HomeMy WebLinkAboutFMC RESULTS 2017MONITORING 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 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).
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 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
#9933 Fastrip
4800 Fairfax Road Bakersfield 93306
Omero Garcia (661) 393-7000
Veeder-Root TLS-350 05/17/2017
12,000 gal. Regular
847390-107
794390-407
794380-208
794380-208
FX1V
847390-107
12,000 gal. Super
847390-107
794390-407
794380-208
794380-208
FX1V
847390-107
12,000 gal. Diesel
847390-107
794390-407
794380-208
794380-208
FX1DV
847390-107
1-2
794380-208
3-4
794380-208
5-6
794380-208 794380-208
7-8
9-10
794380-208
11-12
794390-208
Cameron Mason
B42599
4800 Fairfax Road Bakersfield, CA 93306 05/17/2017
794380-208
794380-208
794380-208 794390-208
Monitoring System Certification
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:
Page 2 of 3
327.04
90
Gasoline was discovered in 91 Annular space.
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:
Fastrip Oil Company
P.O. Box 82515
Bakersfield, CA 93380-2515
38900
05/17/2017
8485827-UT
Regular Mechanical FX1V
Cameron Mason
(661) 393-7000Omero Garcia
Bakersfield, CA 93306
4800 Fairfax Road
#9933 Fastrip
22 PSI 270 ml Pass
FX1VMechanicalPremium 18 PSI 170 ml Pass
FX1DVMechanicalDiesel 20 PSI 140 ml Pass
Cameron Mason 8485827-UT
05/17/2017
Responses Received: 200 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 MAY 17, 2017 8:24 PM TANK PRODUCT GALLONS INCHES WATER DEG F ULLAGE 1 REGULAR 87 7826 58.40 0.0 69.0 3801 2 SUPER 91 4518 38.56 0.0 70.9 7109 3 DIESEL 6704 51.36 0.0 73.6 4923 I90500 MAY 17, 2017 8:24 PM SOFTWARE REVISION LEVEL VERSION 334.00 SOFTWARE# 346334-100-A CREATED - 15.05.29.10.36 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I50500 MAY 17, 2017 8:24 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 MAY 17, 2017 8:24 PM SHIFT TIME 1 : DISABLED I50202 MAY 17, 2017 8:24 PM SHIFT TIME 2 : DISABLED I50203 MAY 17, 2017 8:24 PM
SHIFT TIME 3 : DISABLED I50204 MAY 17, 2017 8:24 PM SHIFT TIME 4 : DISABLED I54600 MAY 17, 2017 8:24 PM TANK PER TST NEEDED WRN: DISABLED I54900 MAY 17, 2017 8:24 PM TANK ANN TST NEEDED WRN: DISABLED I55300 MAY 17, 2017 8:24 PM LINE RE-ENABLE METHOD PASS LINE TEST I55600 MAY 17, 2017 8:24 PM LINE PER TST NEEDED WRN: DISABLED I55900 MAY 17, 2017 8:24 PM LINE ANN TST NEEDED WRN: DISABLED
I50D00 MAY 17, 2017 8:24 PM PRINT TC VOLUMES ENABLED I50E00 MAY 17, 2017 8:24 PM TEMP COMPENSATION VALUE (DEG F ): 60.0
I60B00 MAY 17, 2017 8:24 PM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I51400 MAY 17, 2017 8:24 PM H-PROTOCOL DATA FORMAT HEIGHT I51A01 MAY 17, 2017 8:24 PM DAYLIGHT SAVING TIME DISABLED I51B00 MAY 17, 2017 8:24 PM I51600 MAY 17, 2017 8:24 PM RE-DIRECT LOCAL PRINTOUT DISABLED I50400 MAY 17, 2017 8:24 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 MAY 17, 2017 8:24 PM TANK CHART SECURITY DISABLED
I5BD00 MAY 17, 2017 8:24 PM CUSTOM ALARM LABELS DISABLED I56000 MAY 17, 2017 8:24 PM MASS/DENSITY DISABLED I88101 MAY 17, 2017 8:24 PM PORT SETTINGS: COMM BOARD : 1 (EDIM ) RS-232 SECURITY CODE : DISABLED I88102 MAY 17, 2017 8:24 PM PORT SETTINGS: COMM BOARD : 2 (S-SAT ) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED DTR NORMAL STATE: HIGH I88103
MAY 17, 2017 8:24 PM PORT SETTINGS: COMM BOARD : 3 (RS-232) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED I88104 MAY 17, 2017 8:24 PM
I88105 MAY 17, 2017 8:24 PM PORT SETTINGS: COMM BOARD : 5 (RS-485) BAUD RATE : 2400 PARITY : EVEN STOP BIT : 1 STOP DATA LENGTH: 7 DATA RS-232 SECURITY CODE : DISABLED I88106 MAY 17, 2017 8:24 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 MAY 17, 2017 8:24 PM RECEIVER AUTO DIAL TYPE & START TIME RCVR LOCATION LABEL DIAL TYPE START TIME 1 ON DATE MAY 5, 2016 DISABLED 2 ON DATE MAY 5, 2016 DISABLED 3 ON DATE MAY 5, 2016 DISABLED 4 ON DATE MAY 5, 2016 DISABLED 5 ON DATE MAY 5, 2016 DISABLED 6 ON DATE MAY 5, 2016 DISABLED 7 ON DATE MAY 5, 2016 DISABLED 8 ON DATE MAY 5, 2016 DISABLED I60100
MAY 17, 2017 8:24 PM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 REGULAR 87 ON 2 SUPER 91 ON 3 DIESEL ON 4 OFF I60200 MAY 17, 2017 8:24 PM TANK PRODUCT LABEL TANK PRODUCT LABEL
1 REGULAR 87 2 SUPER 91 3 DIESEL 4 I60300 MAY 17, 2017 8:24 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 REGULAR 87 1 2 SUPER 91 2 3 DIESEL 3 4 4 I60900 MAY 17, 2017 8:24 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 REGULAR 87 0.000700 2 SUPER 91 0.000700 3 DIESEL 0.000450 4 0.000000 I60700 MAY 17, 2017 8:24 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 REGULAR 87 99.00 2 SUPER 91 99.00 3 DIESEL 99.00 4 0.00 I60A00 MAY 17, 2017 8:24 PM
TANK FULL VOLUME TANK PRODUCT LABEL TANK PROFILE GALLONS 1 REGULAR 87 4 PTS 11627 2 SUPER 91 4 PTS 11627 3 DIESEL 4 PTS 11627 4 1 PT 0 I60400 MAY 17, 2017 8:24 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 REGULAR 87 11627 2 SUPER 91 11627 3 DIESEL 11627 4 0
I60500 MAY 17, 2017 8:24 PM TANK 4 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 REGULAR 87 11627 10128 6403 2453 2 SUPER 91 11627 10128 6403 2453 3 DIESEL 11627 10128 6403 2453 4 0 0 0 0 I60600 MAY 17, 2017 8:24 PM TANK 20 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 REGULAR 87 11627 0 0 0 0 10128 0 0 0 0 6403 0 0 0 0 2453 0 0 0 0 2 SUPER 91 11627 0 0 0 0 10128 0 0 0 0 6403 0 0 0 0 2453 0 0 0 0 3 DIESEL 11627 0 0 0 0 10128 0 0 0 0 6403 0 0 0 0 2453 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 I61500 MAY 17, 2017 8:24 PM
TANK PRODUCT LABEL METER DATA 1 REGULAR 87 NO 2 SUPER 91 NO 3 DIESEL NO 4 NO I62F00 MAY 17, 2017 8:24 PM MAG PROBE FLOAT SIZE TANK PRODUCT LABEL FLOAT SIZE: 1 REGULAR 87 4.0 IN. 2 SUPER 91 4.0 IN. 3 DIESEL 4.0 IN.
