HomeMy WebLinkAbout2018 FMC RESULTSLG163-1,Enc.IIMonitoring System Certification Form: Addendum for Vacuum/ Pressure Interstitial Sensors
I. Results of Vacuum/ Pressure Monitoring Equipment Testing #643 Bakersfield - 5/16/18
Manufacturer:Model: 857280-100 System Type:
Sensor ID
87A Product
Vapor
87A Vent
87B Product
87B Siphon
87B Vent
Premium Product
Premium Vent
Lubrizol Product
Lubrizol Vent
How was interstitial communication verified?
Vacuum was restored to operating levels in all interstitial spaces:xYes No (If no describe in Sec. J, below )
Page of
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 test date.
S-2 Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
Veeder-Root
Component(s) Monitored by this Sensor
Component(s) Monitored by this Sensor:
Interstitial Communication Test Result: xPass failS-1 Sensor Functionality Test Result: xPass fail
Pressure xVacuum
Interstitial Communication Test Result: xPass fail
S-3
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
S-4
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail
S-12
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
S-10
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
J.Comments: If the sensor successfully detects 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.
xLeak introduced at far end of interstitial space Gauge Visual Other (Describe in Sec. J,below)
S-14
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
S-9
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
S-5
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail
S-6
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result: xPass fail Interstitial Communication Test Result: xPass fail