The URL can be used to link to this page

Home My WebLink About2612 BUCK OWENS BOULEVARD SB989 2012HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: X4415 Date Received: fd Underground Storage minor1 modification Underground Storage Tank removal Underground Storage Tank Other. Address: ",?6/z- ;FJcl< nUje K-3 (;- Bakersfield, CA 933 Business Name: Av'c-4) BUILDING SQUARE FEET: Building Sq. Feet: Calculation Bldg. Sq. Ft: 9. 2. 3. 4. INSPECTION LOG Date Time 119113 FM SYSTEM: PW Matey New Mod. 1130113 Commercial Hood System Fire Alarm System Fire Sprinkler System Spray Finish System Aboveground Storage Tank fd Underground Storage minor1 modification Underground Storage Tank removal Underground Storage Tank Other. Address: ",?6/z- ;FJcl< nUje K-3 (;- Bakersfield, CA 933 Business Name: Av'c-4) BUILDING SQUARE FEET: Building Sq. Feet: Calculation Bldg. Sq. Ft: 9. 2. 3. 4. INSPECTION LOG Date Time 119113 FM 1123113 EAj PW Matey 1130113 5&c' • PiP5 p vz e t s FA4 C- 4x/. l ctJ Signature Signature Comments: Sg- 9 *'9 CJST /R i"kn y L: P1E'EC i 5 ; ;a,) 7Z-7ST,,2.5 /tee dy -24/13 '` n P BILLING & PERMIT STATEMENT • BAKERSFIELD FIRE DEPARTMENT Prevention Services PERMIT # PIRa 2101 H StreetAP Bakersfield, CA 93301 Phone: 661- 326 -3979 • Fax: 661 - 852 -2171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. O Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 SITE INFORMATION Underground Storage Tank (Modification) MOD 878 /site t ~ «`l Z ta LOCATION OF PROJECT S 4 ! Z PROPERTY OWNER 4 82 v Underground Storage Tank (Removal) TR 14 . 84 A STARTING DATE 96 /hr (2 hrs minimum) _ $192 COMPLETION DATE NAME Oil well (Installation, Inspection, or re- Inspection) X G 2 PNov c PRq2Eg NAME 84 ADDRESS 121 /hr (2 hrs minimum) = $242 PHONE # Pyrotechnic (i.permit per event, plus an Inspection fee of 96 /hr during business hours) PY NOTE: After hours Pyrotechnic event inspection is Q $121 /hr 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee Ins = 605 84 PROJECT ADDRESS Re- Inspection /Follow -up Inspection 96 /hr CITY gAhCERLSFI E(.D STATE C.4 ZIP CODE 33 w v 84 Explosive Storage 266 CONTRACTOR INFORMATION 84 Copying & File Research (File Research fee $50 /hr) CqXrRACTOR NAME CA LICENSE # I TYPE OF LICENSE EXPIRATION DATE PHONE # 84 4 Fnwmi icm, nvi i CONTRACTOR COMPANY NAME F # 12, L'X L Mme' ADDRESS ZIP CODE 3 v a t All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. O Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878 /site t ~ «`l Z ta 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test/per site /per UST system ven If scheduled at the same time 96 /hr (2 hrs minimum) _ $192 82 Oil well (Installation, Inspection, or re- Inspection) X 96 /hr 82 Tent # 96 /tent 84 After -hours Inspection fee 121 /hr (2 hrs minimum) = $242 Pyrotechnic (i.permit per event, plus an Inspection fee of 96 /hr during business hours) PY NOTE: After hours Pyrotechnic event inspection is Q $121 /hr 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee Ins = 605 84 Re- Inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of 'Cages? 96 /hr 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 Fnwmi icm, nvi i BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT t . Prevention Services PERMIT # OAIPfMfl lf 2101 H Street Bakersfield, CA 93301 f" Dhnnn• GGi _'27G_'2070 Cam..• Gfi -RC7 -7171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) $280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - New & Modification (minimum charge) $280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) $470 Additional Hood 58 hood Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 Spray Booth (New & Modification) 470 98 SITE INFORMATION 82 LOCATION OF PROJECT ( 2Y j 2 PROPERTY OWNER 82 Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR 109 /tank 82 STARTING DATE COMPLETION DATE NAME IVAvt 82 G - 2 y 3b Nti c PRO)g NAME Underground Storage Tank (Minor Modification) MTM ADDRESS PHONE # Underground Storage Tank (Removal) TR 573 /tank 84 PROJECT ADDRESS Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test/per site /per UST system ven if scheduled at the same time CITY STATE CA ZIP CODE l1 Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 CONTRACTOR INFORMATION 96 /tent 84 C TRACTOR NAME After -hours inspection fee CA LICENSE # 0 TYPE OF LICENSE EXPIRATION DATE PHONE # Pyrotechnic (1 permit per event, plus an inspection fee of 96 /hr