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Home My WebLink AboutFMC 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. az6=3SS-5 File Number: f2 K Address: -5-3 z I S(oc Bakersfield, CA 933 Date Received: r„- i3 _ Business Name: S oc << SYSTEM: IF BUILDING SQUARE FEET: INSPECTION LOG New Mod. Commercial Hood System Fire Alarm System Fire Sprinkler System Spray FiNsh System Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank Ga' Other. f-w C-1 Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: 1. 2. 3. 4. natp Timp Signature 1 %.— MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifornia 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 certification or report must be nrenared 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: STOCKDALE FOODMART Bldg. No.: Site Address: 5321 STOCKDALE HWY City: BAKERSFIELD Zip: Facility Contact Person: FONIG CHAO Make/Model ofMonitoring System: TLS -350 B. Inventory of Equipment Teste&Certified Check the appro riate boxes to indicatespecific equipment inspected/serviced: Contact Phone No.: ( ) Date of Testing/Servicing: 81271201 3 Tank ID: UNL87 Tank ID: PREM91 In -Tank Gauging Probe. Model: MAG In -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor. Model: 420/463 Annular Space or Vault Sensor. Model: 420/463 Piping Sump / Trench Sensor(s). Model: 2081304 Piping Sump / Trench Senors). Model: 2081304 Fill Sump Sensor(s). Model: 2081304 Fill Sump Sensor(s). Model: 2081304 Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: VEEDER -ROOT Electronic Line Leak Detector. Model: VEEDER -ROOT Tank Overfill / High -Level Sensor. Model: GOA Tank Overfill / High -Level Sensor. Model: GOA 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: DIESEL Tank ID: VENT BOX In -Tank Gauging Probe, Model: MAG In -Tank Gauging Probe. Model: Annular Space or Vault Sensor. Model: 4021463 Annular Space or Vault Sensor. Model: Piping Sump / Trench Sensor(s). Model: 2081304 Piping Sump / Trench Sensor(s). Model: 2081304 Fill Sump Sensor(s). Model: 208/304 Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: VEEDER -ROOT Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: GOA 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: 112 Dispenser ID: 314 Dispenser Containment Sensor(s). Model: 2081304 Dispenser Containment Sensor(s). Model: 2081304 Shear Valve(s). 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: 208/304 Dispenser Containment Sensor(s). Model: 2081304 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 9110 Dispenser ID: Dispenser Containment Sensor(s). Model: 208/304 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: r Certification No.: B3688015297857 -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 of Testing/Servicing: 8/27/2013 Page 1 of 5 UN- 036 -1/4 www.unidocaorg Rev. 01 /17/08 Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: 330.02 rmmnlete the Mllnwina Apeklict! Yes No* Is the audible alarm operational? IR 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 ofsecondary 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 an sensor failure /disconnection? IS Yes; No. Yes p 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 of tank capacity does the alarm trigger? 