I62700 MAY 17, 2017 8:24 PM TANK HIGH WATER WARNING LIMIT TANK PRODUCT LABEL INCHES 1 REGULAR 87 3.0 2 SUPER 91 3.0 3 DIESEL 3.0 I64200 MAY 17, 2017 8:24 PM WATER ALARM FILTER TANK PRODUCT LABEL 1 REGULAR 87 LOW 2 SUPER 91 LOW 3 DIESEL LOW I62400 MAY 17, 2017 8:24 PM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 REGULAR 87 2.0 2 SUPER 91 2.0 3 DIESEL 2.0 I62800 MAY 17, 2017 8:24 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 11627 2 SUPER 91 11627
3 DIESEL 11627 4 0 I62300 MAY 17, 2017 8:24 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 10464 2 SUPER 91 10464 3 DIESEL 10464 4 0 I62200 MAY 17, 2017 8:24 PM
TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 11046 2 SUPER 91 11046 3 DIESEL 11046 4 0 I62900 MAY 17, 2017 8:24 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 1163 2 SUPER 91 1163 3 DIESEL 1163 4 0 I62100 MAY 17, 2017 8:24 PM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 800 2 SUPER 91 800 3 DIESEL 800 4 0 I62600 MAY 17, 2017 8:24 PM TANK LEAK ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 99 2 SUPER 91 99 3 DIESEL 99 4 99
I62500 MAY 17, 2017 8:24 PM TANK SUDDEN LOSS LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 99 2 SUPER 91 99 3 DIESEL 99 4 99 I60800 MAY 17, 2017 8:24 PM TANK TILT
TANK PRODUCT LABEL INCHES 1 REGULAR 87 1.00 2 SUPER 91 1.50 3 DIESEL 1.75 4 0.00 I60B00 MAY 17, 2017 8:24 PM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I60C00 MAY 17, 2017 8:24 PM TANK STICK HEIGHT OFFSET TANK PRODUCT LABEL INCHES 1 REGULAR 87 0.00 2 SUPER 91 0.00 3 DIESEL 0.00 4 0.00 I61200 MAY 17, 2017 8:24 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 REGULAR 87 NONE NONE 2 SUPER 91 NONE NONE 3 DIESEL NONE NONE 4 NONE NONE I63600 MAY 17, 2017 8:24 PM PERIODIC LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 REGULAR 87 5813
2 SUPER 91 5813 3 DIESEL 5813 4 0 I62A00 MAY 17, 2017 8:24 PM ANNUAL LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 REGULAR 87 5813 2 SUPER 91 5813 3 DIESEL 5813 4 0 I62C00
MAY 17, 2017 8:24 PM TANK PERIODIC TEST TYPE TANK PRODUCT LABEL PERIODIC TEST TYPE 1 REGULAR 87 STANDARD 2 SUPER 91 STANDARD 3 DIESEL STANDARD 4 STANDARD I62D00 MAY 17, 2017 8:24 PM TANK LEAK TEST FAIL ALARMS TANK PRODUCT LABEL 1 REGULAR 87 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 2 SUPER 91 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 3 DIESEL GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 4 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED I63100 MAY 17, 2017 8:24 PM TANK LEAK TEST AVERAGING TANK PRODUCT LABEL ANNUAL PERIODIC 1 REGULAR 87 OFF OFF 2 SUPER 91 OFF OFF
3 DIESEL OFF OFF 4 OFF OFF I63000 MAY 17, 2017 8:24 PM IN-TANK LEAK TEST NOTIFY TANK PRODUCT LABEL TANK TEST NOTIFY: 1 REGULAR 87 OFF 2 SUPER 91 OFF 3 DIESEL OFF 4 OFF
I63200 MAY 17, 2017 8:24 PM TANK TEST SIPHON BREAK TANK PRODUCT LABEL SIPHON BREAK 1 REGULAR 87 OFF 2 SUPER 91 OFF 3 DIESEL OFF 4 OFF I61000 MAY 17, 2017 8:24 PM TANK DELIVERY DELAY TANK PRODUCT LABEL 1 REGULAR 87 1 2 SUPER 91 1 3 DIESEL 1 4 1 I63A00 MAY 17, 2017 8:24 PM LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD TANK PRODUCT LABEL PUMP THRESHOLD 1 REGULAR 87 10.00% 2 SUPER 91 10.00% 3 DIESEL 10.00% 4 10.00% I61100 MAY 17, 2017 8:24 PM LEAK TEST METHOD - - - - - - - - - - - - TEST ON DATE : ALL TANK MAY 29, 2015
START TIME : DISABLED TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:DISABLED I61300 MAY 17, 2017 8:24 PM CSLD PROBABLITY OF DETECTION I61400 MAY 17, 2017 8:24 PM CSLD CLIMATE FACTOR
I61600 MAY 17, 2017 8:24 PM TANK PRODUCT LABEL CAL UPDATE 1 REGULAR 87 IMMEDIATE 2 SUPER 91 IMMEDIATE 3 DIESEL IMMEDIATE 4 IMMEDIATE I61A00 MAY 17, 2017 8:24 PM IN-TANK LEAK TEST EARLY STOP TANK PRODUCT LABEL TST EARLY STOP: 1 REGULAR 87 DISABLED 2 SUPER 91 DISABLED 3 DIESEL DISABLED 4 DISABLED I61B00 MAY 17, 2017 8:24 PM IN-TANK LEAK GROSS TEST AUTO-CONFIRM I61C00 MAY 17, 2017 8:24 PM CSLD REPORT ONLY I62B00 MAY 17, 2017 8:24 PM
TANK LAST ANNUAL TEST TANK PRODUCT LABEL DATE 1 REGULAR 87 ??? 0, 0 2 SUPER 91 ??? 0, 0 3 DIESEL ??? 0, 0 4 ??? 0, 0 I63300 MAY 17, 2017 8:24 PM LEAK TEST REPORT FORMAT: NORMAL
I63400 MAY 17, 2017 8:24 PM RECONCILIATION WARNING LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 0 2 SUPER 91 0 3 DIESEL 0 4 0 I63500 MAY 17, 2017 8:24 PM RECONCILIATION ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR 87 1 2 SUPER 91 1 3 DIESEL 1 4 1 I63900 MAY 17, 2017 8:24 PM ACCU CHART END SHAPE FACTOR TANK PRODUCT LABEL 1 REGULAR 87 END FACTOR: NONE 2 SUPER 91 END FACTOR: NONE 3 DIESEL END FACTOR: NONE 4 END FACTOR: NONE
