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HomeMy WebLinkAbout4050 GOSFORD ROAD FMC 2013HOODS ALARMS SPRINKLER SYSTEMS S ° IRAV BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: Z Address: -5/0 5-0 Bakersfield, CA 933 Date Received: y -i5 - i,3 Business Name: ,,5 ,- C r INSPECTION LOGBUILDINGSQUAREFEET: SYSTEM: New Mod. Commercial Hood System Building Sq. Feet:" Date Time Fire Alarm System Calculation Bldg. Sq. Ft: C/ 1. Fire Sprinkler System 2. Spvay Finish System 3. Aboveground Storage Tank 4. O Underground Storage Tank minor SignatureSignature modification Underground Storage Tank removal Underground Storage Tank Signature LiY Other t'`-17 i C- Comments: zz'c4 r %1i heAV MasoAJ ircc I' sag ? d5'2 6xP rziv /is y',e %r )3 3&R 0 6?sP 9/t&//y VM "41- a I VFs EEO '1111115-- BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Romove for Duration of Work Inspection Request Phone No. (6c")41) 326 -3979 UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANK TESTING UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE EVRUPGRADE PRIOR TO OPERATION OF ANY SYSTEM,' ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY, MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) 5hyllly REMARKS: BUILDING ADDRESS: Q JOB DESCRIPTION: FvAA L OCCUPANCY TYPE: OWNER: (,( PERMIT NO. X-3-166 CONTRACTOR: PHONE FD 1743 6ILLING & PERMIT STATEMENT PERMIT NO.: BAKERSFIELD FIRE DEPT. B A E R 8 F I D Prevention Services FtR6 fA/P fI/ 1600 Truxtm Ave Ste 401 Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax (661) 852 -2171 SITE INFORMATION LOCATION OF PROJECT \ _ \ PROPERTYOWNER STARTING DATE ^ ` 3 COMPLETION DATE NAME PROJECT NAME ADDRESS l PHONE NO. PROJECTADDRESS C `/ CITY STATE ZIP CODE CONTRACTOR CONTRACTOR NAME CA LICENSE NO. J II 1'Yl S tC tt SCE INFORMATION TYPE OF LICENSE. EXPIRATION DATE fv.4NA 3b .201 PHONE NO. g CONTRACTOR COMPANY NAME t C- FAX NO. O ADDRESS 5LO L4 - i CITY Agi ZlPwve c, All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. Rl PERN-11T TYPE FEE CALCULATION TOTAL DUE Alarms - New & Modifications - (Minimum Charge) $280.00 ONLY TREASURY ACCT • 98 Over 10,000 Sq. Ft Sq- Ft x.028 = Permit fee 4 Sprinklers - New & Modifications - (Minimum Charge) 280.00 84 98 Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee 84 98 Minor Sprinkler Modifications (< 10 heads) 96.00 [Inspection Only] 84 98 Commercial Hoods - New & Modifications 470.00 84 98 Additional Hoods 58.00 84 98 Spray Booths - New & Modifications 470.00 84 98 Aboveground Storage Tanks (Instailaaordlnsp.-1 Time) 180.00 82 Additional Tanks 96.00 82 1 Aboveground Storage Tanks (Remova//inspection) 109.00 NJ S2 Underground Storage Tanks (Installation inspection) 878.00 (per tank) 82 Underground Storage Tanks (Modification) 878.00 (persite) 82 Underground Storage Tanks (Minor Modification) 167.00 82 Underground Storage Tanks (Removg 573.00 (per tank) 84 Oihnrell (Installation) 96.00 Mandated Leak Detection (Testing) Fuel Monit. rt/SB989. Note: $96.00 foreach type of test /per hedu/ed at the same dme) v&ftfpeF O d 82 13, ents 96.00 {per tend 84 otechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby feennspectim)- X576..00 84 i After hours inspection fee 121.00 as O. RE- iNSPECT/ON(S) /FOLLOW -UP /NSPEC770N(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. OF CAGES? _ 96.00 84 Explosive Storage 266.00 84 Copying & File Research (File Research Fee $50.00 per hr) 250 per page 84 Miscellaneous 84 FD 2021 (Rev. 