90% 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. Ifyes, 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 1 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) 91 SPILL BUCKET FAILED LAKE TEST. DRAIN WAS CLOGGED, I CLEANED AND RETESTED - PASSED Page 2 of 5 UN-036 — 2/4 www.unidocs.org Rev. 01 /17/08 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 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 fnllnwino Apeklict! Check this box ifLLDs 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 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 ifany portion ofthe 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.unidocs.org Rev. 01/17/08 r. V V i. f- I is IF i 0 v 4 -4 t v 4. • a I t a :4 1 k V .0 a a A -0 j 8 a w 4 1 'r 'i CL X I A jw .1 L + s i it t;!• a a t:flK "A- 4 V • 4 I q L a - W- 5, A' 4k. -8 a .4 9 6 It ' -I k 'I v jv 4 a 14-4 i i i: .i - j, IF. h: s At 4. r -F t -1 • v v I , T, 1p <K 0 1. ilr41I1r4w ' k B Ir g 1 .4 r it f. r X t L it A w I F"a 4 -C.1,4 ri 1 .14 • -p A Ijr ;k it Al 1 0 It ort ,r1 a-6 W --;,Ljr a A-4 4 I kA ft jr- :k zk i k t iL a - v -7jIM a 4; A' 14•'1 lk I a • it 9 1 it 14 C'! "1 .04. • -0, % W.- •" Ot I -P,A,.A A IL A zo 't tip I'L t AL Y a f a I • A. 4- I or. -A • it 4 -k d T-W k if.p .1 .4 1 4 kl' 10 k t c A • or •0. if, -$- 'vx --p i s IA .1 11 IP *A • 1 '1--f I. J. 0 1 4 R A 1 40 .11 fA • t • Y f* -I. v j 9 4. 0j 4L 4t ;C it. -4 • wit fl, 41 4 k a 4, Ir J S'11 1 0 1 r• A • f a a! s a -0 a 4 1 s a 19 RICHENVIRONMENTAL 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: STOCKDALE FOODMART FACILITY ADDRESS: 5321 STOCKDALE HWY, 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 L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # ELECTRONIC 91 L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # ELECTRONIC DIESEL L/D TYPE: VEEDER -ROOT YES 0 PASS SERIAL # ELECTRONIC 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: 71/ DATE: 8127/13 r SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and printoutsfrom tests (ifapplicable), shouldbeprovided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: STOCKDALE FOODMART Date ofTesting: 8/27/13 Facility Address: 5321 STOCKDALE HWY, BAKERSFIELD Facility Contact: FONIG CHAD I Phone: Date Local Agency Was Notified of Testing: 7/9/13 Name of Local Agency Inspector (fpresent during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: RICHARD MASON Credentials': CSLB Contractor X ]CC Service Tech. 0 SWRCB Tank Tester Other (Specify) License Number(s): 5297857 -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic 0 Vacuum Other Test Equipment Used: VISUAL Equipment Resolution: 0 Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 87 2 91 3 DIESEL 4 91 RE -TEST Bucket Installation Type: 0 Direct Bury X Contained in Sump Direct Bury X Contained in Sump 0 Direct Bury X Contained in Sump Direct Bury X Contained in Sum Bucket Diameter: 12" 12" 12" 1299 Bucket Depth: 14" 14" 14" 14" Wait time between applying vacuum /water and start of test: 30MIN 30MIN 30MIN 30MIN Test Start Time (Tj): 9:00 9:00 9:00 9:30 Initial Reading (111): 14" 5" 14" 14" Test End Time (TF): 10:00 10:00 10:00 10:30 Final Reading (RF): 14" 0" 14" 14" Test Duration (TF — Tj): 60MIN 60MIN 60MIN 60MIN Change in Reading (RF - Ri): 0 5" 0 0 Pass/Fail Threshold or Criteria: 0.00 0.00 0-00 0.00 Test Result: X Pass 0 Fail Pass X Fail X Pass 0 Fail X Pass 0 Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) 91 SPILL BUCKET FAILED LAKE TEST. I CLEANED DRAIN. RETESTED - PASSED CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certJ& that