I78000 MAY 17, 2017 8:24 PM I77700 MAY 17, 2017 8:24 PM I77800 MAY 17, 2017 8:24 PM
I78C00 MAY 17, 2017 8:24 PM I78300 MAY 17, 2017 8:24 PM I78F00 MAY 17, 2017 8:24 PM I78700 MAY 17, 2017 8:24 PM I70200 MAY 17, 2017 8:24 PM LIQUID LABEL DEVICE LABEL 1 REGULAR 87 ANNULAR 2 REGULAR 87 STP SUMP 3 REGULAR 87 FILL SUMP 4 SUPER 91 STP 5 SUPER 91 ANNULAR 6 SUPER 91 FILL SUMP 7 DIESEL ANNULAR 8 DIESEL STP SUMP 9 DIESEL FILL SUMP 10 DIS 1-2 UDC 11 DIS 3-4 UDC 12 DIS 5-6 UDC 13 DIS 7-8 UDC 14 DIS 9-10 UDC 15 DIS 11-12 UDC 16 VENT BOX UDC
I70300 MAY 17, 2017 8:25 PM LIQUID TYPE SENSOR LOCATION TYPE 1 REGULAR 87 ANNULAR TRI-STATE (SINGLE FLOAT) 2 REGULAR 87 STP SUMP TRI-STATE (SINGLE FLOAT) 3 REGULAR 87 FILL SUMP TRI-STATE (SINGLE FLOAT) 4 SUPER 91 STP TRI-STATE (SINGLE FLOAT) 5 SUPER 91 ANNULAR TRI-STATE (SINGLE FLOAT) 6 SUPER 91 FILL SUMP TRI-STATE (SINGLE FLOAT) 7 DIESEL ANNULAR TRI-STATE (SINGLE FLOAT) 8 DIESEL STP SUMP TRI-STATE (SINGLE FLOAT) 9 DIESEL FILL SUMP TRI-STATE (SINGLE FLOAT) 10 DIS 1-2 UDC TRI-STATE (SINGLE FLOAT) 11 DIS 3-4 UDC TRI-STATE (SINGLE FLOAT)
12 DIS 5-6 UDC TRI-STATE (SINGLE FLOAT) 13 DIS 7-8 UDC TRI-STATE (SINGLE FLOAT) 14 DIS 9-10 UDC TRI-STATE (SINGLE FLOAT) 15 DIS 11-12 UDC TRI-STATE (SINGLE FLOAT) 16 VENT BOX UDC TRI-STATE (SINGLE FLOAT) I70400 MAY 17, 2017 8:25 PM LIQUID CATEGORY SENSOR LOCATION CATEGORY 1 REGULAR 87 ANNULAR ANNULAR SPACE 2 REGULAR 87 STP SUMP STP SUMP 3 REGULAR 87 FILL SUMP PIPING SUMP 4 SUPER 91 STP STP SUMP 5 SUPER 91 ANNULAR ANNULAR SPACE 6 SUPER 91 FILL SUMP PIPING SUMP 7 DIESEL ANNULAR ANNULAR SPACE 8 DIESEL STP SUMP STP SUMP 9 DIESEL FILL SUMP PIPING SUMP 10 DIS 1-2 UDC DISPENSER PAN 11 DIS 3-4 UDC DISPENSER PAN 12 DIS 5-6 UDC DISPENSER PAN 13 DIS 7-8 UDC STP SUMP 14 DIS 9-10 UDC DISPENSER PAN 15 DIS 11-12 UDC DISPENSER PAN 16 VENT BOX UDC DISPENSER PAN I74200 MAY 17, 2017 8:25 PM I74300 MAY 17, 2017 8:25 PM I74400 MAY 17, 2017 8:25 PM
I74700 MAY 17, 2017 8:25 PM I74800 MAY 17, 2017 8:25 PM I74900 MAY 17, 2017 8:25 PM
I7BC00 MAY 17, 2017 8:25 PM I80200 MAY 17, 2017 8:25 PM I80300 MAY 17, 2017 8:25 PM I80400 MAY 17, 2017 8:25 PM I80700 MAY 17, 2017 8:25 PM RELAY LABEL DEVICE LABEL 1 REGULAR 87 2 SUPER 91 3 DIESEL 4 OVERFILL I80900 MAY 17, 2017 8:25 PM RELAY ORIENTATION RELAY DESIGNATION ORIENTATION 1 REGULAR 87 NORMALLY CLOSED 2 SUPER 91 NORMALLY CLOSED 3 DIESEL NORMALLY CLOSED 4 OVERFILL NORMALLY OPEN
I80B00 MAY 17, 2017 8:25 PM RELAY TANK ASSIGNMENT RELAY DESIGNATION TANK 1 REGULAR 87 1 2 SUPER 91 2 3 DIESEL 3 4 OVERFILL NONE I80A00 MAY 17, 2017 8:25 PM RELAY TYPE
RELAY DESIGNATION TYPE 1 REGULAR 87 STANDARD 2 SUPER 91 STANDARD 3 DIESEL STANDARD 4 OVERFILL STANDARD I80C00 MAY 17, 2017 8:25 PM I80800 MAY 17, 2017 8:25 PM RELAY SETUP REPORT R 1:REGULAR 87 TYPE: STANDARD NORMALLY CLOSED TANK #: 1 IN-TANK ALARMS T 1:HIGH WATER ALARM T 1:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 2:FUEL ALARM L 8:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L15:FUEL ALARM L 2:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L13:SENSOR OUT ALARM
L14:SENSOR OUT ALARM L15:SENSOR OUT ALARM L 2:SHORT ALARM L 8:SHORT ALARM L10:SHORT ALARM L11:SHORT ALARM L12:SHORT ALARM L13:SHORT ALARM L14:SHORT ALARM L15:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD HOSE ALARMS
ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL PMC ALARMS VP EMISSIONS FAIL VP PRESSURE FAIL VP DUTY CYCLE FAIL R 2:SUPER 91 TYPE: STANDARD NORMALLY CLOSED TANK #: 2 IN-TANK ALARMS T 2:HIGH WATER ALARM T 2:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 4:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L13:FUEL ALARM L14:FUEL ALARM L15:FUEL ALARM L 3:SENSOR OUT ALARM L 4:SENSOR OUT ALARM L 5:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L13:SENSOR OUT ALARM L14:SENSOR OUT ALARM L15:SENSOR OUT ALARM L 5:SHORT ALARM L10:SHORT ALARM L11:SHORT ALARM L12:SHORT ALARM L13:SHORT ALARM L14:SHORT ALARM
L15:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD HOSE ALARMS h 1:GROSS COLLECT FAIL h13:GROSS COLLECT FAIL h14:GROSS COLLECT FAIL h15:GROSS COLLECT FAIL h16:GROSS COLLECT FAIL h17:GROSS COLLECT FAIL h18:GROSS COLLECT FAIL h19:GROSS COLLECT FAIL h20:GROSS COLLECT FAIL