06/07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) BILLING & PERMIT STATEMENT PERMIT NO:: oA. 8 8 R 3 1 D FIRM wRfr T BAKERSFIELD FIRE DEPT. Prevention Services 1600 TruxtLm Ave Ste 401 Bakersfield CA 93301 Tel.: 1`6611 326 -3979 9 Fax: (6611 852 -2171 SITE INFORMATION PERIVIIT TYPE LOCATION OF PROJECT 1 PROPERTY OWNER COMPLETION DATESTARTINGDATE S ^ NAME 13 84 PROJECT NAME dYNA ADDRESSLAO5D C `! PHONE NO, PROJECT ADDRESS OvO ` v CITY 0- STATE n ZIPCODE CONTRACTOR • • r • Over 10,WO Sq. Ft. CONTRACTOR NAME CA LICENSE NO. TYPEOFLICENSE. EXPIRATION DATE YY1> —: S C ti Oq SO PHONE NO. CONTRACTOR COMPANY NAME C FAX NO. pOO ADDRESS 5t y CnY ZIP wut q:330 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. fl PERIVIIT TYPE FEE CALCULATION TOTAL TREASURY 82 Tents DUE ACCT NO 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee Anspection)=$576. -00 84 After hours inspection fee Over 10,WO Sq. Ft. Sq. Ft. x.028 Permit fee 84 RE- INSPEC770N(S) /FOLLOW-UP /NSPECflON(S) 96.00 (per hour) 84 Sprinklers - New & Modifications - (Minimum Charge) Portable LPG (Propane): NO. OF CAGES? _ 96.00 84 Explosive Storage ter .• '+' l/ • e• ` ray. -, `7,.'.'.'rt- . ti°; ift, 4ait:`. s. J. •'Z'`.:a it.'r<.S..:i. >..' "kt Al - - - - - 2 CHASE JP Morgan Chase Bank, N.A. Bakersfield, CA 93308 FOR - `—` " d SV LQ O I/O - rwwe DOLLARS rF ti A H RIZED SIGNATURE 004 L ?a. us 1: 3 2 2 2 ? L 6.2 ?i: 308 3 50400 ?ll• 1 84 V Mandated Leak Detection (Testing) Fuel Monit. rt/SB989. Note: $96.00 foreach type of test / per heduled at the same time) 9 9 ,In, n 82 Tents 96.00 (per tenfl 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee Anspection)=$576. -00 84 After hours inspection fee 121.00. 84 RE- INSPEC770N(S) /FOLLOW-UP /NSPECflON(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. OF CAGES? _ 96.00 84 Explosive Storage 266.00 84 Copying & File Research (File Research Fee $50.00 per hr) 250 per page 84 Miscellaneous 84 FD 2021 (Rev. 0617) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to Fite) 1 -PINK (to Customer) s- ' UNDERGROUND STORAGE TANKS APPLICATION ; FIRS TO PERFORM HD /LINE TESTING /: SS989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION Pisses note that these are separate individual testm and wQl be charged per separate type tot accordingly) PERMIT ik BAKERSFIELD FIRE DEPARTMENT Prevention Services slot t-k S-MF -F.T Bakersfield, CA 93301 Phone: 661- 326 -3979 9 Fax: 561- 852 -2171 Pegs 1 Of 1 ENNANC£D LEAK DETECTION 13 SB-989 sECONDARY coNTAINMENT 13 TANK TIGHTNESS FUEL MONITORING C8RIIFI SITE INFORMATION FACILITY S\1e` NAME g PNONS N PF CONTACT PERSON ADDRESS a OWNER NAME OPERATOR NAME PERMIT TO OPERATE A OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? O YES 0 NO TANK O VOLUME CONTENTS 1 L-i V 1e5 TAPW T1STD16 COMPANY TESTING COMPANY NAME g PHONE # OF CONTACT PERSON MAnnrG ADDRESS y 3 R.,bo GT. — FS/tKE+RSF 1E.t^U C 9 3308 NAME a PHONE * TESTER OR SPECIAL INSPECTOR CERTIFICATION Q p DATE & TIMETEST M BE CONDUCTED ICC a TEST METHOD APPLICANT RE f)4 (6^G 4 DATE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ppppy p LATE F02095 (Rev 03 /08) t t .iu MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifornia Authority Cited: Chapter 6 7, Health and Safety Code; Chapter 1,6, Division 3, Title 23, California Code ofRegulations 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 ofthis form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: GOSFORD SHELL Bldg. No.: Site Address: 4050 