all the information contained in this report is true, accurate, and infull compliance with legal requirements. Technician's Signature: Date: 8/27/13 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. IN -TANK SETUP COMMUNICATIONS SETUP SYSTEM SETUP T 1:87 AUG 27, 2013 9:46 AM PRODUCT CODE 1 PORT SETTINGS: THERMAL COEFF :.000700 TANK DIAMETER 113.75 COMM BOARD : 1 (EDIM } TANK PROFILE I PT RS -232 SECURITY SYSTEM UNITS FULL VOL 15022 CODE : DISABLED U.S. SYSTEM LANGUAGE COMM BOARD : 2 (RS -232) ENGLISH FLOAT SIZE: 3.0 IN. BAUD RATE : 1200 SYSTEM DATE /TIME FORMAT PARITY : ODD MON DD YYYY HH:MM:SS xM WATER WARNING : 2.0 STOP BIT : 1 STOP HIGH WATER LIMIT: 3.0 DATA LENGTH: 7 DATA STOCKDALE FOOD MART RS -232 SECURITY 5321 STOCKDALE HWY MAX OR LABEL VOL: 15022 CODE : DISABLED BAKERSFIELD CA 93309 OVERFILL LIMIT : 720% 10615 COMM BOARD 3 (FXMOD) HIGH PRODUCT 76% BAUD RATE : 2400 SHIFT TIME 1 DISABLED 11 PARITY ODD SHIFT TIME 2 : DISABLED DELIVERY LIMIT STOP BIT 1 STOP SHIFT TIME 3 DISABLED 1502 DATA LENGTH: 7 DATA SHIFT TIME 4 DISABLED SECURITY LOW PRODUCT 500 CODE : CODE DISABLED TANK PER TST NEEDED WRN LEAK ALARM LIMIT: 99 DIAL TYPE : TONE DISABLED SUDDEN LOSS LIMIT: 50 ANSWER ON : 1 RING TANK ANN TST NEEDED WRN TANK TILT 0.00 MODEM SETUP STRING : DISABLED PROBE OFFSET 0.00 DIAL TONE INTERVAL: 32 LINE RE- ENABLE METHOD PASS LINE TEST SIPHON MANIFOLDED TANKS TO: NONE AUTO TRANSMIT SETTINGS: LINE PER TST NEEDED WRN LINE MANIFOLDED TANKS DISABLED TO: NONE AUTO LEAK ALARM LIMIT DINE ANN TST NEEDED WRN DISABLED AUTO HIGH WATER LIMIT LEAK MIN PERIODIC: DISABLED PRINT TC VOLUMES 1502 AUTO OVERFILL LIMIT ENABLED DISABLED LEAK MIN ANNUAL : 10% AUTO LOW PRODUCT TEMP COMPENSATION 1502 DISABLED VALUE (DEG F ): 60.0 AUTO THEFT LIMIT STICK HEIGHT OFFSET DISABLED DISABLED PERIODIC TEST TYPE AUTO DELIVERY START ULLAGE: 90% STHNDARD DISABLED AUTO DELIVERY END H- PROTOCOL DATA FORMAT ANNUAL TEST FAIL DISABLED HEIGHT ALARM DISABLED AUTO EXTERNAL INPUT ON PRECISION TEST DURATION DISABLED PERIODIC TEST FAIL AUTO EXTERNAL INPUT OFF DAYLIGHT SAVING TIME ALARM DISABLED DISABLED ENABLED AUTO SENSOR FUEL ALARM START DATE GROSS TEST FAIL DISABLED APR WEEK 1 SUN ALARM DISABLED AUTO SENSOR WATER ALARM START TIME DISABLED 2:00 AM ANN TEST AVERAGING: OFF AUTO SENSOR OUT ALARM END DATE PER TEST AVERAGING: 'OFF DISABLED OCT WEEK 6 SUN END TIME TANK TEST NOTIFY: OFF 2 :00 AM TNK TST SIPHON BREAK:OFF RE- DIRECT LOCAL PRINTOUT DISABLED DELIVERY DELAY : 15 MIN' RECEIVER SETUP: PUMP THRESHOLD : 10.00% EURO PROTOCOL PREFIX NONE S SYSTEM SECURITY CODE : 000000 MAINTENANCE HISTORY DISABLED LEAK 'PEST METHOD TEST ANNUALLY: ALL TANK DEC WEEK 1 2SUN AMSTARTTIME DURATION :0220NAL/HR TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT PRESSURE LINE LEAK SETUP A 1:87 2YOIN• DIA F LEN: 120R B FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUT40 : NO LOW PRESSURE PSI T 1-87 DISPENSE MODE: STANDARD SENSOR: NON— VENTED PRESSURE OFFSET: O.OPSI MECHANICAL BLENDER: NO A 2:91 TYP :2.0/3.0IN FIBERGLASS 2.0IN DIA LEN: 120 FEET 3.0IN DIA LEN: 0 FEET SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF :NO LOW PRESSURE T. 2:91 DISPENSE MODE: STANDARD SENSOR: NON— VENTED PRESSURE OFFSET: O.OPSI MECHANICAL BLENDER: NO T 3:DIESEL PRODUCT CODE 3 THERMAL COEFF 000450 TANK DIAMETER 113.75 TANK PROFILE 1 PT FULL VOL 7070 FLOAT SIZE: 3.