h21:GROSS COLLECT FAIL h22:GROSS COLLECT FAIL h23:GROSS COLLECT FAIL h24:GROSS COLLECT FAIL h25:GROSS COLLECT FAIL h26:GROSS COLLECT FAIL h27:GROSS COLLECT FAIL h28:GROSS COLLECT FAIL h29:GROSS COLLECT FAIL h30:GROSS COLLECT FAIL h31:GROSS COLLECT FAIL h32:GROSS COLLECT FAIL h33:GROSS COLLECT FAIL h34:GROSS COLLECT FAIL h35:GROSS COLLECT FAIL h36:GROSS COLLECT FAIL h37:GROSS COLLECT FAIL h38:GROSS COLLECT FAIL h39:GROSS COLLECT FAIL h40:GROSS COLLECT FAIL h41:GROSS COLLECT FAIL h42:GROSS COLLECT FAIL h43:GROSS COLLECT FAIL h44:GROSS COLLECT FAIL h45:GROSS COLLECT FAIL h46:GROSS COLLECT FAIL h47:GROSS COLLECT FAIL h48:GROSS COLLECT FAIL h49:GROSS COLLECT FAIL h50:GROSS COLLECT FAIL h51:GROSS COLLECT FAIL h52:GROSS COLLECT FAIL h53:GROSS COLLECT FAIL h54:GROSS COLLECT FAIL h55:GROSS COLLECT FAIL h56:GROSS COLLECT FAIL h57:GROSS COLLECT FAIL h58:GROSS COLLECT FAIL h59:GROSS COLLECT FAIL h60:GROSS COLLECT FAIL h61:GROSS COLLECT FAIL h62:GROSS COLLECT FAIL h63:GROSS COLLECT FAIL h64:GROSS COLLECT FAIL h65:GROSS COLLECT FAIL
h66:GROSS COLLECT FAIL h67:GROSS COLLECT FAIL h68:GROSS COLLECT FAIL h69:GROSS COLLECT FAIL h70:GROSS COLLECT FAIL h71:GROSS COLLECT FAIL h72:GROSS COLLECT FAIL h73:GROSS COLLECT FAIL h74:GROSS COLLECT FAIL h75:GROSS COLLECT FAIL h76:GROSS COLLECT FAIL h77:GROSS COLLECT FAIL h78:GROSS COLLECT FAIL h79:GROSS COLLECT FAIL h80:GROSS COLLECT FAIL h81:GROSS COLLECT FAIL h82:GROSS COLLECT FAIL h83:GROSS COLLECT FAIL
h84:GROSS COLLECT FAIL h85:GROSS COLLECT FAIL h86:GROSS COLLECT FAIL h87:GROSS COLLECT FAIL h88:GROSS COLLECT FAIL h89:GROSS COLLECT FAIL h90:GROSS COLLECT FAIL h91:GROSS COLLECT FAIL h92:GROSS COLLECT FAIL h93:GROSS COLLECT FAIL h94:GROSS COLLECT FAIL h95:GROSS COLLECT FAIL h96:GROSS COLLECT FAIL h97:GROSS COLLECT FAIL h98:GROSS COLLECT FAIL h99:GROSS COLLECT FAIL h 1:DEGRD 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 h19:DEGRD COLLECT FAIL h20:DEGRD COLLECT FAIL h21:DEGRD COLLECT FAIL h22:DEGRD COLLECT FAIL h23:DEGRD COLLECT FAIL h24:DEGRD COLLECT FAIL h25:DEGRD COLLECT FAIL h26:DEGRD COLLECT FAIL h27:DEGRD COLLECT FAIL h28:DEGRD COLLECT FAIL h29:DEGRD COLLECT FAIL h30:DEGRD COLLECT FAIL h31:DEGRD COLLECT FAIL h32:DEGRD COLLECT FAIL h33:DEGRD COLLECT FAIL h34:DEGRD COLLECT FAIL h35:DEGRD COLLECT FAIL h36:DEGRD COLLECT FAIL h37:DEGRD COLLECT FAIL h38:DEGRD COLLECT FAIL h39:DEGRD COLLECT FAIL h40:DEGRD COLLECT FAIL
h41:DEGRD COLLECT FAIL h42:DEGRD COLLECT FAIL h43:DEGRD COLLECT FAIL h44:DEGRD COLLECT FAIL h45:DEGRD COLLECT FAIL h46:DEGRD COLLECT FAIL h47:DEGRD COLLECT FAIL h48:DEGRD COLLECT FAIL h49:DEGRD COLLECT FAIL h50:DEGRD COLLECT FAIL h51:DEGRD COLLECT FAIL h52:DEGRD COLLECT FAIL h53:DEGRD COLLECT FAIL h54:DEGRD COLLECT FAIL h55:DEGRD COLLECT FAIL h56:DEGRD COLLECT FAIL h57:DEGRD COLLECT FAIL h58:DEGRD COLLECT FAIL
h59:DEGRD COLLECT FAIL h60:DEGRD COLLECT FAIL h61:DEGRD COLLECT FAIL h62:DEGRD COLLECT FAIL h63:DEGRD COLLECT FAIL h64:DEGRD COLLECT FAIL h65:DEGRD COLLECT FAIL h66:DEGRD COLLECT FAIL h67:DEGRD COLLECT FAIL h68:DEGRD COLLECT FAIL h69:DEGRD COLLECT FAIL h70:DEGRD COLLECT FAIL h71:DEGRD COLLECT FAIL h72:DEGRD COLLECT FAIL h73:DEGRD COLLECT FAIL h74:DEGRD COLLECT FAIL h75:DEGRD COLLECT FAIL h76:DEGRD COLLECT FAIL h77:DEGRD COLLECT FAIL h78:DEGRD COLLECT FAIL h79:DEGRD COLLECT FAIL h80:DEGRD COLLECT FAIL h81:DEGRD COLLECT FAIL h82:DEGRD COLLECT FAIL h83:DEGRD COLLECT FAIL h84:DEGRD COLLECT FAIL h85:DEGRD COLLECT FAIL h86:DEGRD COLLECT FAIL h87:DEGRD COLLECT FAIL h88:DEGRD COLLECT FAIL h89:DEGRD COLLECT FAIL h90:DEGRD COLLECT FAIL h91:DEGRD COLLECT FAIL h92:DEGRD COLLECT FAIL h93:DEGRD COLLECT FAIL h94:DEGRD COLLECT FAIL h95:DEGRD COLLECT FAIL h96:DEGRD COLLECT FAIL h97:DEGRD COLLECT FAIL h98:DEGRD COLLECT FAIL h99:DEGRD COLLECT FAIL h 1:FLOW 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 h19:FLOW COLLECT FAIL h20:FLOW COLLECT FAIL h21:FLOW COLLECT FAIL h22:FLOW COLLECT FAIL h23:FLOW COLLECT FAIL h24:FLOW 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 h31:FLOW COLLECT FAIL h32:FLOW COLLECT FAIL h33:FLOW COLLECT FAIL
h34:FLOW COLLECT FAIL h35:FLOW COLLECT FAIL h36:FLOW COLLECT FAIL h37:FLOW COLLECT FAIL h38:FLOW COLLECT FAIL h39:FLOW COLLECT FAIL h40:FLOW COLLECT FAIL h41:FLOW COLLECT FAIL h42:FLOW COLLECT FAIL h43:FLOW COLLECT FAIL h44:FLOW COLLECT FAIL h45:FLOW COLLECT FAIL h46:FLOW COLLECT FAIL h47:FLOW COLLECT FAIL h48:FLOW COLLECT FAIL h49:FLOW COLLECT FAIL h50:FLOW COLLECT FAIL h51:FLOW COLLECT FAIL h52:FLOW COLLECT FAIL h53:FLOW COLLECT FAIL h54:FLOW COLLECT FAIL h55:FLOW COLLECT FAIL h56:FLOW COLLECT FAIL h57:FLOW COLLECT FAIL h58:FLOW COLLECT FAIL h59:FLOW COLLECT FAIL h60:FLOW COLLECT FAIL h61:FLOW COLLECT FAIL h62:FLOW COLLECT FAIL h63:FLOW COLLECT FAIL h64:FLOW COLLECT FAIL h65:FLOW COLLECT FAIL h66:FLOW COLLECT FAIL h67:FLOW COLLECT FAIL h68:FLOW COLLECT FAIL h69:FLOW COLLECT FAIL h70:FLOW COLLECT FAIL h71:FLOW COLLECT FAIL h72:FLOW COLLECT FAIL h73:FLOW COLLECT FAIL h74:FLOW COLLECT FAIL h75:FLOW COLLECT FAIL h76:FLOW COLLECT FAIL h77:FLOW COLLECT FAIL h78:FLOW COLLECT FAIL