GOSFORD RD. City: BAKERSFIELD Zip: 93309 Facility Contact Person: HENG MakeiModel of Monitoring System: TLS -350 B. Inventory of Equipment Tested /Certified Check the annrnnriate hnYes to indicate sneeiftc eaninment insnected/serviced: Contact Phone No.: (661) 304-4083 Date of Testing/Servicing: 612812013 Tank ID: REG. 87 #1 Tank ID: REG. 87 #2 Z In -Tank Gauging Probe. Model: MAG Z In -Tank Gauging Probe. Model: MAG Z Annular Space or Vault Sensor. Model: 304 Annular Space or Vault Sensor, Model: 301 Piping Sump / Trench Sensor(s). Model: 208 Piping Sump / Trench Sensor(s). Model: 208 Fill Sump Sensor(s). Model: 208 Z Fill Sump Sensor(s). Model: 208 Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: 2 Electronic Line Leak Detector. Model: VEEDEROOT Z Electronic Line Leak Detector. Model: VEEDEROOT 2 Tank Overfill / High -Level Sensor. Model: FLAPPER Z Tank Overfill / High -Level Sensor. Model: FLAPPER 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: PREM 91 Tank ID: DIESEL In -Tank Gauging Probe. Model: MAG Z In -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor. Model: 301 Z Annular Space or Vault Sensor. Model: 301 Piping Sump /Trench Sensor(s). Model: 208 Z Piping Sump /Trench Sensor(s). Model: 208 Fill Sump Sensor(s). Model: 208 Z Fill Sump Sensor(s). Model: 208 Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: VEEDEROOT Z Electronic Line Leak Detector. Model: VEEDEROOT Tank Overfill / High -Level Sensor. Model: FLAPPER Z Tank Overfill / High -Level Sensor. Model: FLAPPER 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 1D: 314 Dispenser Containment Sensor(s). Model: 208 Dispenser Containment Sensor(s). Model: 208 Shear Valve(s). Z Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 516 Dispenser ID: 718 Dispenser Containment Sensor(s). Model: 208 Z Dispenser Containment Sensor(s). Model: 208 Shear Valve(s). Z ShearValve(s). Dispenser Containment Float(s) and Chain(s). DispenserContainment Float(s) and Chain(s). Dispenser ID: FDispenser tainment Sensor(s). Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). tainment 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 - 1 certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): ® System set -up ® Alarm history report Technician Name (print): RICHARD MASON Signature: &= Certification No.: 5297857 -UT / B36880 License. No.: C61'7 D40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 392 -8687 Testing Company Address: 5643 BROOKS CT. BAKERSFIELD, CA 93308 Date of Testing/Servicing: 5/28/2013 Page 1 of 5 UN -036 — 1/4 www.unidoes.org Rev. 01 /17/08 Monitoring System Certification 1 D. Results of Testing/Servicing Software Version Installed: 327.04 n... nln /n ho fnlln ar :nn nhnn4Ge• 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 El No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Q 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 ltd 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? If so, at what percent oftank 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) F-1 Product; ® Water. If yes, describe causes in Section E, below. Yes p No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, ifapplicable Yes 1 Q 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: DIESEL STP HAD 1 GALLON OF WATER - NOT ENOUGH TO SET OFF SENSOR. ALSO 87 TANK 1 FILL SUMP HAD 1 GALLON OF WATER AND DISPENSER 3/4 HAD SMALL AMOUNT OF WATER AROUND EDGE NOT ENOUGH TO SET OFF SENSOR. I CLEANED WATER OUT OF ALL THREE SUMPS Page 2 of 5 IIN -036 — 2/4 www.unidomorg Rev. 01/17/08 H Monitoring System Certification F. In -Tank Gauging / SIR Equipment: t) kl15b Check this box iftank gauging is used only for inventory control. El 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? L3 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): Cmmnlete the fnllnwinu checklist- 0 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.; [10. 