during business hours) PY NOTE: After hours Pyrotechnic event inspection is @ $121 /hr JV 116 v Re- inspection /Follow -up Inspection CONTRACTOR COMPANY NAME 84 F # i.L Wj 84 V ADDRESS CITY_ ZIP CODE 3 v 84 7v All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) $280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - New & Modification (minimum charge) $280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) $470 Additional Hood 58 hood Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 inspection per installation) AST 180 /tank 82 Additional Tank ATI 96 /tank 82 Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR 109 /tank 82 Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878/site —_16 `I Z fR 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test/per site /per UST system ven if scheduled at the same time 96 /hr (2 hrs minimum) _ $192 82 Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 Tent # 96 /tent 84 After -hours inspection fee 121 /hr (2 hrs minimum) = $242 Pyrotechnic (1 permit per event, plus an inspection fee of 96 /hr during business hours) PY NOTE: After hours Pyrotechnic event inspection is @ $121 /hr 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee ins = 605 84 Re- inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of Cages? 96 /hr 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 UNDERGROUND STORAGE TANK t '`;c PERMIT APPLICATION TO CONSTRUCT- INSTALL NEW TANK (NEW FACILIM /NEW TTANKINSTALL (E)ISTING FACILITY) /MOD -MINOR MOD TYPE OF APPLICATION: trwr -r'K nNF nNT Y) J.- ft-.. r'... 4Aor% BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 1st Floor Bakersfield, CA 93301 Phone: 661 - 326 -3979 a Fax: 661- 852 -2171 Page 1 of 1 0 NEW TANK INSTAL.LINEW FACILM . NEW TANK INSTALL/MSTING FACILITY I MAn7FTrATION DF FACILTTY MINOR MODIFICATION OF FACILITY STARTING DATE,/ PROPOSED COMPLETION DATE fACR1TY NAME ' EXISTING FACILITY PERMIT t FAC LITY ADDRESS 1-4 S \ ZIP CODE TYPE OF O APN 3 TANK OWNER YY1 PHONE II ADDRESS ZIP DE CONTRACTOR Cif LICENSE t IOC AnOVARM s a CODE n Pfi01 E's ^\ QTY 81151 5 LICFIISE t WORJQ CAMP a REit BRIEFLY DESCRIBETHE WORK TO BE DONE: POAA OViF Lc, u 7 C o c v WATERTO FACRLTTY PROVIDED BY TO GRQUND WATER SOIL TYPE EXPECTED AT SITE OF. TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? a YES o NO SPILL PREVENTION CONTROLAND COUNTERMEASURES PLAN ON FILE? 0 YTS O No 1 MIS.SECTION IS FOR STORAGE TANK IDENTIFICATION TAIUII ..':' ` :. vauum UNLEADW WWLAR PROM M DIESEL. OTHot erg h 2 Z-17 Slt 2 Tank_TeWnE Company NAME OF TWnMJ3V4VAKY NUMBI3t ItAtSiNOADDRESS NAME OF TTeTEIZ . , tiL I V rat, fil. G l 4 !i i THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PER7URY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OF Tog= V-o ICC d 33 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY i0j17EAOPRANED: // / y .,. / BY r FD20Fs6 (Rev 08/09) RICH ENVIRONMENTAL 5643 BROOKS CT. - BAKERSFIELD, CA 93308 OFF.(661)392 -8687 FAX(661)588 -7808 ACURITE TM PIPELINE TESTER PRECISION PRODUCT LINE TEST TEST RESULTS DATE: 2/06/2013 BILLING: JOHNNY'S ARCO SITE: JOHNNY'S ARCO 2612 BUCK OWENS BLVD 2612 BUCK OWENS BLVD BAKERSFIELD, CA 93308 BAKERSFIELD, CA 93308 PRODUCT PRODUCT MECHANICAL PRODUCTS LINE TEST LEAK DETECTORS UNL -87 - .010 -PASS N/A PREM -91 - .005 -PASS N/A COMMENTS A PRECISION TEST WAS PERFORMED ON PRODUCT LINES AT THE ABOVE LOCATION USING THE ACURITE TM PIPELINE TESTER. I HAVE REVIEWED THE DATA PRODUCED IN CONJUNCTION WITH AES PROTOCOL, AND THEREFORE SATISFIES ALL REQUIREMENTS FOR SUCH TESTING AS SET FORTH BY NFPA- 329 -92 AND USE 40 CFR PART 280. THE RESULTS OF TESTING ARE SHOWN ON THE FOLLOWING PAGE. INCLUDED WITH THE REPORT ARE REPRODUCTION OF DATA COMPLIED DURING THE TEST WHICH FORMED THE BASIS FOR THESE CONCLUSION. THIS INFORMATION IS STORED IN A PERMANENT FILE IF FUTURE VERIFICATION OF TEST RESULTS IS NEEDED. I DECLARE UNDER PENALTY OF PERJURY THAT I AM A LICENSED TANK TESTER IN THE STATE OF CALIFONIA AND THAT THE INFORMATION CONTAINED IN THIS REPORT IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. TES RTIFIED BY: ii S J. RI MFG# LTN -2245 CERT# 90 -1072 4 .r RICH ENVIRONMENTAL 5643 BROOKS CT. BAKERSFIELD, CA. 93308 OFFICE (661)392 -8687 FAX (661)392 -0621 ACURITE TM PIPELINE TESTER TEST RESULTS WORK SHEET DATE: A / G / 4*3_ W/O #: FACILITY NAME: 1 V Al AJ / A&C-n FACILITY ADDRESS: G/ 2 jam , Le, O A I -N 5 03 4 U n A-A Y9A- 5;t2-;944 , am- 933og' PRODUCT LINE TYPE: IBERGLASS STEEL PLASTIC (CIRCLE ONE) SYSTEM TYPE: RESS SUCTION GRAVITY (CIRCLE ONE) TURBINE MANUFACTURER: PRODUCT GRADE START TIME INITIAL READING 00:00/GPH END TIME FINAL READING 00:00/GPH TEST PRESSURE P.S.I.) VOLUME RATE G.P.H.) RESULTS PASS OR FAIL 6/6assaHs 41:10 JU Cloyto 1 CERTIFY THAT THE ABOVE LINE TESTS WERE CONDUCTED ACCORDING TO THE EQUIPMENT MANUFACTURERS PROCEDURES. THE TEST RESULTS AS LISTED IS TRUE AND ACCURITE TO THE BEST OF MY KNOWLEDGE. THE TEST PASS /FAIL STATUS IS DETERMINED USING A THRESHOLD OF 190 ML PER HOUR, 0.05 G.P.H.), RATE AT I Y2 TIMES OPERATING PRESSURE, OR 50 P.S.I. WHICH EVER IS GREATER. TECHNICIAN: 19 STATE LICENSE #Rlo SIGNATURE: MFG. CERTIFICATION #: ?.2 zfs %-T.,t/ ry- awY.. SWRCB, January 2002 Page of Secondary Containment Testing Report Form This form is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages ofthis form to report resultsfor all components tested. The completedform, written test procedures, and printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: JOHNNYS ARCO I Date ofTesting: 2/6/13 Facility Address: 2612 BUCK OWENS BLVD, BAKERSFIELD Facility Contact: Phone: Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (fpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: Fail Credentials: X CSLB Licensed Contractor 0 SWRCB Licensed Tank Tester License Type: C61 / D40 Manufacturer TLicense Number: 809850 Manufacturer Trainine Component(s) ) Date Training Expires INCON INCON TS -STS 6/25/2013 Repairs Made 87 SECONDARY PIPE X 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made 87 SECONDARY PIPE X 0 0 91 SECONDARY PIPE X 0 0 0 87 SECONDARY SYPHON X I 0 0 0 1 VAPOR RETURN SEC X 87 MASTER STP X 87 SLAVE STP X 0 0 0 91 STP X UDC #1/2 X UDC #3/4 X UDC #516 X 0 0 0 0 0 0 UDC #7/8 X 0 0 0 0 0 If hydrostatic testing was performed, describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, thefacts stated in this document are accurate and infull compliance with legal requirements Technician's Signature: Date: 2/6/13 SWRCB, January 2002 Page of 5. SECONDARY PIPE TESTING Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer Other (Specify) Test Method Used: X Pressure Vacuum Hydrostatic Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5% Piping Run # 87 Piping Run # 91 Piping Run #SYPH Piping Run #VAPOR RETURN Piping Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS Piping Manufacturer: AO SMITH AO SMITH AO SMITH AO SMITH Piping Diameter: 3" 3" 3" 3" Length ofPiping Run: Product Stored: 87 91 87 VAPOR Method and location of piping-run isolation: TEST PORT IN STP TEST PORT IN STP TEST BOOT IN STP TEST PORT IN STP Wait time between applying pressure /vacuum/water and starting test: 30 MIN 30 MIN 30 MIN 30 MIN Test Start Time: 9:15 9:05 11 :30 9:30 Initial Reading (R): 5.4 5.1 5.0 5.2 Test End Time: 10:15 10:05 12:30 10:30 Final Reading (RF): 5.4 5.1 5.0 5.2 Test' Duration: 60MIN 60MIN 60MIN 60 MIN Change in Reading (RF -R,): 0 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 0 Test +`81t'' °` >; }' X .Pass Fail X Pass Fail X Pass Fail X Pass Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests) SWRCB, January 2002 Page of 6. PIPING SUMP TESTING Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: Pressure Vacuum X Hydrostatic Other (Spec) Test Equipment Used: INCON TS -STS Sump # 87 MSTR Sump #87 SLAVE Sump Diameter: 42" 42" Equipment Resolution: Sump # 91 Sump # 42" Sump Depth: 60" 60" 60" Sump Material: FIBERGLASS FIBERGLASS FIBERGLASS Height from Tank Top to Top of Highest Piping Penetration: 32" 32" 32" Height from Tank Top to Lowest Electrical Penetration: 20" 20" 20" Condition of sump prior to testing: GOOD GOOD GOOD Portion of Sump Tested' 34" 34" 34" Does turbine shut down when sump sensor detects liquid (both r'oducfand Water)?* Yes No X NA Yes No X NA Yes No X NA Yes No NA Turbine shutdown response time Is system programmed for fail -safe shutdown ?* Yes No X NA Yes No X NA Yes No XNA Yes No NA Was fail -safe verified to be Io rational ?