fill Sump Sensor(s).Model:
Mechanical Line Leak Detector.Model:
Electronic Line Leak Detector.Model:
Tank Overfill / High-Level Sensor.Model:
Other (specify equipment type and model in Section E on Page 2).
Tank ID:
In-Tank Gauging Probe.Model:
Annular Space or Vault Sensor.Model:
Piping Sump / Trench Sensor(s).Model:
Fill Sump Sensor(s).Model:
Mechanical Line Leak Detector.Model:
Electronic Line Leak Detector.Model:
Tank Overfill / High-Level Sensor.Model:
Other (specify equipment type and model in Section E on Page 2).
Tank ID:
In-Tank Gauging Probe.Model:
Annular Space or Vault Sensor.Model:
Piping Sump / Trench Sensor(s).Model:
Fill Sump Sensor(s).Model:
Mechanical Line Leak Detector.Model:
Electronic Line Leak Detector.Model:
Tank Overfill / High-Level Sensor.Model:
Other (specify equipment type and model in Section E on Page 2).
Dispenser
ID:
Dispenser Containment Sensor(s).Model:
Shear Valve(s).
Dispenser Containment Float(s) and Chain(s).
Dispenser
ID:
Dispenser Containment Sensor(s).Model:
Shear Valve(s).
Dispenser Containment Float(s) and Chain(s).
Dispenser
ID:
Dispenser Containment Sensor(s).Model:
Shear Valve(s).
Dispenser Containment Float(s) and Chain(s).
Dispenser
ID:
Dispenser Containment Sensor(s).Model:
Shear Valve(s).
Dispenser Containment Float(s) and Chain(s).
Dispenser
ID:
Dispenser Containment Sensor(s).Model:
Shear Valve(s).
Dispenser Containment Float(s) and Chain(s).
Dispenser
ID:
Dispenser Containment Sensor(s).Model:
Shear Valve(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):Edwin Pineda Signature:
Certification No.: B37453 License. No.:743160 Class 'A'
Testing Company Name:Tanknology Phone No.:(800) 800-4633
Testing Company Address:11000 N. MoPac Expressway Suite 500 Date of Testing/Servicing:12/12/2016
Monitoring System Certification Page 1 of 3 12/07
D. Results of Testing/Servicing
Software Version Installed:
Complete the following checklist:
Yes No*Is the audible alarm operational?
Yes No*Is the visual alarm operational?
Yes No*Were all sensors visually inspected, functionally tested, and confirmed operational?
Yes No*Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with
their proper operation?
Yes No*
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 of tank capacity does the alarm trigger? %
Yes* No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the
manufacturer name and model for all replacement parts in Section E, below.
Yes* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)
Product; Water. If yes, describe causes in Section E, below.
Yes No*Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable
Yes No*Is all monitoring equipment operational per manufacturer's specifications?
* In Section E below, describe how and when these deficiencies were or will be corrected.
E. Comments:
Monitoring System Certification Page 2 of 3 12/07
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 that are programmed for positive shut down, does the turbine automatically shut off if any portion of the
monitoring system is disabled or disconnected?
Yes No*
N/A
For electronic LLDs that are programmed for positive shut down, 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:
Only annular sensors on both tanks and diesel 2 piping sensor were tested.
Page 3 of 3 12/07
Site Diagram
(This site diagram is for reference only and is not drawn to scale)
Work Order:3433940
Site ID / Name:CA-094/0198-10 / PENSKE CA-094
Address:2929 E. BRUNDAGE
City:BAKERSFIELD State:CA Zip:93307
W.O.# SC1-3433940
OVF
W.O.# SC1-3433940
TAPES
W.O.# SC1-3433940
TAPES
W.O.# SC1-3433940
sensor label pictures
W.O.# SC1-3433940
sensor label pictures