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 ifit 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 ifany 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: 11N -036 —3/4 Page 3 of 5 wwwxnidoes.org Rev. 01/17/08 T TCT Mtmifnri win L I. 70r, to HIS: r • . . . . • i r _ _ • - - - _ - _ - - w - _ • • _ . - • _ - • • _ _ - - • _ - . • . - - r • . . . . . r . _ . . . . . . . . . . . . _ • _ _ • _ _ • • - _ - • . _ • _ • w • r - _ _ - - • • - - - - _ _ • • • - • _ - r - - - - - - - - - - - - t • - • - - - - - - - - - - - - - - - - - - - - - - - - - - - - • - r _ r • w • - _ _ r . r . • r . . r . . r . . . . . . Date map vm dawn; v1F-- 'IICtIaI1S . Ifyou already have a diagram that shows all required information, you may include it, rather than this paA with yourMonitoring5`ystem Certification. On your site plan; shaw the general layout'oftanks and piping. Qearly ideotdylocationsofthefollowingequipment; ifinstalled: monitoring system control panels; sensors monitoring tank annularSPAsummdisP== PanS, spill c onWners, or other secondary contaianent areas; mecmmiral or electronic line leak detectors; and imp, liquid level probes (ifused for leak ddectian }. In the space provided, note thedate this Site Planwasprepared. Page -5- of-.S:-- 95100 5 Wbi SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing ofUST spill containment structures. The completedform and printoutsfrom tests (fapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: SHELL STATION Date of Testing: 50-8/13 Facility Address: 4050 GOSFORD RD. BAKERSFIELD Facility Contact: HENG I Phone: (661) 304 -4083 Date Local Agency Was Notified ofTesting: 5/9/13 Name of Local Agency Inspector (ifpresent during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: RICHARD MASON Credentials: CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Spec) License Number(s): 5297857 -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: VISUAL Equipment Resolution: 0.00 Identify Spill Bucket (By Tank Number, Stored Product, etc. ) 1 REGULAR 87 -FILL 2 PREMIIUM 91- FILL 3 DIESEL FILL 4 REG 87 #2 Bucket Installation Type: Direct Bury X Contained in Sump Direct Bury X Contained in Sump Direct Bury X Contained in Sump Direct Bury X Contained in Sum Bucket Diameter: 12" 12" 12" 12" Bucket Depth: 14" 14" 14" 14" Wait time between applying vacuum/water and start oftest: 30 MIN 30 MIN 30 MIN 30 MIN Test Start Time (Tj): 10:00 10:00 10:00 10:00 Initial Reading (Rj): 12" 12" 12" 12" Test End Time (TF): 11:00 11:00 11:00 11 :00 Final Reading (RF): 12" 12" 12" 12" Test Duration (TF — Ti): 60 MIN 60 MIN 60 MIN 60 MIN Change in Reading (RF - Ri): 0 0 0 0 Pass/Fail Threshold or Criteria: 0.00 0.00 0.00 0.00 Test Result: X Pass Fail X Pass Fail X Pass Fail X Pass 0 Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed 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: 5/28/13 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. 