* Yes No X NA Yes No X NA 0 Yes No X NA Yes No NA Wait time between applying I ressure/vacuum/water and starting test: 30 MIN 30 MIN 30 MIN Test Start Time: 9:28 9:47 9:28 9:47 9 :28 9:47 Initial Reading (Rj): 4.110 4.110 4.313 4.313 6.023 6.023 Test End Time: 9:44 10:02 9:44 10:02 9:44 10:02 Final Reading (RF): 4.110 4.110 4.313 4.313 6.023 6.023 Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading (RF -RI): 000 000 000 000 000 000 Pass/Fail Threshold or Criteria: 002 002 002 002 002 002 X Pass Fail X Pass Fail X Pass Fail Pass Fail Was sensor removed for testing? X Yes No NA X Yes No NA X Yes 0 No NA Yes No NA Was sensor properly replaced and verified' functional after testing? X Yes No NA X Yes No NA X Yes No NA Yes No NA Comments — (include information on repairs made prior to testing and recommendedfollow -upforfailed tests) If the entire depth ofthe sump is not tested, specify how much was tested. Ifthe answer to My ofthe questions indicated with an asterisk ( *) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160) SWRCB, January 2002 Page of f 7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: Pressure Vacuum X Hydrostatic Other (Spec) Test Equipment Used: INCON TS -STS Equipment Resolution: UDC # 1/2 UDC # 3/4 UDC # 5/6 UDC # 7/8 UDC Manufacturer: BRAVO BRAVO BRAVO BRAVO UDC Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS UDC Depth: 30" 30" 30" 30" Height from UDC Bottom to Top of Highest Piping Penetration: 13" 13" 13" 13" Height from UDC Bottom to Lowest Electrical Penetration: NO ELECT NO ELECT NO ELECT NO ELECT Condition of UDC prior to testing: GOOD GOOD GOOD GOOD Portion ofUDC Tested 15" 15" 15" 15" Does turbine shut down when UDC sensor detects liquid (both product and water)?* Yes No X NA Yes No X NA Yes No X NA Yes No X NA Turbine shutdown response time Is system programmed for fail- safe shutdown ?* Yes No X NA Yes No X NA Yes No X NA Yes No X NA Was fail -safe verified to be o rational ?* Yes No XNA Yes No X NA Yes No X NA Yes No X NA Wait time between applying pressure /vacuum/water and starting test 30 MIN 30 MIN 30 MIN 30 MIN Test StartTime: 10:17 10:35 10:17 10:35 10:17 10:35 10:54 11:11 Initial Reading (RO: 2.639 2.638 3.112 3.112 4.680 4.680 5.563 5.563 Test End Tune: 10:32 10:50 10:32 10:50 10:32 10:50 11:09 11:26 final Reading ): 2.638 2.638 3.112 3.112 4.680 4.680 5.563 5.563 Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading Rj): 001 000 000 000 000 000 000 000 Pass/Fail Threshold or Criteria: 000 000 000 000 000 000 000 000 TestResulr .. X Pass Fail X Pass Fail X Pass Fail X Pass Fall Was sensor removed for testing? X Yes No NA X Yes No NA X Yes No NA X Yes No NA Was sensor properly replaced and verified functional after testing? X Yes No NA X Yes No NA X Yes No NA X Yes No NA Contents - (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) 1 If the entire depth ofthe UDC is not tested, specify how much was tested. Ifthe answer to gay of the questions indicated with an asterisk (•) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160) p6,2 BuCKOw& LIMP --cAK '.E:Sl- REPORT I'EST $TARTED 9:28 HM 7rST STARTED47L6INL-EUEL 4.1106 1 END TIME 9.44 AN c.ND -)ATE 01/06/2013 END LEQEL. 4.1103 lN iK 7HRESHOLO 0.002 IN TE.q7 RESULT PASSED 67STP S TEl;Tl STARTED 9.26 tip; TEST STARTED 01/06/2013 BEGIN --EUEL 4.3139 lN END 71ME 9.44 Ni Er-J.0 DATE @I/06/20io Ei,40 -r--VE:L 4.3!37 !N LEAK THRESHOLD 0.002 iN 7ST RESULT PASSED 9iSTP TES STARTED 9:28 HNED RRXT, EC 01/0, i3 LL VO E ERR tl_ V q "' 3EENGD TIMENE 9:29 AN PIT_ 1/_ - DATE lo(: LNO DATE 1/06/21013 END LEUEL ir-1 LEAK TH u) 0. IN STEST UL7 EE OR 91STP TEST STARTED 9.28 AP; TEST STARTED 01/06/2013 BEGIN LEUEL 6.0236 IN END -1-IME 9.44 AM END DATE 01/06/26i3 END LEVEL 6.0233 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSEL) ONNY HNW 261:e 80CKOwr-*r aKE;R8FlL-L1) i;A OVOb/20.- 10;462 AP. bufV -z-AK ic5i REPORT 7STr !,. b'I-ARTED 9- 4, hmFES7STARTED01 /06/`20::3 BEGIN LEVEL 4-lios INEN:) 7*;*mE 10;02 HP ENE) - r-, v f- KC ','mRESM(JLO 43-002 !N PASSED TER7 47 Ap,, Tw-s7 STARTED 01/06/2013BEC,Ir LEOEL 4.3136 imENDTIME18:02 AM END DATE 01/06/2013ENDLEVEL4.3134 jN LEAK THRESHOLD 0.002 INS71RESULTPASSED 91STP ES- - STARTED 9.47 AMTESS1TARtEDO!/ 13 iE31N L L -UELL LUML ERRENDIME9:47 AhCNf) DATE 01/06/2013 ri- I- END L L 0000 1NIii-HRESHOLD 004 1. N7RESULT- kESUL7 91STP TES-1 STARTED 9;47 Af., IIES, STARTED i31/06/201.3BEGIN. i EUEL 6.0233 InENOViME0:02 HMENDDATE01/06/2013E-NO LEOEL 6.0230 !N LERK THRESHOLD FEST 0.002 !NkESUL7PASSE) a, IT1 "S m -" -1 z rTI fl. ff."J) ff.