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 7070 OVERFILL LIMIT 90% 6363 HIGH PRODUCT 95% 6716 DELIVERY LIMIT : 10% 707 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS TO: NONE LINE MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 10% 707 LEAK MIN ANNUAL 10%b 707 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% 0 % L -0- r T 2:91 2.0 PRODUCT CODE 2 THERMAL COEFF 000700 TANK DIAMETER 113.75 TANK PROFILE i PT FULL Vol. 804'2' FLOAT SIZE: 3.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 8042 OVERFILL LIMIT : 90% 7237 HIGH PRODUCT 95% 7639 DELIVERY LIMIT : 10% 804 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS Tit: NONE LINE MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 1(?n 804 LEAK MIN ANNUAL : 10% 804 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 10.001a PLLD LINE DISABLE SETUP Q 1:87 LIQUID SENSOR ALMS L 1:FUEL ALARM L 9:FUEL ALARM L15 :FUEL ALARM L 17 :.FUEL ALARM L19:FUEL ALARM L21:FUEL ALARM L23:FUEL ALARM L 1:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L15:SENSOR OUT ALARM L17:SENSOR OUT ALARM L 19 : S'ENSOR OUT ALARM L21 :SENSOR OUT ALARM L23 :SENSOR OUT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRE$ FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL Q 2:91 LIQUID SENSOR ALMS L 3:FUEL ALARM L15-FUEL ALARM L17:FUEL ALARM L19-FUEL ALARM L21:FUEL ALARM L23 :FUEL ALARM L W SENSOR OUT ALARM L15:SENSOR OUT ALARM L17:SENSOR OUT ALARM L19 :SENSOR OUT ALARM 1.21:8ENOOR OUT ALARM L23: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 SETUP FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL Q 3:DIEBEL LIQUID SENSOR ALMS L 5:FUEL ALARM L13:FUEL ALARM L19:FUEL ALARM L23:FUEL ALARM L 5 :SENSOR OUT ALARM L M SENSOR OUT ALARM L19:SENSOR OUT ALARM L23 :SENSOR OUT ALARM L13 :DIESEL FILL TRI -STATE (SINGLE FLOAT) CATEGORY : PIPING SUMP LIQUID SENSOR SETUP L W DIESEL FILL ANNTRI -STATE TRI. -STATE STP SINGLE FLOAT) SINGLE FLOAT)* CATEGORY : ANNULAR SPACE STP SUMP L 2:87 STP ANN L15:DISP 1 -2 TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACETRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L 3:91 STP L16:DISP 1-2 ANN TRI -STATE (SINGLE FLOAT) CATEGORY STP SUMPTRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 4:91 STP ANN TRI -STATE (SINGLE FLOAT) L17:DISP 3 -4 CATEGORY : ANNULAR SPACE TRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L 5:DIESEL STP TRI-STATE (SINGLE FLOAT) L18:DISP 3 -4 ANN CATEGORY : STP SUMP TRI -STATE (SINGLE FLOAT) . CATEGORY : ANNULAR SPACE L 6:DIESEL STP ANN TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE LI9 :DISP 5 -6 TRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L 7:VENT TRI -STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS L20:DISP 5 -6 ANNTRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 8:VENT ANN TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L21:DISP 7 -8 TRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L 9:87 FILL TRI -STATE (SINGLE FLOAT) CATEGORY : PIPING SUMP L22:DISP 7 -8 ANNTRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L10:87 FILL ANN TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L23:DISP 9 -10 TRI -STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L11:91 FILL TRI -STATE (SINGLE FLOAT) CATEGORY : PIPING SUMP L24 :DISP 9 -10 ANNTRI -STATE (SINGLE FLOAT) L12:91 FILL ANN TRI -STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE CATEGORY : ANNULAR SPACE ALARM HISTORY REPORT SENSOR ALARM -- - -- L 1:87 STP STP SUMP SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM AUG 27. 