5 W56 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: GOSFORD SHELL FACILITY ADDRESS: 4050 GOSFORD RD. BAKERSFIELD PRODUCT LINE TYPE: PRESSURE PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL REG87 L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # 150749 PREM91 L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # 150747 DIESEL L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # 210783 L/D TYPE YES PASS SERIAL # NO 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: RICHARD MASON SIGNATURE: / DATE: 5/28/13 If IN -TANK SETUP T 1:B7 -1 PRODUCT CODE 1 THERMAL COEFF :.000700 TANK DIAMETER - 92.00 TANK PROFILE 1 PT FULL VOL 11627 FLOAT SIZE: 4.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 WATER ALARM FILTER: LOW MAX OR LABEL VOL: 11627 OVERFILL LIMIT 90% 10464 HIGH PRODUCT 95% 11045 DELIVERY LIMIT 15% 1744 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOS'S LIMIT: 50 TANK TILT 3.75 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS T #: 02 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 3 MIN PUMP THRESHOLD : 10.00% COMMUNICATIONS SETUP PORT SETTINGS: COMM BOARD 1 (FXMOD) BAUD RATE 2400 PARITY ODD STOP BIT I STOP DATA LENGTH: 7 DATA RS -232 SECURITYCODE : DISABLED DIAL TYPE TONE ANSWER ON 1 RING MODEM SETUP STRING DIAL TONE INTERVAL: 32 COMM BOARD : 2 (EDIM ) RS -232 SECURITY CODE : DISABLED COMM BOARD 3 (RS -232) BAUD RATE 9600 PARITY NONE STOP BIT 2 STOP DATA LENGTH: 8 DATA RS -232 SECURITY CODE : DISABLED AUTO TRANSMIT SETTINGS: AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMITDISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EXTERNAL INPUT OFFDISABLED AUTO SENSOR FUEL ALARMDISABLED . AUTO SENSOR WATER ALARMDISABLED AUTO SENSOR OUT ALARM DISABLED RECEIVER SETUP: NONE 5ll )b SYSTEM SETUP MAY 28, 2013 8:58 AM SYSTEM UNITS U.S. ` SYSTEM LANGUAGE ENGLISH SYSTEM DATE /TIME FORMAT MON DD YYYY HH:MM:SS xM GOSFORD SHELL 4050 GOSFORD RD BAKERSFIELD CA SHIFT TIME 1 5:00 AM SHIFT TIME 2 DISABLED SHIFT TIME 3 DISABLED SHIFT TIME 4 DISABLED TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED LINE RE- ENABLE METHOD PASS LINE TEST LINE PER TST NEEDED WRN DISABLED LINE ANN TST NEEDED WRN DISABLED PRINT TC VOLUMES ENABLED TEMP COMPENSATION VALUE (DEG F ): 60.0 STICK HEIGHT OFFSET DISABLED ULLAGE: 90% H- PROTOCOL DATA FORMAT HEIGHT PRECISION TEST DURATION HOURS: 12 DAYLIGHT SAVING TIME ENABLED START DATE APR WEEK, 1' SUN START .TIME ... . 2:00 AM END DATE OCT WEEK 6 SUN END TIME 2:00 AM RE- DIRECT LOCAL PRINTOUT DISABLED EURO PROTOCOL PREFIX S SYSTEM SECURITY CODE : 000000 MAINTENANCE HISTORY T 4:DIESEL PRODUCT CODE 4 THERMAL COEFF :.000450 TANY DIAMETER 92.00 TANK PROFILE 1 PT FULL VOL 9728 FLOAT SIZE: 4.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 WATER ALARM FILTER: LOW MAX OR LABEL VOL: 9728 OVERFILL LIMIT 90% 8755 HIGH PRODUCT 95% 9241 DELIVERY LIMIT 14% 1361 LOW PRODUCT 500 LEAK. ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 0,91 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS Tit: NONE LINE MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 1 972 LEAK MIN ANNUAL 10% 972 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED•- PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED APd14 TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 3 MIN PUMP THRESHOLD 10.00% T 3:91 PRODUCT CODE 3THERMALCOEFF000700TANKDIAMETER92,00TANKPROFILE1PTFULLVOL9728 J %«u 2:87 -2 PRODUCT CODE THERMAL COEFF .00070'1 TANK DIAMETER 92.0'1 TANK PROFILE 1 P• FULL VOL 9721 FLOAT SIZE: 4,0 IN, FLOAT SIZE: 4.0 IN WATER WARNING 2.0 WATER WARNING 2.