h79:FLOW COLLECT FAIL h80:FLOW COLLECT FAIL h81:FLOW COLLECT FAIL h82:FLOW COLLECT FAIL h83:FLOW COLLECT FAIL h84:FLOW COLLECT FAIL h85:FLOW COLLECT FAIL h86:FLOW COLLECT FAIL h87:FLOW COLLECT FAIL h88:FLOW COLLECT FAIL h89:FLOW COLLECT FAIL h90:FLOW COLLECT FAIL h91:FLOW COLLECT FAIL h92:FLOW COLLECT FAIL h93:FLOW COLLECT FAIL h94:FLOW COLLECT FAIL h95:FLOW COLLECT FAIL h96:FLOW COLLECT FAIL
h97:FLOW COLLECT FAIL h98:FLOW COLLECT FAIL h99:FLOW COLLECT FAIL PMC ALARMS VP EMISSIONS FAIL VP PRESSURE FAIL R 3:DIESEL TYPE: STANDARD NORMALLY CLOSED TANK #: 3 IN-TANK ALARMS T 3:HIGH WATER ALARM T 3:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 8:FUEL ALARM L11:FUEL ALARM L13:FUEL ALARM L15:FUEL ALARM L 8:SENSOR OUT ALARM L11:SENSOR OUT ALARM L13:SENSOR OUT ALARM L15:SENSOR OUT ALARM L 8:SHORT ALARM L11:SHORT ALARM L13:SHORT ALARM L15:SHORT ALARM R 4:OVERFILL TYPE: STANDARD NORMALLY OPEN TANK #: NONE IN-TANK ALARMS
ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM ALL:MAX PRODUCT ALARM I79000 MAY 17, 2017 8:25 PM EDIM:1 VR:349867-001-A TD:15.10.21.11.32 I79100 MAY 17, 2017 8:25 PM
I72300 MAY 17, 2017 8:25 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 SMARTSENSOR ASSIGNMENT DEVICE LABEL CATEGORY 01 DIS 1-2 FM AIR FLOW METER 02 DIS 3-4 FM AIR FLOW METER 03 DIS 5-6 FM AIR FLOW METER 04 DIS 7-8 FM AIR FLOW METER 05 DIS 09-10 FM AIR FLOW METER 06 DIS 11-12 FM AIR FLOW METER 07 VAPOR PRESSUR SENSOR VAPOR PRESSURE 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 IV4E00 MAY 17, 2017 8:25 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306
EVR/ISD SETUP TYPE: VACUUM ASSIST VACUUM ASSIST TYPE: HEALY VAC IV4F00 MAY 17, 2017 8:25 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 NOZZLE A/L RANGE A/L RATIO: 0.95 - 1.15 IV4000 MAY 17, 2017 8:25 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 VAPOR PROCESSOR TYPE NONE IV4700 MAY 17, 2017 8:25 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 ASSESSMENT TIME START TIME: 10:00 AM TIME DELAY MINUTES: 1
IV5200 MAY 17, 2017 8:25 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 ACCEPT HIGH ORVR: NO IV4A00 MAY 17, 2017 8:25 PM 9933 FASTRIP
4800 FAIRFAX RD BAKERSFIELD CA 93306 ISD HOSE TABLE HOSE FP FP AFM REL HOSE ID ID LABEL ID ID LABEL 01 01 01 01 01 BLEND3 02 02 02 01 01 BLEND3 03 03 03 02 01 BLEND3 04 04 04 02 01 BLEND3 05 05 05 03 01 BLEND3 06 06 06 03 01 BLEND3 07 07 07 04 01 BLEND3 08 08 08 04 01 BLEND3 09 09 09 05 01 BLEND3 10 16 10 05 01 BLEND3 11 17 11 06 01 BLEND3 12 18 12 06 01 BLEND3 IV4B00 MAY 17, 2017 8:26 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 PRODUCT/HOSE MAP TABLE FP AFID M1/H1 M2/H2 M3/H3 M4/H4 01 01 02/01 01/01 09/01 xx/xx 02 01 02/02 01/02 09/02 xx/xx 03 02 02/03 01/03 09/03 xx/xx 04 02 02/04 01/04 09/04 xx/xx 05 03 02/05 01/05 09/05 xx/xx 06 03 02/06 01/06 09/06 xx/xx 07 04 02/07 01/07 09/07 xx/xx 08 04 02/08 01/08 09/08 xx/xx 09 05 02/09 01/09 09/09 xx/xx 16 05 02/10 01/10 09/10 xx/xx 17 06 02/11 01/11 09/11 xx/xx
18 06 02/12 01/12 09/12 xx/xx IV4900 MAY 17, 2017 8:26 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 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 MAY 17, 2017 8:26 PM ISD VERSION: 01.05
Responses Received: I10200 MAY 17, 2017 8:26 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 9683789 9462576 2 4 PROBE / G.T. 162763 162617 3 INTERSTITIAL BD 200219 200193 4 INTERSTITIAL BD 200872 200555 5 UNUSED 9633765 9471597 6 8SMARTSENSOR BD 39267 39271 7 UNUSED 9633869 9454770 8 UNUSED 9616519 9445034 9 RELAY BOARD 14923 14949 10 UNUSED 9642950 9465702 11 UNUSED 9622385 9444299 12 UNUSED 9613324 9443475 13 UNUSED 9607123 9460888 14 UNUSED 9616456 9468304 15 UNUSED 9620005 9455445 16 UNUSED 9616059 9441394 COMM 1 ELEC DISP INT. 100494 100394 COMM 2 SERIAL SAT BD 485250 485587 COMM 3 RS232 SERIAL BD 9626122 14992 COMM 4 UNUSED 9610673 9476804 COMM 5 RS485 SERIAL BD 68561 68632 COMM 6 RS232 SERIAL BD 15007 15014 I90200 MAY 17, 2017 8:26 PM SOFTWARE REVISION LEVEL VERSION 334.00 SOFTWARE# 346334-100-A CREATED - 15.05.29.10.36
S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I11100 MAY 17, 2017 8:26 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME
L 5 ANNULAR SUPER 91 ANNULAR FUEL ALARM CLEAR 5-17-17 12:34PM L 5 ANNULAR SUPER 91 ANNULAR FUEL ALARM ALARM 5-17-17 12:32PM L 5 ANNULAR SUPER 91 ANNULAR FUEL ALARM CLEAR 5-17-17 11:26AM L 5 ANNULAR SUPER 91 ANNULAR FUEL ALARM ALARM 5-17-17 11:26AM L 5 ANNULAR SUPER 91 ANNULAR FUEL ALARM CLEAR 5-17-17 11:26AM L 5 ANNULAR SUPER 91 ANNULAR FUEL ALARM ALARM 5-17-17 11:26AM L16 DISP PAN VENT BOX UDC FUEL ALARM CLEAR 5-17-17 10:20AM L16 DISP PAN VENT BOX UDC FUEL ALARM ALARM 5-17-17 10:19AM L 8 STP SUMP DIESEL STP SUMP SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 7 ANNULAR DIESEL ANNULAR SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 6 PIPE SUPER 91 FILL SUMP SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 4 STP SUMP SUPER 91 STP SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 3 PIPE REGULAR 87 FILL SUMP SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L10 DISP PAN DIS 1-2 UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 2 STP SUMP REGULAR 87 STP SUMP SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L16 DISP PAN VENT BOX UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L15 DISP PAN DIS 11-12 UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 5 ANNULAR SUPER 91 ANNULAR SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L14 DISP PAN DIS 9-10 UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L12 DISP PAN DIS 5-6 UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L11 DISP PAN DIS 3-4 UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 9 PIPE DIESEL FILL SUMP SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 1 ANNULAR REGULAR 87 ANNULAR SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L13 STP SUMP DIS 7-8 UDC SENSOR OUT ALARM CLEAR 5-17-17 10:14AM L 4 STP SUMP SUPER 91 STP SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 3 PIPE REGULAR 87 FILL SUMP SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 2 STP SUMP REGULAR 87 STP SUMP SENSOR OUT ALARM ALARM 5-17-17 10:13AM L16 DISP PAN VENT BOX UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L15 DISP PAN DIS 11-12 UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 8 STP SUMP DIESEL STP SUMP SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 7 ANNULAR DIESEL ANNULAR SENSOR OUT ALARM ALARM 5-17-17 10:13AM L14 DISP PAN DIS 9-10 UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 6 PIPE SUPER 91 FILL SUMP SENSOR OUT ALARM ALARM 5-17-17 10:13AM L12 DISP PAN DIS 5-6 UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L11 DISP PAN DIS 3-4 UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L10 DISP PAN DIS 1-2 UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 1 ANNULAR REGULAR 87 ANNULAR SENSOR OUT ALARM ALARM 5-17-17 10:13AM L13 STP SUMP DIS 7-8 UDC SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 5 ANNULAR SUPER 91 ANNULAR SENSOR OUT ALARM ALARM 5-17-17 10:13AM L 9 PIPE DIESEL FILL SUMP SENSOR OUT ALARM ALARM 5-17-17 10:13AM T 3 TANK DIESEL MAX PRODUCT ALARM CLEAR 5-17-17 10:11AM T 3 TANK DIESEL MAX PRODUCT ALARM ALARM 5-17-17 10:11AM T 2 TANK SUPER 91 MAX PRODUCT ALARM CLEAR 5-17-17 10:11AM T 2 TANK SUPER 91 MAX PRODUCT ALARM ALARM 5-17-17 10:10AM T 1 TANK REGULAR 87 MAX PRODUCT ALARM CLEAR 5-17-17 10:10AM
T 1 TANK REGULAR 87 MAX PRODUCT ALARM ALARM 5-17-17 10:09AM L15 DISP PAN DIS 11-12 UDC FUEL ALARM CLEAR 5-17-17 10:07AM L15 DISP PAN DIS 11-12 UDC FUEL ALARM ALARM 5-17-17 10:06AM L15 DISP PAN DIS 11-12 UDC FUEL ALARM CLEAR 5-17-17 10:06AM L15 DISP PAN DIS 11-12 UDC FUEL ALARM ALARM 5-17-17 10:06AM I11200 MAY 17, 2017 8:26 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME
T 3 TANK DIESEL HIGH PRODUCT ALARM CLEAR 5-17-17 10:11AM T 3 TANK DIESEL HIGH PRODUCT ALARM ALARM 5-17-17 10:11AM T 2 TANK SUPER 91 HIGH PRODUCT ALARM CLEAR 5-17-17 10:11AM T 2 TANK SUPER 91 HIGH PRODUCT ALARM ALARM 5-17-17 10:10AM T 1 TANK REGULAR 87 HIGH PRODUCT ALARM CLEAR 5-17-17 10:10AM T 1 TANK REGULAR 87 HIGH PRODUCT ALARM ALARM 5-17-17 10:09AM T 1 TANK REGULAR 87 DELIVERY NEEDED CLEAR 4-26-17 4:29PM T 1 TANK REGULAR 87 DELIVERY NEEDED ALARM 4-26-17 3:51PM SYSTEM PRINTER ERROR CLEAR 4-18-17 10:39AM SYSTEM PRINTER ERROR ALARM 4-18-17 10:39AM SYSTEM PRINTER ERROR CLEAR 4-18-17 10:39AM SYSTEM PAPER OUT CLEAR 4-18-17 10:39AM SYSTEM PRINTER ERROR ALARM 4-18-17 10:34AM SYSTEM PAPER OUT ALARM 4-18-17 10:34AM T 1 TANK REGULAR 87 LOW TEMP WARNING CLEAR 4-12-17 10:46AM T 1 TANK REGULAR 87 LOW TEMP WARNING ALARM 4-12-17 10:46AM T 2 TANK SUPER 91 DELIVERY