- U-) 1", 3. rri F 2 r- - au - ' : - IT1rfII; i 7R i-; rI Cox) r r,1 rrs U -1 D -- rvi -z 2 2 IT iriP- r S rTI i rT; rtt Pivjcr rri sm rI \- c rr , CK, m X. 4: c("4r. X J: cr- i M i. r 7- 2 in r; 1-. Q. 7 P, x U, a -C -I:B r -1 -1 C- xxrU7ryi -1 r C) a. a DM 7 C4 r r- r, 1'. m -1 -: IT, :2 Z' e M P. P- r Z- C' (n C- Vxmmmmxi c rr, r C X AL, r cr, r" E- 1 -1IX. r !rll 1 C, K- K Cr. a, Q. 2 i f :" I- ' LL - 1 ... rTj r :2 : rz rr v I a M, Q N X- .... cri Lr' 0'. x cr, kA Or- X rT F. r 7, S Q, T: C. rf. C., i IN. N h; X IS, M CA Lp Cc- tr.t-0a,65tinl" C J cr.. re; - :3> 11 1' rr 1-. il, r z :z IT r C, ri crZ. U t,: Lr-. 7, V. ;x.' 3: r C X Mz il 0 4. jUNNY hltLb 26!2 8uC;KGwEr, 1_Wlt' L-LAK "EST lE?ORT YEz,,7 STARTED oi/o5/20i6 iEGIN LEVEL 5.5638 iN END TIME -, 1:09 Api rD )ATE o1/&/2013 END LEVEL b.b636 iN iK TmREShOLO O.2 im TEST RESULT PASSED bNNY HKCG 26-2 BuCKOwEr, iAKERSt;:IEL.L) CA o t /06/'20 _ti. ii:26 fim 6uMr —HK _CLST REPORT UDC,?-t, Tc.S7 STAKTEO ii:ii AN TEST STARTED OI/06/20i3 6EGIN LEVEL 5.5636 !H END 71ME 11-26 AM E?10 )ATE 01/06/2013 END LEVEL 5.5636 !N ZAK THRESHOLD 0.002 !N TEST RESUL7 PASSED SB989 TESTING FAILURE REPORT SITE NAME: JOHNNY'S ARCO DATE: 2/6/13 THE FOLLOWING COMPONENTS WERE REPLACEDAU,,P'AIRED TO COMPLETE TESTING. REPAIRS: NONE LABOR: NONE PARTS INSTALLED: NONE NAME: TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR CONVIENENCE. t, 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 ofRegulations This form must be used to document testing and servicing of monitoring equipment. A separate ce ification or report must be prellared for each monitoring system control panel by the technician who performs the work. A copy ofthis form must be provided to the tank system owner /operator. The owner /operator must submit a copy ofthis form to the local agency regulating UST systems within 30 days of test date. { A. General Information Facility Name: JOHNNYS ARCO Bldg. No.: Site Address: 2612 BUCK OWENS BLVD City: BAKERSFIELD Zip: Facility Contact Person: JOHNNY Contact Phone No.: ) Make/Model ofMonitoring System: TLS -350 Date of Testing/Servicing: 218/2013 B. Inventory of Equipment Teste&Cerdfied Check the auvropriate boxes to Indicate specific a ui ment Inspected/serviced., Tank ID: UNL87 Tank ID: UNL 87 SIPHON Z In -Tank Gauging Probe. Model: MAG In -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor. Model: 409 Annular Space or Vault Sensor. Model: 409 Piping Sump / Trench Sensor(s). Model: 208 Piping Sump / Trench Sensor(s). Model: 208 Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Z Mechanical Line leak Detector. Model: RED JACKET DIAPHRAM Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: FLAPPER Z Tank Overfill / High -Level Sensor. Model: FLAPPER Other (specify equipmenttype and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2). Tank ID: PREM 91 Tank ID: Z In -Tank Gauging Probe. Model: MAG In -Tank Gauging Probe. Model: Z Annular Space orVault Sensor. Model: 409 Annular Space or Vault Sensor. Model: Piping Sump / Trench Sensor(s). Model: 208 Piping Sump/ Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Z Mechanical Line Leak Detector. Model: RED JACKET Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Z TankOverfill / High -Level Sensor. Model: FLAPPER 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: 1 -2 Dispenser ID: 3-4 Z Dispenser Containment Sensor(s). Model: 406 Dispenser Containment Sensor(s). Model: 406 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5-6 Dispenser ID: 7-8 Z Dispenser Containment Sensor(s). Model: 406 Z Dispenser Containment Sensor(s). Model: 406 Z 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). Ifthe 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): RICHARD MASON Signature: .-% V111_-- Certification No.: 836880 / 5297857 -UT License. No.: C6(/ D40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 392 -8687 Testing Company Address: 5643 BROOKS CT. BAKERSFIELD, CA 93308 Date ofTesting/Servicing: 218/2013 Page 1 of 5 UN -036— 114 www.unidoes.org Rev. 01n7M Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: 330.01 rmmnlete the fnllnwinu cheekikt! Ado"__ f 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* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) N/A operational? Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment N/A 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* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? Ifso, at what percent oftank capacity does the alarm trigger? % Yes* No Was any monitoring equipment replaced? Ifyes, 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* I 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: 1) L:1 87 1 STP SUMP SENSOR FAILED - I REPLACED AND RETESTED. L:3 91 STP SUMP SENSOR FAILED - I REPLACED AND RETESTED. Page 2 of 5 UN-036 — 2/4 www.unidoes.org Rev. 01/17/08 Monitoring System Certification F. In -Tank Gauging / SIR Equipment: 01 Check this box iftank gauging is used only for inventory control. Check this box ifno 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 ofsystem product level readings tested? Yes No* Was accuracy ofsystem 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 Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Complete the following checklist Check this box if LLDs are not installed. Yes No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? N/A 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* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? N/A Yes No* For electronic LLDs, does the turbine automatically shut off ifthe LLD detects a leak? N/A Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled N/A or disconnected? Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions N/A or fails a test? Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: UN -036 — 3/4 Page 3 of 5 www.anidomorg Rev. 01/17/08 Cerm"thm UST Monitoriag Sete Plan Address: 2Q'2 BU.CK OWENS BLVD. BAKERSFIELD, CA. 93308 V- .... C40 Irf4 ate f ap was drawn- ,r11.1M. to trueetl,. If you already have a dialtrar,::.. ".&I shawl b' ....ve :..rnrma+ion, vnn tr+c . »- SKr=- it, rather 'thad ft page: ltb your MonitoringSystemCettttict.imL On your site plan, snow the semj iaya4= u'tanks . 'V106.. CltA ly idw. y Iv.stiam of the followingeyuipnwmt. if ice.. ,ailed: r"to-ring system control vuaels; sensors -I.• ;.W=ar spaces, sw4,s, dispenser pant, spill containers, or other secondary containment areas; mechanical or electronic li +e ieak detectors; Bind in -tank liquid level probes t if used for leak deve- fioal. :pace provided, ooze the date this Site Plan was pr e : 1. I N-036 -414 Pape 4 of 4 www.,wida - Nop SWRCB, January 200 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing of USTspill containment structures. The completedform and printouts from tests (ifapplicable), should beprovided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: JOHNNY'S ARCO I Date ofTesting: 2/8/13 Facility Address: 2612 BUCK OWENS BLVD, BAKERSFIELD Facility Contact: JOHNNY Phone: Date Local Agency Was Notified ofTesting: Name ofLocal Agency Inspector (!fpresent during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: RICHARD MASON I Credentials': CSLB Contractor X ICC Service Tech. 0 SWRCB Tank Tester Other (Specify) I License Number(s): 5297857 -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: VISUAL Equipment Resolution: 0 Identify Spill Bucket (By Tank Number, StoredProduct, etc. 1 REG87 -FILL 2 UNLV SIPHON -FILL 3 PRE Mtin L 4 Bucket Installation Type: X Direct Bury Contained in Sump X Direct Bury Contained in Sum X Direct 0 Containum Direct Bury Contained in Sum Bucket Diameter. 12" 12" Bucket Depth: 14" 14" Wait time between applying vacuum/water and start oftest: 30 MIN 30 MIN 30 MIN Test Start Time (T,): 9:30 9:30 9:30 Initial Reading (Rj): 10" 10" 10" Test End Time (TF): 10:30 10:30 10:30 Final Reading (RF): 9" 9" 9" Test Duration (TF —TO: 1 -HOUR 1 -HOUR 1 -HOUR Change in Reading (RF - RO: 0 0 0 Pass/Fail Threshold or Criteria: 0.00 0.00 0.00 Test Result: X Pass Fail X Pass 0 Fail ' X Pass 0 Fail Pass 0 Fail Comments — (include Information on repairs madeprior to testing, andrecommendedLollow -upfbrfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the Information contained in this report is true, accurate, and infull compliance with legal requirements. Technician's Signature: "V r Date: 2/8/13 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. j'4'(ooa-- f RICH ENVIRONMENTAL 5643 BROOKS CT. BAKERSFIELD, CA. 93308 OFFICE (661)392 -8687 FAX (661)392 -0621 PRODUCT LINE LEAK DETECTOR TEST WORK SHEET W /0#: FACILITY NAME: JOHNNY'S ARCO FACILITY ADDRESS: 2612 BUCK OWENS BLVD, BAKERSFIELD PRODUCT LINE TYPE: PRESSURE PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL 87 LID TYPE: RED JACKET YES 11 PASS SERIAL # 6776 91 LID TYPE: RED JACKET YES 10 PASS SERIAL # 3486 L/D TYPE : PASS YES SERIAL # FAEL L/D TYPE: PASS YES SERIAL # FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS DATE ACCORDING TO RED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATIONS. THE