( HIGH WATER LIMIT: 3.0 HIGH WATER LIMIT: 3.( WATER ALARM FILTER: LOW WATER ALARM FILTER: L06 MAX OR LABEL VOL: 9728 MAY OR LABEL VOL: 972E OVERFILL LIMIT 90% OVERFILL LIMIT 90/. 8755 8755 HIGH PRODUCT 95% HIGH PRODUCT 95% 9241 9241 DELIVERY LIMIT 141 DELIVERY LIMIT 14% 1367 1361 LOW PRODUCT 500 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 SUDDEN LOSS LIMIT: 50 TANK TILT 2.19 TANK TILT 2.29 PROBE OFFSET 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKSTO: NONE LINE MANIFOLDED TANKSTO: NONE LEAK MIN PERIODIC: IO% 972 LEAK MIN ANNUAL 10% 972 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 PNK TST SIPHON BREAK:OFF ELIVERY DELAY 3 MINUMPTHRESHOLD10.00/ SIPHON MANIFOLDED TANKS Tit: NONE LINE MANIFOLDED TANKS Tit: 01 LEAK. MIN PERIODIC: 101 972 LEAK MIN ANNUAL 10% 972 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 3 MIDI PUMP THRESHOLD 10.00% RI- STATE (SINGLE FLOAT) ATEGOR`! : STP SUMP 2:87 -2 STP RI -STATE (SINGLE FLOAT) ATEGORY : STP SUMP 3 :91 STP R 1 -STATE ( SINGLE FLOAT) ATEGOkY : STP SUMP 4:DIESEL STP RI -STATE (SI•.NGL£ FLOAT) ATEGORY : STP SUMP 5:87 -1 FILL RI -STATE (SINGLE FLOAT) ATEGORY : OTHER SENSORS 6:67-2 FILL RI -STATE (SINGLE FLOAT) Ai'EGORY : OTHER SENSORS 7 :91 FILL RI -STATE (SINGLE FLOAT) ATEGORY : OTHER SENSORS 8:DSL FILL RI -STATE (SINGLE FLOAT) ATEGORY : OTHER SENSORS 9 :67-1 ANN RI -STATE (SINGLE FLOAT) ATEGORY : ANNULAR SPACE 10:87 -2 ANN RI -STATE (SINGLE FLOAT) ATEGOP.Y : ANNULAR SPACE 11:91 ANN RI -STATE (SINGLE FLOAT) ATEGORY : ANNULAR SPACE 12:DSL ANN RI -STATE (SINGLE FLOAT) ATEGORY : ANNULAR SPACE 13:DISP 1 -2 RI -STATE (SINGLE FLOAT) ATEGOR`. : DISPENSER PAN 14 :DISP 3 -4 RI -STATE (SINGLE FLOAT) ATEGORY.: DISPENSER PAN 15:DISP 5 -6 RI -STATE (SINGLE FLOAT) ATEGORY : DISPENSER PAN A 3:DIESEL TYP :2.0/3.OIN FIBERGLASS 2.0IN DIA LEN: 200 FEET 3:0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI T 4 :DIESEL DISPENSE MODE: STANDARD SENSOR' NON- VENTED PRESSURE OFFSET: 0 OPSI MECHANICAL BLENDER: NO LINE LEAK LOCKOUT SETUP LOCKOUT SCHEDULE DAILY START TIME: DISABLED STOP TIME : DISABLED ALARM HISTOPY REPORT SENSOR ALARM L16:DISP 7-8DISPENSERPAN SENSOR OUT ALARM MAY 26. 2013 10 :46 AM FUEL ALARM MAY 28, 2013 10 :21 AM SENSOR OUT ALARM JUN 4,..2012 10:25 AM LEAK TEST METHOD TEST WEEKLY ALL TA14K MON START TIME DISABLED TEST RATE 0.20 GAL /HR DURATION 2 HOURS TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT i NORMAL PRESSURE LINE LEAK SETUP TYP:2.0i3.0IN FIBERGLASS 2.0IN DIA LEN: 400 FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI T 1:67 -1 DISPENSE MODE: MANIFOLDED: ALTERNATE SENSOR: NON- VENTED PRESSURE OFFSET: O.OPS1 MECHANICAL BLENDER: 140 Q 2:91 TYP :2.0:3.0IN FIBERGLASS 2.01N DIA LEN: 200 FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE : 0 PSI T'3:91 DISPENSE MODE: STANDARD SENSOR: NON- VENTED PRESSURE OFFSET: 0.0PSI MECHANICAL BLENDER: NO 5 k%D o ti j t\.,.:)a RS -232 END OF MESSAGE DISABLED AUTO DIAL ALARM SETUP SOFTWARE REVISION LEVEL VERSION 332.00 SOFTWARE# 346332 -100 -A CREATED - 11.05.27.16.12 EVR /ISD SETUP PLLD LINE DISABLE BE S- MODULEO 330160 -004 -a Q 1:87SYSTEMFEATURES: PERIODIC IN -TANK TESTS ANNUAL. IN -TANK TESTS EVR TYPE: VACUUM ASSIST VACUUM ASSIST TYPE IN -TANK ALARMS ISD:APM HEALY VAC T !:HIGH WATER ALARM T !:LOW PRODUCT ALARM, NOZZLE A/L RANGE MAX: 1.15 MIN: 0.95 LIQUID SENSOARMLMS VAPOR PROCESSOR TYPE L 2:FUEL ALARM NONE L13:FUEL ALARM L1,4:FEL ALARM L15 :FUEL ALARM St%RTSENSOR SETUP ANALYSIS TIMES L16:FUEL ALARM TIME: 10:00 AM L I:SENSOR OUT ALARM DELAY MINUTES: 1 L 2:SENSOR OUT ALARM. s 1:DISp'.j -2 FMCATEGORY °:.