2013 9:58 AM SENSOR OU•T ALARM AUG 27. 2012 2:58 PM xkxxx END X*x** ALARM HISTORY REPORT SENSOR ALARM - - - -- L 2:87 STP ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:28 AM SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2012 2:59 PM x * % x * END X * * * x ALARM HISTORY REPORT SENSOR ALARM - - - -- L 3:91 STP STP SUMP SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM AUG 27, 2013 10 :05 AM SENSOR OUT ALARM AUG 27, 2012 2:58 PM E•VR /ISD SETUP EVR TYPE: VACUUM ASSIST VACUUM ASSIST TYPE HEALY VAC NOZZLE A/L RANGE MAX: 1.15 MIN: 0.95 VAPOR PROCESSOR TYPE NONE ANALYSIS TIMES TIME: 9:59 AM DELAY MINUTES: 1 ACCEPT HIGH ORVR: ENABLED ISD HOSE TABLE NUM LABEL 1 ID FP FL HL AA RR 01 01 01 02 01 00 02 02 02 02 01 00 03 03 03 02 02 00 04 04 04 02 02 00 05 05 05 02 03 00 06 06 06 02 03 00 07 07 07 02 04 00 08 08 08 02 04 00 09 09 09 02 05 00 10 16 10 02 05 00 ISD AIRFLOW METER MAP ID SERIAL NUM LABEL 1 7-r1. ,7231 DISP 1 -2 F 2`51729 DISP 3 -4 F 3 50776 DISP 5 -6 F 4 7020 DISP 7 -8 F 5 58152 DISP 9 -10 ISD FUEL GRADE HOSE MAP 1 2 3 4 FP MHH MHH MHH MHH AA 01 101 901 201 U U 1 02 102 902 202 U U 1 03 103 903 203 U U 2 04 104 904 204 U U 2 05 105 905 205 3 U 3 06 106 906 206 3 U 3 07 107 907 207 U U 4 08 108 908 208 U U 4 09 109 909 209 3 U 5 15 110 910 210 3 U 5 LABEL TABLE 1: UNASSIGNED 2: BLEND 3 3: REGULAR 4: MID GRADE 5: PREMIUM 6: GOLD 7: BRONZE 8: SILVER 9: BLEND2 10: BLEND4 s 1:87 TANK ANN CATEGORY VAC SENSOR PUMP 13: A 1:87 VOLUME: 205.7 GALLONS RELIEF VALVE: : NO s 2 :87 VENT CATEGORY VAC SENSOR PUMP 0: A 1:87 VOLUME: 128.8 GALLONS RELIEF VALVE: : NO s 3:87 -91 VAPOR CATEGORY VAC SENSOR PUMP It : Q 1:87 VOLUME: 64.4 GALLONS RELIEF VALVE: : NO s 4:87 -PROD CATEGORY VAC SENOR PUMP 0: Q 1:87 VOLUME: 99.0 GALLONS RELIEF VALVE: : NO s 5:91 VENT CATEGORY VAC SENSOR PUMP 0: Q 291 VOLUME: 64.4 GALLONS RELIEF VALVE: : NO s 6:91 PROD CATEGORY VAC SENSOR PUMP 0: Q 2:91 VOLUME: 110.4 GALLONS RELIEF VALVE: : NO s 7:DIESEL -91 TANK ANN CATEGORY VAC SENSOR PUMP #: Q 3 :DIESEL VOLUME: 205.7 GALLONS RELIEF VALVE: : NO s 8:DIESEL PROD CATEGORY VAC SENSOR PUMP #: Q 3:DIESEL VOLUME: 110,4 GALLONS RELIEF VALVE: : NO s 9:DIESEL VENT CATEGORY VAC SENOR PUMP 1S: Q 3:DIESEL VOLUME: 64.4 GALLONS RELIEF VALVE: : NO s10:DISP 1 -2 FM CATEGORY AIR FLOW METER s11:DISP 3 -4 FM CATEGORY AIR FLOW METER 512 :DISP 5 -6 FM CATEGORY AIR FLOW METER s13:DISP 7 -8 FM CATEGORY AIR FLOW METER s14:DISP 9 -10 FM CATEGORY AIR FLOW METER s15:DISP 5 -6 VP CATEGORY VAPOR PRESSURE 516:ATM PRESS CATEGORY ATM P SENSOR L 0.0- ALARM HISTORY REPORT SENSOR ALARM L10:67 FILL ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:28 AM SENSOR OUT ALARM AUG 27, 2013 10 :16 AM FUEL ALARM AUG 27, 2012 2:59 PM xw * *x END ** *0* ALARM HISTORY REPORT SENSOR ALARM --- -- L11:91 FILL PIPING SUMP SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:06 AM SENSOR OUT ALARM AUG 27, 2012 2:58 PM END * * * * * ALARM HISTORY REPORT SENSOR ALARM -- L12:91 FILL ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:27 AM SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM n oo. 7nr3 12:39 PM ALARM HISTORY REPORT SENSOR ALARM -- L 7:VENT OTHER SENSORS FUEL ALARM AUG 27, 2013 10:33 AM SENSOR OUT ALARM AUG 27, 2013 10 :16 AM FUEL ALARM AUG 27. 