MECHANICAL LEAK DETECTOR TEST PASS / FAIL IS DETERMINED BY USING A LOW FLOW THRESHOLD TRIP RATE OF 3 GALLONS PER HOUR OR LESS AT 10 P.S.I. I ACKNOWLEDGE THAT ALL DATA COLLECTED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. TECHNICIAN: ICHARD MASON SIGNATURE: / DATE: 2/8/13 COMMUNICATIONS SETUP SYSTEM SETUP PORT SETTINGS: FEB 8, 2013 2:02 PM ISO 3166 COUNTRY CODE: RS-232 END OF MESSAGE DISABLED MASS/DENSITY WIIT6 WAr araura cr=Tlm DISABLED COMM BOARD : I {EDIM ) RS -232 SECURITY Ally SETUP - _ _ CODE DISABLED SYSTEM UNITS UNLEADED R COMM BOARD 2 (RS -232) BAUD RATE 1200 U.S. SYSTEM 1UCTCODE COEFF :.D00700 PARITY ODD STOP BIT l STOP ISLANGUAGE SYSTEM DATE /TIME FORMAT iMAL DIAMETER 92.00 DATA LENGTH: 7 DATA MON DD YYYY HH:MM:SS xM PROFILE : 4 PTS FULL VOL 11627 RS -232 SECURITY CODE : DISABLED ARCO 81360 INCH VOL : 9438 2612 Buck Owens Blvd 9.0 6.0 INCH'L '. 5814 VOL : 2190 f AUTO TRANSMIT SETTINGS: Bakersfield CA 93308 3.0 INCH AUTO LEAK ALARM LIMIT SHIFT TIME 1 : 10:05 PM AT SIZE: 3.0 IN- DISABLED SHIFT TIME 2 : DISABLED. - SHIFT TIME 3 DISABLED 2.0 AUTO HIGH WATER LIMIT DISABLED SHIFT TIME 4 DISABLED PER WARNING WATER LIMIT: 3.0 AUTO OVERFILL LIMIT TANK PER TST NEEDED WRNaHDISABLED X OR LABEL VOL: 11627 90% AUTO LOW PRODUCT DISABLED DISABLED TANK ANN TST NEEDED WRN ERFILL LIMIT 1Og AUTO THEFT LIMIT DISABLED GH PRODUCT 11045 DISABLED AUTO DELIVERY START LINE RE- ENABLE METHOD SLIVERY LIMIT 10% DISABLED PASS LINE TEST 1162 AUTO DELIVERY END DISABLED LINE PER TST NEEDED WRN 500 OW PRODUCT ALARM LIMIT: 99 AUTO'EXTERNAL INPUT ON DISABLED DISABLED LINE ANN TST NEEDED WRN EAK LOSS LIMIT: 50 AUTO EXTERNAL INPUT OFF DISABLED UDDEN ANK TILT 0.00 OFFSET 0.00 DISABLED AUTO SENSOR FUEL ALARM PRINT TC VOLUMES PROBE DISABLED ENABLED MANIFOLDED TANKS AUTO SENSOR WATER ALARM DISABLED TEMP COMPENSATION 31 pHON O AUTO SENSOR OUT ALARM VALUE (DEG F ): 60.0 Ti MAiVIFOLDEU TANKS DISABLED STICK HEIGHT OFFSET LINE DISABLED TO-- NONE ULLAGE : 909: PERIODIC: 10° H-PROTOCOL DATA FORMAT LEAK MIN 1162 HEIGHT RECEIVER SETUP: DAYLIGHT SAVING TIME LEAK MIN ANNUAL : 10: 1162 NONE DISABLED RE- DIRECT LOCAL PRINTOUT DISABLED TEST TYPE EURO PROTOCOL PREFIX PERIODIC STANDARD S ANNUAL TEST FAILALARM DISABLED SYSTEM SECURITY PERIODIC TEST FAIL CODE : 000000 ALARM DISABLED MAINTENANCE HISTORY GROSS TEST FAIL AUTO DIAL TIME SETUP: DISABLED ALAR11 DISABLED NONE ANN TEST AVERAGING: OFF TAW CHART 'SECUR I TY PER TEST AVERAGING: OFF DISAILED TANK TEST NOTIFY. OFF CUSTOM ALARMS SIPHON BREAK:OFF DISABLED TNK TST DELIVERY DELAY : 15 MIN 10.00'/ SERVICE NOTICEpUMP•THRESHOLD DISABLED ISO 3166 COUNTRY CODE: RS-232 END OF MESSAGE DISABLED MASS/DENSITY WIIT6 WAr araura cr=Tlm DISABLED EVR /ISD SETUP EVR TYPE: BALANCE BALANCE NOZZLE TYPE VST VAPOR PROCESSOR TYPE VEEDER -ROOT POLISHER ANALYSIS TIMES TIME: 10:00 AM DELAY MINUTES: 1 ACCEPT HIGH ORVR: HOSE MAP ENABLED 1 2 ISD HOSE TABLE 92.00 ID FP FL HL .'AA RR 01 01 01 02 01 02 02 02 02 02 01 02 03 03 03 02 02 02 04 04 04 02 02 02 05 05 05 02 03 02 06 06 06 02 03 02 07 07 07 02 04 02 08 OB 08 02 04 02 ISD AIRFLOW METER MAP ID SERIAL NUM LABEL 3 1 42020 DISP 1 -2 2 42045 DISP 3 -4 3 42039 DISP 5 -6 4 42018 DISP 7 -8 ISD FUEL GRADE HOSE MAP PRODUCT CODE 1 2 3 4 92.00 FP MHH MHH MHH MHH AA C1 101 501 -901 23.0 INCH VOL U U 1 02 102 502 902 U U 1 03 103 503 303 9 U 2 04 104 504 304 9 U 2 05 105 505 905 U U 3 d6 106 506 906 U U 3 07 107 507 307 U U 4 X18 108 508 308 U U 4 LABEL TABLE 4: UNASSIGNED 2: BLENDS 8: REGULAR MID GRADE 5: PREMIUM 6: GOLD 7: BRONZE 8: SILVER 9: BLEND2 0: BLEND4 T 3:UL PREMIUM 2.0 PRODUCT CODE 3THERMALCOEFF ' 000700TANKDIAMETER92.00TANKPROFILE4PTS 1943B 110 69.0 INCH VOL 1162 46,0 INCH VOL 581423.0 INCH VOL 1170 FLOAT SIZE: 3.0 IN. WATER WARNING 2.0HIGHWATERLIMIT: 3.0 w1AX OR LABEL VOL: 11627OVERFILLLIMIT : 90% HIGH PRODUCT • 10464 95% DELIVERY LIMIT 110 69.0 INCH VOL- 1162 LOW PRODUCT 500LEAKALARMLIMIT: 99SUDDENLOSSLIMIT: 50TANKTILT3.50PROBEOFFSET0.00 SIPHON MANIFOLDED TANKSTO: NONE LINE MANIFOLDED TANKSTO: NONE LEAK MIN PERIODIC: 104/0 1162 LEAK MIN ANNUAL 1014 1162 PERIODIC•TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL , ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING:. OFFPERTESTAVERAGING: OFF TANK TEST NOTIFY:... OFF . TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 MINPUMPTHRESHOLD : 10.0 ilA_ T 2:UNLEADED R. 2.0 PRODUCT CODE 1 THERMAL COEFF 000700 TANK DIAMETER. 