• L13:SENSOR OUT ALARM L14:SENSOR OUT ALARM FLOW L15:SENSOR OUT ALARMAIRMETERACCEPTHIGHORVR: s 3:DISP 5 -8 ,MCATEGORY ENABLED L16:SENSOR OUT ALARM AIR FLOW METER ISD HOSE TABLE ISD SITE ALARMS s q ;DISP 7 -8 FMCgTEG{yRy. ID FP_yFI:_ HL- AA- RR ISD GROSS PRES FAIL ISD DEGRD PRES FAILAIRFL ©W METER O1 tai 01 02 O1 00 ISD VAPOR LEAK FAIL s 5: DISP $ -6 PSCATEG{yRy VAPOR s 02 lit 02 02 O1 00 03 03= 03 02 02 00 ISD HOSE ALARMS PRESSU 6 :DISP 3_q 04 04 04 02 02 00 02 Q3 00 ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL' CATEGORY Fly AIR Plow 05 05 05 06 06 06 02 03 00 METER,.. .' 07 07 07 02 04 00 G 2:91 08 08 fle 02 04 00 IN -TANK ALARMS T 3:HIGH WATER ALARM ISD AIRFLOW METER MAP T 3:LOW PRODUCT ALARM ID SERIAL NUM ABEL_.__._.,., -: LIOUID SENSOR ALMS r1 12173 - DISP 1 -2 F L 3:FUEL ALARM 2 55252 DISP 3 -4 F L13:FUEL ALARM 3 12182 DISP 5 -6 F L14:FUEL ALARM 4 10965 DISP 7 -8 F L15:FUEL ALARM OUTPUT RELAY SETUP L16:FUEL ALARM L 3:SENSOR OUT ALARM ISD FUEL GRADE. MAP L14: SENSORR1:87 - 2 STP 4SE 1 2 3 4 OUT ALARM TYPE: FP MHH MHH MHH MHH AA L15:SEPISOR OUT ALARM PUMP CONTROL OUTPUT L16:SENSOR OUT ALARM TANK. 0: 2 O1 2D1 101 901 U U I U 1 ISD SITE ALARMS02202902102U 03 203 103 903 3 U 2 ISD GROSS PRES FAIL IN —TANK ALARMS 104.204 904..3 U 2 ISD DEGRD PRES FAIL T 2:HIGH WATER ALARM 04 205 105.905 U U• 3 ISD VAPOR'LEAK FAIL T 2:LOW PRODUCT ALARM 05 06-206 106-906 U U 3 07 207 107 907 3 U 4 ISD HOSE ALARMS LIQUID SENSOR ALMS 08.208 108 908 3 U i4 ALL :GROSS COLLECT FAIL L !:FUEL ALARM ALL:DEGRD.COLLECT FAIL L 2:FUEL ALARM L13:FUEL ALARM LABEL TABLE A'3:DIESEL L14:FUEL ALARM L15:FUEL ALARM 1 UNASSIGNED• IN —TANK ALARMS L16:FUEL ALARM 2: BLEND3 T 4:HIGH WATER ALARM L !:SENSOR OUT ALARM 3: REGULAR T 4:LOW PRODUCT ALARM L 2:SENS6R OUT ALARM q: MID GRADE L13:SENSOR OUT ALARM 5: PREMIUM LIQUID SENSOR ALMS L14:SENSOR OUT ALARM 6: GOLD L 4:FUEL ALARM L15- SENSOR OUT ALARM 7: BRONZE L14:FUEL ALARM L16:SENSOR OUT ALARM 8: SILVER L16:FUEL ALARM 9: BLEND2 L14: SENSOR ALARMPRESSURELINELEAK10: BLEND4 OUT Q !:GROSS LINE FAIL L16:SENSOR OUT ALARM h M ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HJSTOR'l REPORT SENSOR ALARM - - - -- SENSOR ALARM - - - -- SENSOR ALARM - - - -- L 4:DIESEL STP L 1:87 -1 STP L 7 :92 FILL STP SUMP STP SUMP OTHER SENSORS SENSOR OUT ALARM SENSOR OUT ALARM SENSOR OUT ALARM MAY 28, 2013 10:46 AM MAY 28, 2013 10:46 AM MAY 28, 2013 10:46 AM FUEL ALARM FUEL ALARM FUEL ALARM MAY 28, 2013 9:51 AM MAY 28. 2013 10:08 AM MAY 25. 2013 10:00 All SENSOR OUT ALARM SENSOR OUT ALARM SENSOR OUT AIj-iRM JUN 4, 2012 10:29 AM JUN 4, 2012 10:29 All JUN 4, 2012 10 :29 AM FUEL ALARM SENSOR OUT ALARM x x x w x END * x oi x x R X x X x END ;* X)k x f* x n END *i x n x x x x x X END A* w x x 0 x x* END X x X A A xx w ENDk * xxX ALARM HISTORY REPORT SENSOR ALARM - - --- L 9 :87 -1 ANN ANNULAR SPACE SENSOR OUT ALARMMAY28. 2013 10:46 AM FUEL ALARM MAY 28, 2013 9:45 AM SENSOR OUT ALARM711IJA .no ALARM HISTORY REPORT SENSOR ALARM - - -- L 6:87 -2 FILL OTHER SENSORS SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 10:02 AM SENSOR OUT ALARM JUN 4, 2012 10:29 All ALARM HISTORY REPORT SENSOR ALARM - -- L 3:91 STP STP SUMP SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 9:57 AM SENSOR OUT ALARM JUN 4. 