NEEDED CLEAR 4-12-17 10:42AM T 2 TANK SUPER 91 INVALID FUEL LEVEL CLEAR 4-12-17 10:42AM T 2 TANK SUPER 91 DELIVERY NEEDED ALARM 4-12-17 10:42AM T 2 TANK SUPER 91 INVALID FUEL LEVEL ALARM 4-12-17 10:41AM T 3 TANK DIESEL INVALID FUEL LEVEL CLEAR 4-12-17 10:40AM T 3 TANK DIESEL DELIVERY NEEDED CLEAR 4-12-17 10:40AM T 3 TANK DIESEL DELIVERY NEEDED ALARM 4-12-17 10:40AM T 3 TANK DIESEL INVALID FUEL LEVEL ALARM 4-12-17 10:40AM T 1 TANK REGULAR 87 HIGH PRODUCT ALARM CLEAR 4-12-17 10:10AM T 1 TANK REGULAR 87 HIGH PRODUCT ALARM ALARM 4-12-17 10:10AM T 2 TANK SUPER 91 HIGH PRODUCT ALARM CLEAR 4-12-17 10:10AM T 2 TANK SUPER 91 HIGH PRODUCT ALARM ALARM 4-12-17 10:10AM T 3 TANK DIESEL HIGH PRODUCT ALARM CLEAR 4-12-17 10:09AM T 3 TANK DIESEL HIGH PRODUCT ALARM ALARM 4-12-17 10:09AM T 2 TANK SUPER 91 LOW TEMP WARNING CLEAR 4-12-17 9:40AM T 2 TANK SUPER 91 LOW TEMP WARNING ALARM 4-12-17 9:39AM T 2 TANK SUPER 91 DELIVERY NEEDED CLEAR 4-12-17 9:39AM T 2 TANK SUPER 91 INVALID FUEL LEVEL CLEAR 4-12-17 9:39AM T 2 TANK SUPER 91 INVALID FUEL LEVEL ALARM 4-12-17 9:38AM T 2 TANK SUPER 91 DELIVERY NEEDED ALARM 4-12-17 9:38AM T 3 TANK DIESEL DELIVERY NEEDED CLEAR 4-12-17 9:37AM T 3 TANK DIESEL DELIVERY NEEDED ALARM 4-12-17 9:36AM T 3 TANK DIESEL INVALID FUEL LEVEL CLEAR 4-06-17 12:10PM T 3 TANK DIESEL DELIVERY NEEDED CLEAR 4-06-17 12:10PM T 3 TANK DIESEL DELIVERY NEEDED ALARM 4-06-17 12:10PM T 3 TANK DIESEL INVALID FUEL LEVEL ALARM 4-06-17 12:10PM T 1 TANK REGULAR 87 HIGH PRODUCT ALARM CLEAR 4-06-17 11:00AM T 1 TANK REGULAR 87 HIGH PRODUCT ALARM ALARM 4-06-17 10:59AM T 2 TANK SUPER 91 HIGH PRODUCT ALARM CLEAR 4-06-17 10:59AM
T 2 TANK SUPER 91 HIGH PRODUCT ALARM ALARM 4-06-17 10:59AM T 3 TANK DIESEL HIGH PRODUCT ALARM CLEAR 4-06-17 10:58AM T 3 TANK DIESEL HIGH PRODUCT ALARM ALARM 4-06-17 10:58AM T 3 TANK DIESEL LOW TEMP WARNING CLEAR 4-06-17 10:11AM T 3 TANK DIESEL LOW TEMP WARNING ALARM 4-06-17 10:11AM I20600 MAY 17, 2017 8:26 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 TANK ALARM HISTORY
TANK 1 REGULAR 87 OVERFILL ALARM MAY 13, 2017 5:28 AM APR 25, 2017 5:20 AM APR 22, 2017 4:15 AM LOW PRODUCT ALARM MAR 6, 2017 9:44 PM DEC 12, 2016 7:02 PM DEC 6, 2016 6:08 PM HIGH PRODUCT ALARM MAY 17, 2017 10:09 AM APR 12, 2017 10:10 AM APR 6, 2017 10:59 AM INVALID FUEL LEVEL MAY 11, 2016 5:03 PM MAY 11, 2016 4:43 PM MAY 5, 2016 7:48 AM PROBE OUT APR 12, 2017 10:45 AM APR 12, 2017 9:40 AM APR 6, 2017 12:16 PM DELIVERY NEEDED APR 26, 2017 3:51 PM MAR 31, 2017 3:50 PM MAR 6, 2017 8:21 PM MAX PRODUCT ALARM MAY 17, 2017 10:09 AM MAY 5, 2016 11:50 AM LOW TEMP WARNING APR 12, 2017 10:46 AM MAY 5, 2016 11:51 AM TANK 2 SUPER 91 SETUP DATA WARNING MAY 4, 2016 5:25 PM MAY 4, 2016 5:24 PM HIGH WATER ALARM MAY 5, 2016 10:32 AM MAY 4, 2016 5:29 PM OVERFILL ALARM NOV 5, 2016 5:13 PM NOV 5, 2016 5:08 PM OCT 16, 2016 6:12 AM
LOW PRODUCT ALARM APR 12, 2017 10:42 AM APR 12, 2017 9:38 AM APR 6, 2017 10:07 AM HIGH PRODUCT ALARM MAY 17, 2017 10:10 AM APR 12, 2017 10:10 AM APR 6, 2017 10:59 AM INVALID FUEL LEVEL APR 12, 2017 10:41 AM APR 12, 2017 9:38 AM APR 6, 2017 10:07 AM PROBE OUT APR 12, 2017 10:41 AM APR 12, 2017 9:38 AM APR 6, 2017 12:11 PM HIGH WATER WARNING MAY 5, 2016 10:32 AM MAY 4, 2016 5:29 PM
DELIVERY NEEDED APR 12, 2017 10:42 AM APR 12, 2017 9:38 AM APR 6, 2017 10:07 AM MAX PRODUCT ALARM MAY 17, 2017 10:10 AM MAY 5, 2016 12:00 PM LOW TEMP WARNING APR 12, 2017 9:39 AM MAY 11, 2016 5:05 PM MAY 5, 2016 7:54 AM TANK 3 DIESEL HIGH WATER ALARM MAY 5, 2016 7:59 AM MAY 3, 2016 10:24 AM OVERFILL ALARM MAY 5, 2016 12:05 PM LOW PRODUCT ALARM APR 12, 2017 10:40 AM APR 12, 2017 9:36 AM APR 6, 2017 12:10 PM HIGH PRODUCT ALARM MAY 17, 2017 10:11 AM APR 12, 2017 10:09 AM APR 6, 2017 10:58 AM INVALID FUEL LEVEL APR 12, 2017 10:40 AM APR 6, 2017 12:10 PM MAY 3, 2016 9:43 AM PROBE OUT APR 12, 2017 10:39 AM APR 12, 2017 9:36 AM APR 6, 2017 12:09 PM HIGH WATER WARNING MAY 5, 2016 7:59 AM MAY 3, 2016 10:24 AM DELIVERY NEEDED APR 12, 2017 10:40 AM APR 12, 2017 9:36 AM APR 6, 2017 12:10 PM MAX PRODUCT ALARM MAY 17, 2017 10:11 AM MAY 5, 2016 12:06 PM
LOW TEMP WARNING APR 6, 2017 10:11 AM MAY 5, 2016 12:07 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 MAY 17, 2017 8:27 PM I30200 MAY 17, 2017 8:27 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 REGULAR 87 ANNULAR MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:56 AM FUEL ALARM MAY 17, 2017 9:56 AM FUEL ALARM 2 REGULAR 87 STP SUMP MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:39 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 3 REGULAR 87 FILL SUMP MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:42 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 4 SUPER 91 STP MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:39 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 5 SUPER 91 ANNULAR