2012 3 :05 PM END * * * * * ALARM HISTORY REPORT SENSOR ALARM - - - -- L B:VENT ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:33 AM SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2012 3:05 PM END * * * * * ALARM HISTORY REPORT SENSOR ALARM - - - -- L 9:87 FILL PIPING SUMP SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:07 AM SENSOR OUT ALARM AlIC 27. 2012 2:58 PM SENSOR ALARM - - - -- L 4:91 STP ANN ANNULAR SPACE FUEL ALARM AUG 27. 2013 10:27 AM SENSOR OUT ALARM AUG 27, 2013 10 :16 AM FUEL ALARM AUG 27, 2013 5:31 AM END **x** ALARM HISTORY REPORT SENSOR ALARM - - - -- L 5:DIESEL STP STP SUMP SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:01 AM SENSOR OUT ALARM AUG 27. 2012 2:58 PM x x * END * * * x * ALARM HISTORY REPORT SENSOR ALARM - - - -- L 6:DIESEL STP ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:26 AM SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM JAN 28, 2013 6:45 AM J1 l-.71-j ALARM HISTORY REPORT SENSOR ALARM ----- L19:DISP 5 -6 DISPENSER PAN SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:14 AM SENSOR OUT ALARM AUG 27. 2012 2:56 PM x x x x x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -_ L20:DISP 5 -6 ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:31 AM SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2012 2:59 PM x* x* END * x* x x ALARM HISTORY REPORT SENSOR ALARM -- L21:DISP 7 -8 DISPENSER PAN SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:14 AM SENSOR OUT ALARM Al lel 017. on t 9 P: 58 PM ALARM HISTORY REPORT SENSOR ALARM - - - -- L16:DISP 1 -2 ANN ANNULAR SPACE FUEL ALARM AUG 27. 2013 10:28 AM SENSOR OUT ALARM AUG 27. 2013 10:16 AM FUEL ALARM AUG 27. 2012 5:46 PM x x x x x END x x x x* ALARM HISTORY REPORT SENSOR ALARM - - - -- L17:DISP 3 -4 DISPENSER PAN. SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:12 AM SENSOR OUT ALARMAUG27. 2012 2:58 PM x x** x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L18:DISP 3 -4 ANN ANNULAR SPACE FUEL ALARM AUG 27, 2013 10:29 AM SENSOR OUT ALARMAUG27, 2013 10:16 AM FUEL ALARM Al h- oo nn I f . ao na ALARM HISTORY REPORT J! L ..r- SENSOR ALARM - - - -- L13:DIESEL FILL PIPING SUMP SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:03 AM SENSOR OUT ALARM AUG 27, 2012 2:56 PM x* x x x END x x x* x ALARM HISTORY REPORT SENSOR ALARM - - - -- L14 :DIESEL FILL ANN ANNULAR SPACE FUEL ALARM AUG 27. 2013 10:27 AM SENSOR OUT ALARM AUG 27. 2013 10:16 HM FUEL ALARM JUN 28. 2013 6:49 AM xxxx END xx *x'x ALARM HISTORY REPORT SENSOR ALARM - - - -- L15 *18P 1 -2 DISPENSER PAN SENSOR OUT ALARM AUG 27, 2013 10:16 AM FUEL ALARM AUG 27, 2013 10:10 AM SENSOR OUT ALARM ALARM HISTORY REPORT 51 [ SENSOR ALARM ALARM HISTORY REPORT 0 1:87 - - - -- SENSOR ALARM - - - -- PLLD SHUTDOWN ALARM L22:DISP 7 -8 ANNAUG27, 2013 11:36 AM ANNULAR SPACE FUEL ALARM GROSS LINE FAIL AUG 27. 2013 10:30 AM AUG 27. 2013 11:36 AM SENSOR OUT ALARM AUG 27. 2013 10:16 AM PLLD SHUTDOWN ALARM FUEL ALARMAUG27. 2013 10:16 AM AUG 27, 2012 2:59 PM PLLD SHUTDOWN ALARM AUG 27, 2013 10:14 AM PLLD SHUTDOWN ALARM AUG 27, 2013 10:14 AM ALARM HISTORY REPORT PLLD SHUTDOWN ALARM AUG 27, 2013 10:13 Aft END SENSOR ALARM - AUG 27, 2013 10:12 AM SENSOR ALARM - - - -- 0- 3:UIESEL PLLD SHUTDOWN ALARMPLLDSHUTDOWNALARMAUG27, 2013 10:12 AM FUEL ALARM AUG 27, 2013 11 :40 AM AUG 27. 2013 10:30 AM SENSOR OUT ALARM PLLD SHUTDOWN ALARM AUG 27. 