2012 10:29 AM 4. ALARM HISTORY REPORT ALA1.M HISTORY REPORT ALARM HISTORY REPORT SENSOR ALARM - - - -- SENSOR ALARM SENSOR ALARM ___.._ L 5:87 -1 FILL L 2:67 -2 STP L 8:DSL FILL OTHER SENSORS STP SUMP OTHER SE14BORS SENSOR OUT ALARM SENSOR OUT ALARM SENSOR OUT ALARM MAY 28, 2013 10:46 AM MAY 28, 2013 10:46 All MAY 28, 2013 10:46 AM FUEL ALARM FUEL ALARM FUEL ALARM MAY 28, 2013 9:58 AM MAY 28, 2013 9:57 AM MAY 28, 2013 10:06 AM FUEL ALARM SENSOR OUT ALARM SENSOR OUT ALARM MAY 24, 2013 1:54 P'll JUN 4. 2012 10:29 AM JUN 4. 2012 10:29 AM x x x x X END A* w x x 0 x x* END X x X A A xx w ENDk * xxX ALARM HISTORY REPORT SENSOR ALARM - - --- L 9 :87 -1 ANN ANNULAR SPACE SENSOR OUT ALARMMAY28. 2013 10:46 AM FUEL ALARM MAY 28, 2013 9:45 AM SENSOR OUT ALARM711IJA .no ALARM HISTORY REPORT SENSOR ALARM - - -- L 6:87 -2 FILL OTHER SENSORS SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 10:02 AM SENSOR OUT ALARM JUN 4, 2012 10:29 All ALARM HISTORY REPORT SENSOR ALARM - -- L 3:91 STP STP SUMP SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 9:57 AM SENSOR OUT ALARM JUN 4. 2012 10:29 AM 4. 4y, ., AL 2p pAjL ! 6" ON/v yM 2DCWh qM MLLr Sy /'? FL Q /y /R 0: i V 6 h TLO `I yryrjlyv .: yTbiw/ 16,71li/y O/ 3 9 r, R/ sy r C Vb /4/7O/ /v s5Riy 2M 9/7 ALARM • HISTORY REPORT92:91 SENg0)? A hyDH[ITDOwNMg28, 2013 gy , 1L4Q AMcRseHAY28LIEFAIL p1p 11 .4Q qHpLLDMAY2 , HUTDOWN2>,13 IpLAI, HA/ .28, N fiLA 3 1 G: 2 y r °r BhU2pOWN A 1;1,11Q: 25 ArypLLDSHrrAY28° U20 1 L RPgMpLLL HAY 28.. H21QDt,3N gLARH1p;1s ryaY 2gHprrd gLARH2G 5:57 AMpLLD 201a 10:02 Ah) HAFr,H a3P10: 02 Ary ALARM HISTORY REPORT SENSOR ALARM - - - -- L13:DISP 1 -2 DISPENSER PAN SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28. 2013 10:25 AM SENSOR OUT ALARM JUN 4, 2012 10:25 AM x 0 x* x END x x X X x ALARM HISTORY REPORT SENSOR ALARM L14:DISP 3 -4 DISPENSER PAN SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 10:29 W SENSOR OUT ALARM JUN 4. 2012 10:25 AM x** t* END * A* A x ALARM HISTORY REPORT SENSOR ALARM - - -- L15:DISP 5 -6 DISPENSER PAN SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 10:16 AM SENSOR OUT ALARM JUN 4, 2012 10:25 AM Z;) t%7) a ALARM HISTORY REPORT SENSOR ALARM - -- - L10:87-2 ANN ANNULAR SPACE SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 9:44 AM SENSOR OUT ALARM- JUN 4. 2012 10:25 W x Ot x r E 111D * x* x h ALARM HISTORY REPORT SENSOR. ALARM - - - -- L11:91 ANN ANNULAR SPWrE SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28. 2013 9:44 AM SENSOR OUT ALARM JUN 4. 2012 10:25 AM x x A x X END * X X X A ALARM HISTORY REPORT SENSOR ALARM - - - -- L12:DSL ANN ANNULAR SPACE SENSOR OUT ALARM MAY 28, 2013 10:46 AM FUEL ALARM MAY 28, 2013 9:44 AM SENSOR OUT ALARM JUN 4. 9M9 in:q am ALARM HISTORY REPORT SENSOR ALARM - - - -- 0 3:DIESEL PLLD SHUTDOWN ALARM MAY 28, 2013 11:44 AM GROSS LINE FAIL MAY 28. 2013 11:44 AM PLLD SHUTDOWN ALARM MAY 28. 2013 10:46 AM PLLD SHUTDOWN ALARM MAY 28. 2013 10:29 AM PLLD SHUTDOWN ALARM MAY 2$. 2013 10:21 AM PL1.0 SHUTDOWN ALAR'l MAY 28, 2013 9:51 All PLLD SHUTDOWN ALARM JUN 4. 2012 11:06 AM GROSS LINE FAIL JUN 4. 2012 11:06 AM PLLD SHUTDOWN ALARM JUN 4, 2012 10:25 AM PLLD SHUTDOWN ALARM JUN 4. 2012.10:11 AM 511:50 7 1 MONITOR CERT. FAILURE REPORT SITE NAME: GOSFORD SHELL DATE : 5/28/13 ADDRESS: 4050 GOSFORD ROAD TECHNICIAN: RICHARD MASON CITY: BAKERSFIELD SIGNATURE: THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: I REMOVED SMALL AMOUNT OF WATER IN DSL STP SUMP, 87 TANK I FILL SUMP AND DISP #3/4 LABOR: PARTS INSTALLED 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.