92.00 TANK PROFILE Q PTS FULL VOL 11627 69.0 INCH VOL- 9438 46.0 INCH VOL 5814 23.0 INCH VOL 2190 FLOAT SIZE: 3.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3,0 MAX OR LABEL VOL: 11627 OVERFILL LIMIT 900/0 10464 HIGH PRODUCT 95%, 11045 DELIVERY LIMIT 10% 1162 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 4.50 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS TO: NONE LINE MANIFOLDED -TANKS,. TO: NONE LEAK MIN PERIODIC: 10% 1162 LEAK MIN ANNUAL 10% 1162 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST 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 15 MIN PUMP THRESHOLD 10.00% xxAxx END * * *x( ALARM HISTORY REPORT SENSOR ALARM - - - -- L 5:87 ANN 2 ANNULAR SPACE SENSOR OUT ALARM FEB 8, 2013 2:57 PM FUEL ALARM FEB 8, 2013 2 :42 PM SENSOR OUT ALARM NOV. 7, 2012 11:25 AM x x x x x END * x x x* ALARM HISTORY REPORT x x x x END ** x x X ALARM HISTORY REPORTSENSORALARM - - -- L 1:87 1 L 4:87 ANN 1 SENSOR ALARM - - - -- ANNULAR SPACE L 1:87 1 STP SUMP ALARM HISTORY SENSOR OUT ALARM2:57 PM STP SUMP FEB 8, 2013 FUEL ALARM LEAK TEST METHOD ALARM - - - -- FEB 8, 2013 3:40 PM FUEL ALARM 2:40 PM CATEGORY STP SUMP TEST ON DATE : ALL TANK FEB 8, 2013 FUEL ALARM JAN 29, 2009 FEB 8, 2013 3:39 PM START TIME : 12:00 AM FUEL ALARM 2:40 PM TEST RATE :0.20 GAL /HR FEB B. 2013 FLIEL ALARM FUEL ALARM DURATION 2 HOURS CATEGORY : FEB 8, 2013 3:36 PM 2:25 PM FUEL ALARM TST EARLY STOP:DISABLED L 4:87 ANN 1 JAN 8, 2013 LEAK TEST REPORT FORMAT TRI -STATE SINGLE FLOAT) NORMAL xxAxx END * * *x( ALARM HISTORY REPORT SENSOR ALARM - - - -- L 5:87 ANN 2 ANNULAR SPACE SENSOR OUT ALARM FEB 8, 2013 2:57 PM FUEL ALARM FEB 8, 2013 2 :42 PM SENSOR OUT ALARM NOV. 7, 2012 11:25 AM x x x x x END * x x x* ALARM HISTORY REPORT x x x x END ** x x X SENSOR ALARM - - - -- L 6:91 .ANN ANNULAR SPACE SENSOR OUT ALARM FEB 8, 2013 2:57 PM FUEL ALARM FEB 8. 2013 2:43 PM SENSOR OUT ALARM NOV 7, 2012 11:25 AM x x x x x END x* x x x ALARM HISTORY REPORT SENSOR ALARM. ^ - -• L 3:91 STP STP SUMP FUEL ALARM FEB 8, 2013 3:53 PM FUEL ALARM FEB 8, 2013 3:45 PM SENSOR OUT ALARM FEB 8, 2013 3:43 PM L 5:87 ANN 2 TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 6:91 ANN TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE I LIQUID SENSOR SETUP L 1:87 1 TRI -STATE SINGLE FLOAT) CATEGORY STP SUMP ALARM HISTORY REPORT L. 2:872 SENSOR ALARM - - - -- TRI -STATE SINGLE FLOAT) L 2:87 2 CATEGORY STP SUMP STP SUMP SENSOR OUT ALARM FEB 8, 2013 2:57 PM L 3:91 STP TRI -STATE SINGLE FLOAT) FUEL ALARM CATEGORY : STP SUMP FEB 8, 2013 2:25 PM FUEL ALARM L 4:87 ANN 1 JAN 8, 2013 4:39 PM TRI -STATE SINGLE FLOAT) CATEGORY : ANNULAR SPACE SENSOR ALARM - - - -- L 6:91 .ANN ANNULAR SPACE SENSOR OUT ALARM FEB 8, 2013 2:57 PM FUEL ALARM FEB 8. 2013 2:43 PM SENSOR OUT ALARM NOV 7, 2012 11:25 AM x x x x x END x* x x x ALARM HISTORY REPORT SENSOR ALARM. ^ - -• L 3:91 STP STP SUMP FUEL ALARM FEB 8, 2013 3:53 PM FUEL ALARM FEB 8, 2013 3:45 PM SENSOR OUT ALARM FEB 8, 2013 3:43 PM L 5:87 ANN 2 TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 6:91 ANN TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE I SETUP 4C VERSION: Ol -03 Ap,)p PROCESSOR POLISHEREgR -ROOT SOFTWARE REVISION LEqEL ION 330.01 WARSt 3463023 a25 CREATED - 10.0.23-17-25d.0 . S- MUDU -E 4 330160• -004 - 9FEATURES* SM 1IANT TS S A,,NUAT NTK ISD 4 SMARTSENSOR SETUP CI.VAPOR PRESSURE CATEGORY VAPOR PRESSURE s;2:CANISTER ATEGORY VAPOR VALVE s 3:DISP 1 -2 CATEGORY AIR FLOW METER s 4:DISP 3 -4 CATEGORY AIR FLOW METER 5:DISP 5 -6 CATEGORY AIR FLOW METER s 6:DISP 7 -8 CATEGORY AIR FLOW METER s B:ATM CATEGORY ATM P SENSOR sm OUTPUT RELAY SETUP R 1:87 STP TYPE: STANDARD - NORMALLY CLOSED TANK 0: NONE LIQUID SENSOR ALMS L !:FUEL ALARM L 2:FUEL ALARM L !:SENSOR OUT ALARM L 2:SENSOR OUT 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:FLOW COLLECT FAIL R 2:91 STP TYPE: STANDARD NORMALLY CLOSED TANK #: 3 LIQUID SENSOR ALMS L 3:FUEL ALARM L 3:SENSOR OUT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL. I SD HOSE ALARMS ALL : FLOW COLLECT 'FA I.L 51 d MONITOR CERT. FAILURE REPORT SITE NAME: JOHNNYS ARCO DATE: 2/8/13 ADDRESS: 2612 BUCK OWENS BLVD. TECHNICLAN: RICHARD MASON CITY: BAKERSFIELD SIGNATURE: / ` REPAIRS: BOTH L:1 & L:3 87 1 AND 91 STP SUMP SENSORS WERE BAD - I REPLACED WITH NEW AND RETESTED PARTS INSTALLED: 2- VEEDER -ROOT 208 SENSORS (WERE OWNERS THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR CONVIENENCE.