2013 10:16 AM GROSS LINE FAIL AUGD27H 2O1133N10:1100 AMAUG27, 2013 11:40 AM PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARMAUG27. ALARM HISTORY REPORT AUG 27. 2013 10:16 AM 2013 10:07 AM SENSOR ALARM - - - -- PLLD SHUTDOWN ALARM DISPEINSER9PANPLLDSHUTDOWNALARMAUG27, AUG 27. 2013 9:58 AM SENSOR OUT ALARM201310:14 API AUG 27. 2013 10:16 AM PLLD SHUTDOWN ALARM ALARM HISTORY REPORT FUEL ALARM AUG 27. 2013 10:13 AM SENSOR ALARM - - - -- AUG 27, 2013 10:13 AM 0 2:91 SENSOR OUT ALARM PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARM AUG 27. 2012 2:58 PM AUG 27. 2013 10:03 AM AUG 27. 2013 11:38 AM PLLD SHUTDOWN ALARM GROSS LINE FAIL AUG 27. 2013 10.01 AM AUG 27. 2013 11:38 AM PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARM AUG 27. 2012 2:58 PM AUG 27, 2013 10 :16 AM x x x x END * x X w PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARM AUG 27, 2012 2:39 PM AUG 27. 2013 10:14 AM PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARM AUG 27, 2012 2:37 PM AUG 27, 2013 10:14 AM PLLD SHUTDOWN ALARM AUG 27, 2013 10:13 AM ALARM HISTORY REPORT PLLD SHUTDOWN ALARM AUG 27, 2013 10:12 AM SENSOR ALARM - - - -- L24:DISP 9 -10 ANN ANNULAR SPACE PLLD SHUTDOWN ALARM FUEL ALARM AUG 27, 2013 10:10 AM AUG 27. 2013 10:30 AM SENSOR OUT ALARM PLLD SHUTDOWN ALARM AUG 27. 2013 10:16 AM AUG 27. 2013 10:05 AM QFNRAT? Al T nr nnne ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 7:DIESEL -91 TANK ANN HIGH LIQUID ALARM AUG 27, 2013 11:07 AM NO VACUUM ALARM AUG 27. 2013 11:01 AM NO VACUUM ALARM f AUG 27. 2013 10:51 AM x x* x END x x x x x ALARM HISTORY REPORT SMARTSENSOR ALARM -- s B:DIESEL PROD HIGH LIQUID ALARM AUG 27. 2013 10:52'AM NO VACUUM ALARM AUG 27. 2013 10:52 AM VACUUM WARNING AUG 27. 2012 5:05 PM x x x ** END x x* x* ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 9:DIESEL VENT HIGH LIQUID ALARM AUG 27. 2013 10:52 AM NO VACUUM ALARM AUG 27. 2013 10:51 AM ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 4:87 -PROD HIGH LIQUID ALARM AUG 27,-2013 10:48 AM NO VACUUM ALARM AUG 27, 2013 10:46 AM COMMUNICATION ALARM AUG 27. 2012 5:32 PM X x* x x END ** x* x ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 5:91 VENT HIGH LIQUID ALARM AUG 27. 2013 10:55 AM NO VACUUM ALARM AUG 27, 2013 10:55 AM xxx *x END xxx *x ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 6:91 PROD NO VACUUM ALARM AUG 27. 2013 10:55 AM HIGH LIQUID ALARM AUG 27, 2013 10:55 AM VACUUM WARNING AUG 27. 2012 5:05 PM ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 1:87 TANK ANN HIGH LIQUID ALARM AUG 27. 2013 11:00'AM NO VACUUM ALARM AUG 27, 2013 10:58 AM NO VACUUM ALARM AUG 27. 2013 10:47 AM X x x* x END * x* x x ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 2:87 VENT HIGH LIQUID ALARM AUG 27, 2013 10:48 AM NO VACUUM ALARM AUG 27, 2013 10:47 AM COMMUNICATION ALARM AUG 27, 20I2 5:29 PM xxxx END 9xx *x ALARM HISTORY REPORT SMARTSENSOR ALARM -- s 3:87-91 VAPOR HIGH LIQUID ALARM AUG 27, 2013 10:49 AM NO VACUUM ALARM AUG 27, 2013 10:46 AM 7t ty MONITOR CERT. FAILURE REPORT SITE NAME: STOCKDALE FOODMART DATE: 8/27/13 ADDRESS: 5321 STOCKDALE HWY TECHNICIAN: RICHARD MASON CITY: BAKERSFIELD SIGNATURE: fz VN--- REPAIRS: 91 SPILL BUCKET FAILED LAKE TEST - O -RING WAS TORN. I REPLACED AND RE- TESTED - PASSED PARTS INSTALLED: I- PHIL -TITE SHUT -OFF COLLAR 0 -RING 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. BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request