MAY 17, 2017 12:32 PM FUEL ALARM MAY 17, 2017 11:26 AM FUEL ALARM MAY 17, 2017 11:26 AM FUEL ALARM 6 SUPER 91 FILL SUMP MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:42 AM FUEL ALARM MAY 8, 2017 2:08 AM FUEL ALARM 7 DIESEL ANNULAR MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:47 AM FUEL ALARM MAY 17, 2017 9:46 AM FUEL ALARM 8 DIESEL STP SUMP MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:40 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 9 DIESEL FILL SUMP MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 9:41 AM FUEL ALARM
APR 18, 2017 10:57 AM FUEL ALARM 10 DIS 1-2 UDC MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 10:01 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 11 DIS 3-4 UDC MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 10:01 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 12 DIS 5-6 UDC MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 10:03 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 13 DIS 7-8 UDC MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 10:04 AM FUEL ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM 14 DIS 9-10 UDC MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 10:06 AM FUEL ALARM MAY 17, 2017 10:05 AM FUEL ALARM 15 DIS 11-12 UDC MAY 17, 2017 10:13 AM SENSOR OUT ALARM MAY 17, 2017 10:06 AM FUEL ALARM MAY 17, 2017 10:06 AM FUEL ALARM 16 VENT BOX UDC MAY 17, 2017 10:19 AM FUEL ALARM MAY 17, 2017 10:13 AM SENSOR OUT ALARM APR 12, 2017 10:17 AM SENSOR OUT ALARM I31600 MAY 17, 2017 8:27 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 DIS 1-2 FM 2 DIS 3-4 FM
3 DIS 5-6 FM 4 DIS 7-8 FM 5 DIS 09-10 FM 6 DIS 11-12 FM MAY 3, 2016 10:15 AM COMMUNICATION ALARM 7 VAPOR PRESSUR SENSOR MAY 3, 2016 10:15 AM COMMUNICATION ALARM I40200 MAY 17, 2017 8:27 PM I40300 MAY 17, 2017 8:27 PM
I34200 MAY 17, 2017 8:27 PM I34700 MAY 17, 2017 8:27 PM IV0100 MAY 17, 2017 8:27 PM 9933 FASTRIP 4800 FAIRFAX RD BAKERSFIELD CA 93306 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.05 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME :100% EVR/ISD PASS TIME :100% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 16-11-20 10:02:38 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.05 16-09-24 10:02:50 A/L RATIO DEGRADATION FP 4 BLEND3 0.81 16-09-20 10:02:41 A/L RATIO DEGRADATION FP 9 BLEND3 0.79 16-09-19 10:02:39 A/L RATIO DEGRADATION FP 9 BLEND3 0.79 16-09-08 14:07:27 A/L RATIO GROSS BLOCKAGE FP11 BLEND3 BLKD 16-09-08 10:02:51 A/L RATIO DEGRADATION FP12 BLEND3 BLKD 16-09-08 10:02:51 A/L RATIO GROSS BLOCKAGE FP12 BLEND3 BLKD 16-09-04 10:02:38 A/L RATIO DEGRADATION FP 4 BLEND3 0.80 16-08-08 10:02:20 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.60 16-08-07 10:03:03 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.55 FAILURE ALARMS
DATE TIME DESCRIPTION READING VALUE SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 17-05-17 10:13:11 READINESS ISD:PP EVR:NN EVR READINESS PENDING 17-05-17 10:13:11 ISD STARTUP 17-05-17 10:13:06 ISD SHUTDOWN 17-04-13 10:01:09 READINESS ISD:PP EVR:PP ISD & EVR READY 17-04-12 10:18:29 READINESS ISD:PP EVR:NN EVR READINESS PENDING 17-04-12 10:18:29 ISD STARTUP 17-04-12 10:18:17 ISD SHUTDOWN 17-04-07 10:01:09 READINESS ISD:PP EVR:PP ISD & EVR READY 17-04-06 11:02:51 READINESS ISD:PP EVR:NN EVR READINESS PENDING 17-04-06 11:02:51 ISD STARTUP
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: 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:
Credentials1:6 CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Specify)
License Number(s): CSLB# 804904 ICC#
3. SPILL BUCKET TESTING INFORMATION
Test Method Used:6 Hydrostatic Vacuum Other
Test Equipment Used: Lake Test Equipment 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.
#9933 Fastrip 05/17/2017
4800 Fairfax Road Bakersfield, CA 93306
Omero Garcia (661) 393-7000
03/29/2017
Kris Karns
Cameron Mason
8485827-UT
Regular
12.00"
12.00"
5 min.
9:00 am
11.50"
10:00 am
11.50"
1 hour
0.00"
0.0625"
Super
12.00"
12.00"
5 min.
9:00 am
11.50"
10:00 am
11.50"
1 hour
0.00"
0.0625"0.0625"
Diesel
12.00"
12.00"
5 min.
9:00 am
11.50"
10:00 am
11.50"
1 hour
0.00"
05/17/2017