Phon6 No. (661) 326 -3979 UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANKlESTING- -_ - - =1 UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PIP- 01 ANY SYSTEM, ALL USTAND /ORAST'SYSTEMS SHALL BE IN,STAL-COMPLETE AND ACCEPTED BY MISC. ACTIVITY I sTHE BAKERSFIELD CITY PlRt DEPARTMENT. FIRE;DEPARTMENT- (FINAL)_ , "- REMARKS: BUILDING ADDRESS: —3 "d -e JOB DESCRIPTION: 6CCUPANCY TYPE: OWNER: S v L d d,v PERMIT NO. 13y CONTRACTOR: PHONE -# 2— FD 1743 UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION Please note that these are separate Individual tests and will be charged per separate type test accordingly.) PERMIT # ENHANCED LEAK DETECTION TANK TIGHTNESS Amrzz lRL ARrr r BAKERSFIELD FIRE DEPARTMENT Prevention Services Q10( l-k 5-mr- ET Bakerstield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 1 LINE TESTING SB-989 SECONDARY CONTAINMENT TUEL MONITORING CERTIFICATION SITE INFORMATION :. FACILITY AME 8 PH F CANT PERSON tan ADDRESS OWNER NAME OPERATOR NAME PERMIT TO OPERATE # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO TANK VOLUME CONTENTS l TANK TESTING;COINPANY.. TESTING COMPANY Tsi,F—s NAME a PHONE # OF CONTACT PERSON MAILING ADDRESS rjlay3 ook -S C.T. - F A K+F2SFIE.t -D C °13303 NAME & PHO OF TESTER R SPECIAL INSPECTOR CERTIFICATION # 0 eso DATE & TIME TEST TO BE CONDUCTE ^ IG ICC # TEST METHOD APPLICANT SIGNATU DATE IS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08) BILLING & PERMIT STATEMENT PERMIT NO.: B 13 R S F I D F/RB ARrr r BAKERSFIELD FIRE DEPT. Prevention Services 1600 Truxtun Ave Ste 401 Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax: (661) 852 -2171 FD 2021 (Rev. 06/07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) SITE INFORMATION LOCATION OF PROJECT PROPERTY OWNER STARTING DATE COMPLETIO LA NAM PROJECT NAME ADDRE PHONE NO. PROJECTADDRESS C STATE ZIP CODE INFORMATION CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE. EXPIRATION DATE J e30 PHONE NO. CONTRACTOR COMPANY NAME i= 'E. v FAX NA. 8O ADDRESS 5U L4 CITY WORK ZIPL.we All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING ON THAT PROJECT. • Alarms - New & Modifications - (Minimum Charge) $280.00 , • 98 Over 10,000 Sq. FL Sq. Ft. x.028 = Permit fee 84 98 11 Sprinklers - New & Modifications - (Minimum Charge) 280.00 84 98 Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee 98 Minor Sprinkler Modifications (< 10 heads) 96.00 [Inspection Only] 84 98 Commercial Hoods — New & Modifications 470.00 84 98 Additional Hoods 58.00 B4 98 1:1 Spray Booths - New & Modifications 470.00 84 98 Aboveground Storage Tanks (Installation/Insp. -1" Time) 180.00 82 Additional Tanks 96.00 82 Aboveground Storage Tanks (Removal/Inspection) 109.00 82 Underground Storage Tanks (InstallationAnspection) 878.00 (per tank) 82 Underground Storage Tanks (Modification) 878.00 (persite) 82 Underground Storage Tanks (Minor Modification) 167.00 82 Underground Storage Tanks (RemovA 573.00 (per tank) 84 Oilwell (Installation) 96.00 84 Mandated Leak Detection (Testing) / "uelMon Cert/SB989. Note. $96.00 foreach type oftest /per scheduled at the same time) fi8 66{persite f d g - S-113 82 Tents 96.00 (per tent) 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee /Inspeclion)=$576..00 84 After hours inspection fee 121.00 84 RE- INSPECTIONS) /FOLL OW -UP INSPECTION(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)